Top 10 Trigger Points for Tennis Elbow

Table of Contents

• Introduction
• Top 10 Trigger Points for Tennis Elbow
• 1. Extensor Carpi Radialis Brevis
• 2. Extensor Digitorum
• 3. Extensor Carpi Radialis Longus
• 4. Supinator
• 5. Brachioradialis
• 6. Triceps Brachii
• 7. Anconeus
• 8. Infraspinatus
• 9. Upper Trapezius
• 10. Scalene Muscles
• How to Treat Trigger Points for Tennis Elbow
• Conclusion

Introduction

Tennis elbow, also known as lateral epicondylitis, is one of the most common causes of outer elbow pain. Despite its name, it affects far more than just tennis players. Anyone who performs repetitive gripping, lifting, typing, hammering, or racquet sports can develop symptoms. While tendon irritation at the lateral epicondyle is often blamed for the pain, many cases of tennis elbow are significantly influenced by myofascial trigger points.

Trigger points are hyperirritable knots within muscles that can create local pain, referred pain, weakness, stiffness, and reduced performance. In fact, trigger points in the forearm, upper arm, shoulder, and neck can mimic or contribute to tennis elbow symptoms. Understanding and treating these trigger points can help reduce pain, restore function, and improve recovery.

The Top Ten Trigger Points Commonly Associated with Tennis Elbow (Lateral Epicondylitis)

1. Extensor Carpi Radialis Brevis (ECRB)

The Extensor Carpi Radialis Brevis is often considered the primary muscle involved in tennis elbow. This muscle helps stabilize the wrist during gripping activities and repetitive hand movements.

Trigger Point Symptoms:
- Pain directly over the outer elbow
- Increased discomfort when gripping objects
- Weak grip strength
- Pain when lifting objects with the palm facing downward

Because the ECRB tendon attaches near the lateral epicondyle, trigger points in this muscle frequently reproduce classic tennis elbow pain.

2. Extensor Digitorum

The Extensor Digitorum extends the fingers and assists with wrist extension. It is heavily used during racquet sports, typing, and manual labor.

Trigger Point Symptoms:
- Pain on the outer forearm
- Aching into the back of the hand
- Finger stiffness
- Reduced endurance during gripping tasks

Trigger points in this muscle often coexist with ECRB dysfunction.

3. Extensor Carpi Radialis Longus (ECRL)

The ECRL works closely with the ECRB to extend and stabilize the wrist.

Trigger Point Symptoms:
- Pain along the outer forearm
- Tenderness near the lateral epicondyle
- Weakness during lifting and carrying
- Discomfort when shaking hands

Overuse of this muscle is common in golfers, tennis players, mechanics, and office workers.

4. Supinator

The supinator muscle rotates the forearm into a palm-up position. It sits deep within the forearm and is often overlooked during treatment.

Trigger Point Symptoms:
- Deep aching around the elbow
- Pain during turning motions
- Difficulty opening jars
- Forearm fatigue

Trigger points in the supinator may also irritate the radial nerve, contributing to persistent elbow pain.

5. Brachioradialis

The brachioradialis assists with elbow flexion and is heavily recruited during lifting and carrying.

Trigger Point Symptoms:
- Pain along the thumb side of the forearm
- Tenderness near the elbow crease
- Weakness during carrying tasks
- Aching after repetitive lifting

Athletes and tradespeople commonly develop trigger points in this muscle.

6. Triceps Brachii

The triceps extends the elbow and helps transfer force through the upper extremity.

Trigger Point Symptoms:
- Pain around the elbow joint
- Aching in the back of the arm
- Reduced pushing strength
- Increased elbow stiffness

Trigger points in the lateral head of the triceps can refer pain toward the outer elbow, mimicking tennis elbow symptoms.

7. Anconeus

The anconeus is a small but important muscle located near the back of the elbow.

Trigger Point Symptoms:
- Localized pain at the elbow
- Pain when fully extending the arm
- Elbow stiffness
- Difficulty locking out the elbow

Although small, trigger points in the anconeus can create surprisingly intense elbow discomfort.

8. Infraspinatus

The infraspinatus is one of the rotator cuff muscles responsible for shoulder stability and external rotation.

Trigger Point Symptoms:
- Pain radiating down the arm
- Weakness during throwing activities
- Shoulder stiffness
- Referred pain toward the elbow

Many athletes with chronic tennis elbow also have underlying shoulder dysfunction involving the infraspinatus.

9. Upper Trapezius

The upper trapezius helps support the neck and shoulder girdle. Stress, poor posture, and repetitive computer work often contribute to trigger point formation.

Trigger Point Symptoms:
- Neck tension
- Shoulder tightness
- Referred pain into the arm
- Increased upper extremity fatigue

Trigger points in the upper trapezius can increase muscle tension throughout the arm, indirectly contributing to tennis elbow symptoms.

10. Scalene Muscles

The scalenes are neck muscles that assist with breathing and neck movement.

Trigger Point Symptoms:
- Pain radiating into the shoulder and arm
- Tingling sensations
- Arm heaviness
- Reduced grip strength

When the scalenes become tight, they can contribute to nerve irritation that mimics or worsens tennis elbow symptoms.

How to Treat Trigger Points for Tennis Elbow (Lateral Epicondylitis)

Successfully treating tennis elbow often requires more than just focusing on the elbow itself. Effective strategies include:

• Massage therapy (either self or with professional)
• Self-myofascial release using massage ball
• Trigger point therapy (either self or with professional)
• Acupuncture
• Sports massage
• Stretching of the forearm extensors
• Progressive strengthening exercises
• Dead hangs and grip training
• Improving shoulder and scapular stability
• Correcting posture and workstation ergonomics

Any one of the above treatments can be combined with our Battle Balm line of products to decrease pain, remove inflammation, and improve the chances of a successful outcome. Combining trigger point treatment with tendon-loading exercises often produces the best long-term results. Remember, movement is medicine. If you are not keeping the musculature around the elbow strong, you will have recurring elbow pain.

Conclusion

Tennis elbow is rarely just an elbow problem. Trigger points throughout the forearm, upper arm, shoulder, and neck can all contribute to pain, weakness, and reduced athletic performance. The Extensor Carpi Radialis Brevis, Extensor Digitorum, Extensor Carpi Radialis Longus, Supinator, Brachioradialis, Triceps, Anconeus, Infraspinatus, Upper Trapezius, and Scalene muscles are among the most common sources of referred pain associated with tennis elbow.

By identifying and treating these trigger points while addressing underlying strength, mobility, and movement deficits, individuals can often achieve faster pain relief and more complete recovery. For athletes and active individuals, taking a whole-arm approach rather than focusing solely on the elbow may be the key to overcoming stubborn tennis elbow and returning to peak performance.