Trigger Point Release - Supinator Muscle
Supinator Trigger Points - Dr. Jonathan Kuttner
Trigger Points in the Supinator Muscles are Too Often Overlooked As The Muscle Lies Deep and "Concealed" - They are Often Associated with Elbow Pain.
The supinator is associated with deceleration of the elbow during extension. When the forearm is held between supination and pronation, the supinator will decelerate elbow extension.
The supinator is a lateral elbow pain generator. The muscle sneaks pain down into the web of the thumb on the dorsal side.
Changes in sensations include, but are not limited to, numbness and weakness in the hand (which may be due to compression of the deep branch of the radial nerve—the posterior interosseous nerve) and in the fingers.
Part of the deep group. The supinator is almost entirely concealed by the superficial muscles.
Supinator - Common Trigger Point Site
ORIGIN
Lateral epicondyle of humerus. Radial collateral (lateral) ligament of elbow joint. Annular ligament of superior radioulnar joint. Supinator crest of ulna.
INSERTION
Dorsal and lateral surfaces of upper third of radius.
ACTION
Supinates forearm (for which it is probably the main prime mover, with biceps brachii being an auxiliary). Antagonists: pronator teres, pronator quadratus.
NERVE
Deep radial nerve, C5, 6, (7). BASIC FUNCTIONAL
MOVEMENT
Example: turning a door handle or screwdriver.
REFERRED PAIN PATTERNS
Localized 3–5 cm strong zone of pain at lateral epicondyle and at the web of the thumb (dorsum).
INDICATIONS
Tennis elbow, thumb joint pain, elbow pain (when carrying and at rest), pain turning doorknobs, localized pain on supination, chronic use of walking stick, pain on handshake.
CAUSES
Repetitive motions with straight arm (e.g. tennis, dog walking, carrying heavy case), repetitive motions (e.g. twisting, massaging, driving, ironing), trauma/strain, racquet sports.
DIFFERENTIAL DIAGNOSIS
De Quervain’s tenosynovitis. Lateral epicondylitis (tendo-osseous, musculotendinous, intramuscular). Radial head dysfunction.
CONNECTIONS
Common extensors, biceps brachii, triceps brachii (insertion), anconeus, brachialis, palmaris longus, brachioradialis, extensor carpi radialis longus.
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