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Treating Trigger Points in the Wrist Flexors - Dr. Jonathan Kuttner


Trigger Point Therapy - Where to Start?


Pitcher's Elbow is often mis-diagnosed

Pitcher’s Elbow (medial epicondylitis apophysitis) is a condition that causes pain and inflammation in the tendons that connect the elbow to the forearm.

It occurs around the bony bump on the inner side of the elbow. The pain may also be felt into the forearm and wrist.

This condition will usually develop as a result of overuse to the muscles in the forearm that enable the arm to rotate, flex the wrist, and grip with the hand.

By repeatedly effecting the same arm movement associated with pitching, considerable stress is placed on the related muscles, tendons, and joints. This over time can cause injury from tiny tears in the tendons.



What Are the Symptoms of Pitcher’s Elbow?

In most cases, the pain develops slowly and gradually over weeks and months in the elbow area. It is less common for the symptoms to occur suddenly.

The client may feel stiffness in their elbow and it may be painful for them to make a fist. Pain and tenderness will be felt on the inner side of the elbow and sometimes the forearm too.

Some experience numbness and tingling often into the 4th and 5th fingers, and some will report a noticeable weakness in their hand and wrist.

The pain can be anything from mild discomfort to severe, and it will often affect sleep. The pain will always increase when forcibly trying to stabilize or move the wrist.

Typically clients will report that the pain feels worse when:

• shaking hands
• using tools
• gripping objects e.g. cutlery, pen, computer mouse

• fully extending the arm
• turning a door knob
• lifting

Who Is Prone to Pitcher’s Elbow?

Pitcher’s Elbow affects around 1-3 percent of people. Sufferers tend to be between the ages of 35 and 50.

Older athletes tend to be more prone due to the continuous repetitive movements over time leading to wear and tear of the tendons. 

Less experienced athletes may also be more at risk due to poor technique causing increased strain on the tendons.

Basically anyone who participates in activities that require repetitive and vigorous use of the forearm muscle, especially while gripping something, are
more susceptible to this condition. This broadens its reach considerably!


Palmaris Longus - Self help can be very effective


Differential Diagnosis - What Else Could It Be?

Studies have shown that pain on the medial epicondyle (Pitcher’s Elbow) is about twice as common in men than women.

Here’s a list of other conditions which can mimic a Pitcher’s Elbow:

• Trauma (fracture)
• Problems with the radial head of the radius bone at the elbow joint
• Injury to the ulnar nerve (radial tunnel syndrome)
• Problems with the discs in the neck C6/7 neuropathy (cervical disc)
• Dysfunction to the triangular articular cartilage disc at the wrist
• Osteoarthritis of the inner side of the elbow joint
• Ulnar collateral ligament injury
• Cubital tunnel syndrome (ulnar nerve compression syndrome)
• Guvon’s canal syndrome (ulnar nerve compression syndrome)
• Golfer’s Elbow


Trigger Point Therapy

With Pitcher's elbow we are almost always looking to treat trigger points in the Triceps, Palmaris Longus, and the Flexor muscles.

There are a number of autonomously reproducible trigger point treatment techniques, all of which combine with self-help (stretching and strengthening) to offer effective relief and accelerate recovery times.  



Find a Trigger Point Professional in your area

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Dry Needling for Trigger Points

NAT Professional Courses

Certify as a Trigger Point Therapist

Trigger Point Workbooks 


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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell. 




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