Trigger Points and the Triceps Muscles

As a manual therapist and athletic trainer, I've spent countless hours treating clients with muscle pain and tightness, and I can say the triceps muscle is often an overlooked culprit when it comes to shoulder and arm discomfort.

When we think of muscle tightness, we might jump to the neck, shoulders, or back, but the triceps brachii—commonly just called the triceps—can develop painful trigger points that affect mobility and create referred pain patterns extending to the elbow, forearm, and sometimes even into the shoulder.

Understanding how trigger points develop in the triceps, recognizing their symptoms, and exploring effective ways to treat them can provide significant relief for those struggling with triceps-related pain. Let’s dive into the anatomy of the triceps, what trigger points are, how they develop specifically in this muscle, and the methods I’ve seen work best for alleviating this kind of pain.

Anatomy of the Triceps Muscle

The triceps muscle is a large muscle on the back of the upper arm, responsible for extending the elbow and stabilizing the shoulder. It consists of three heads: the long head, the lateral head, and the medial head. The long head originates from the scapula, while the lateral and medial heads originate from the humerus. The muscle’s primary function is elbow extension, which makes it crucial in many upper-body movements like pushing, pressing, and lifting. The triceps also play a role in shoulder stabilization, especially when the arm is extended overhead.

The long head of the triceps is unique because it crosses the shoulder joint, which means it assists in shoulder movements in addition to elbow extension. This dual role makes the triceps susceptible to overuse, especially in activities that involve repetitive overhead motions, such as throwing sports or weightlifting. With this repetitive use, the triceps can become tight and develop trigger points, particularly in people who regularly engage in heavy lifting or sports that require a strong push-and-pull movement. In my own practice, I often see athletes like swimmers, rowers, or weightlifters who struggle with triceps-related trigger points due to this frequent stress on the muscle.

What Are Trigger Points?

Trigger points, also known as “muscle knots,” are hyper-irritable spots within a muscle that are often tender to the touch. These areas of muscle tension can refer pain to other parts of the body, which means that even though the triceps may be the origin of the issue, the pain could be felt elsewhere, such as in the shoulder, elbow, or forearm. Trigger points are essentially small contractions in the muscle fibers that remain "stuck," causing blood flow restriction, limited oxygen, and the buildup of metabolic waste in that area.

This restriction can create a cycle of pain and tension. The muscle fibers become tighter, and without intervention, the trigger point can spread, affecting neighboring muscle groups and limiting overall mobility. Trigger points are most commonly developed due to stress, overuse, and improper posture, though acute trauma, such as a direct blow or strain to the muscle, can also lead to their formation.

How Trigger Points Develop in the Triceps

Trigger points in the triceps often stem from overuse or repetitive strain, especially in activities that demand prolonged or forceful elbow extension. People who frequently perform push-ups, bench presses, or overhead exercises without proper recovery can quickly develop trigger points in the triceps. In my experience, even seemingly everyday activities like pushing heavy doors, lifting heavy objects, or prolonged typing (where the arms are held in a fixed position) can lead to triceps tension if done repetitively over time.

The long head of the triceps is particularly vulnerable to trigger points because it crosses the shoulder joint. When this head develops a trigger point, the pain often refers to the back of the shoulder or down the arm, creating discomfort that’s easy to mistake for shoulder joint issues. I’ve often seen clients come in with what they believed was a shoulder problem, only to discover it was a triceps trigger point sending pain to the area.

Another factor in the development of triceps trigger points is poor posture, especially forward-head or rounded-shoulder postures. These postures place extra tension on the muscles that stabilize the shoulder, which can lead to compensatory strain on the triceps. The triceps may overwork in an attempt to maintain balance and support the shoulder joint, ultimately leading to the formation of trigger points.

Symptoms of Trigger Points in the Triceps

Recognizing the symptoms of triceps trigger points can be tricky, as the pain may not always be localized. Trigger points in the triceps can refer pain to various areas, causing:

• Pain at the back of the shoulder or upper arm
• Elbow pain, particularly around the olecranon (the bony part of the elbow)
• Pain extending down the forearm to the wrist in severe cases
• A sense of tightness or heaviness in the upper arm, especially during activities that involve pushing or extending the arm

In my practice, I’ve seen clients who thought they had tennis elbow, rotator cuff issues, or even nerve problems, only to discover that the pain stemmed from a trigger point in the triceps. When assessing triceps pain, it’s essential to palpate the muscle and apply pressure to identify the specific trigger points and referral patterns.

Effective Techniques for Treating Triceps Trigger Points

Trigger points in the triceps respond well to several treatment techniques, and I’ve found a multi-modal approach tends to yield the best results. Here are some of the most effective methods I use for treating triceps trigger points:

Manual Trigger Point Therapy

Manual trigger point therapy involves applying sustained pressure to the trigger point until the muscle fibers begin to release. This can be done using the thumb, fingers, or even a tool like a massage ball. In the triceps, it’s important to locate the specific head where the trigger point exists and apply steady pressure, holding it until the muscle begins to relax. This technique is particularly effective for relieving referred pain and can provide almost immediate relief in some cases.

