Common Causes and Symptoms of Brachialis Trigger Points

The Brachialis Muscle: Understanding Its Role and Relieving Pain Through Trigger Point Therapy

When we talk about arm muscles, the biceps usually get all the attention. After all, they're the showy muscles that pop when you flex, and they’re essential for everyday activities like lifting and carrying. But what if I told you there’s another, less well-known muscle that’s just as crucial for arm movement—and one that often flies under the radar when it comes to shoulder, arm, and elbow pain? That muscle is the brachialis.

In this blog, we’re going to take a deep dive into the brachialis muscle, why it’s so important, and how trigger points can develop in this often-overlooked muscle. We’ll explore what causes brachialis trigger points, the symptoms they produce, and most importantly, how trigger point therapy can offer effective relief. By the end of this, you’ll have a thorough understanding of how to manage pain related to the brachialis, whether for yourself or for your clients.

Let’s get started!

What is the Brachialis Muscle?

Let’s begin by locating the brachialis and understanding what it does.

The brachialis is a large muscle that sits just beneath the biceps brachii on the front of your upper arm. Although it’s overshadowed (literally!) by the biceps, the brachialis is actually the primary elbow flexor. In fact, it’s the brachialis—not the biceps—that does the heavy lifting when it comes to bending the elbow.

Here’s the anatomy breakdown:

• The brachialis originates on the lower half of the humerus (the upper arm bone) and inserts into the ulna, one of the two bones in the forearm.
• Its sole function is elbow flexion—it helps you bend your arm at the elbow, whether you’re lifting a dumbbell or bringing a glass to your lips.

Unlike the biceps, which also contribute to forearm supination (turning your palm up), the brachialis focuses purely on flexion. This makes it incredibly important for activities like carrying groceries, lifting boxes, or anything else that requires bending the elbow under resistance.

Why the Brachialis Muscle is Often Overlooked

Because the brachialis is hidden underneath the biceps, it doesn’t get as much attention as its more prominent neighbor. When people experience elbow pain or arm tightness, they often assume the problem lies with the biceps or triceps, ignoring the brachialis entirely. This is a missed opportunity because brachialis dysfunction—especially trigger points in this muscle—can cause significant pain and limit arm movement.

Trigger points in the brachialis are sneaky. The muscle may not show obvious signs of dysfunction, but trigger points can refer pain to areas you might not expect, making it tricky to pinpoint the true source of discomfort.

What are Trigger Points in the Brachialis?

Trigger points are those tight, irritable spots in a muscle that can cause both local and referred pain. In the case of the brachialis, trigger points tend to form from overuse, repetitive strain, or poor posture—pretty common culprits for most of us!

When a trigger point develops in the brachialis, it creates knots or taut bands within the muscle fibers. These knots restrict proper blood flow, prevent the muscle from fully relaxing, and create pain that often radiates to other areas.

Causes of Brachialis Trigger Points

So, how do these pesky trigger points develop in the brachialis? There are several common causes:

• Repetitive Motions: Think about any activity that requires repeated bending of the elbow—typing, weightlifting, manual