Stretching and Range of Motion Exercises

Stretching is crucial for preventing and alleviating trigger points in the triceps. Simple triceps stretches, like overhead triceps extensions or arm-crossing stretches, help elongate the muscle fibers, increase blood flow, and reduce tension. After performing manual therapy, I always recommend gentle stretching exercises to lengthen the muscle and prevent the trigger point from reforming. Range of motion exercises can also help clients regain full functionality, especially if the muscle has become tight or limited due to prolonged tension.

Myofascial Release and Foam Rolling

Myofascial release, particularly through foam rolling, can help release tension along the entire length of the triceps. I often suggest using a foam roller or massage stick, applying pressure along the muscle while focusing on particularly tender areas. This approach can be helpful for individuals with multiple trigger points or generalized tightness in the triceps. For clients who want to perform self-care, I demonstrate proper foam rolling techniques to prevent unnecessary strain or injury.

Dry Needling

Dry needling is a technique I frequently use for clients with stubborn trigger points that don’t respond well to manual therapy alone. During dry needling, thin needles are inserted directly into the trigger point to help release the muscle fibers. This approach is especially effective for deep-seated trigger points in the triceps, and I’ve often seen clients experience a significant reduction in pain after just one or two sessions. However, dry needling should only be performed by trained professionals, as the technique requires knowledge of anatomy and precise needle placement.

Heat Therapy

Heat therapy can also be beneficial for triceps trigger points, especially if the muscle is very tight and sensitive. Applying heat increases blood flow to the area, which can help relax the muscle and reduce pain. I often recommend using a heating pad for 10-15 minutes before performing manual therapy or stretching, as the added warmth can make the treatment more effective. Clients often find that a warm shower or bath can also help relieve triceps tension.

Self-Care and Prevention Tips

Preventing trigger points in the triceps is as important as treating them, especially for individuals who regularly engage in activities that strain the arms. Here are a few strategies I recommend for both clients and athletes:

• Incorporate regular stretching into your routine, particularly after exercise or strenuous activities involving the upper body. Simple triceps stretches and shoulder stretches can help maintain flexibility and prevent trigger points from forming.
• Practice good posture. Avoid prolonged forward-head or rounded-shoulder postures, which place strain on the triceps. Maintaining a neutral spine and bringing awareness to your posture throughout the day can make a big difference in muscle health.
• Use proper form during exercise. In the gym, incorrect form during push-ups, bench presses, and triceps exercises can place unnecessary strain on the muscle. I often advise clients to work with a trainer or coach to ensure they’re lifting with the correct technique.
• Incorporate strength training. Strengthening the shoulder stabilizers and rotator cuff can help distribute the workload across the upper body, preventing the triceps from overcompensating and developing trigger points. Exercises like external rotations, face pulls, and scapular stability exercises are great additions to a well-rounded routine.
• Consider massage or trigger point tools. Many of my clients benefit from using massage tools like trigger point balls or foam rollers to perform self-massage on the triceps and surrounding muscles. These tools allow them to work on their own trigger points at home, especially if they can’t come in for regular treatments.

Final Thoughts on Triceps Trigger Points

Trigger points in the triceps might not be as well-known as those in the neck or back, but they can be equally disruptive and painful. Understanding how to identify, treat, and prevent these trigger points can offer significant relief for those dealing with chronic upper arm pain, shoulder tightness, or referred pain down the arm. Through my years as a manual therapist, I’ve seen how much of an impact these simple techniques can have, and I encourage anyone struggling with triceps pain to consider incorporating some of these strategies into their self-care routine.

If you’re dealing with persistent or severe pain, it’s always a good idea to consult a healthcare professional, as they can provide a more targeted treatment plan and ensure you’re addressing any underlying causes effectively. Trigger points don’t have to be a lifelong burden—understanding and treating them properly can restore mobility, reduce pain, and improve overall quality of life.

Disclaimer: This article is for informational purposes only and is not intended as medical advice. Always consult with a qualified healthcare provider for any health concerns, especially before beginning new treatments or therapies.

References

• Simons, D.G., Travell, J.G., & Simons, L.S. (1999). Myofascial Pain and Dysfunction: The Trigger Point Manual.
• Shah, J.P., & Gilliams, E.A. (2008). "Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: An application of muscle pain concepts to myofascial pain syndrome." Journal of Bodywork and Movement Therapies.
• Hanten, W.P., Olson, S.L., Butts, N.L., & Nowicki, A.L. (2000). "Effectiveness of a home program of ischemic pressure followed by sustained stretch for treatment of myofascial trigger points associated with neck pain: A case series." Journal of Manual & Manipulative Therapy.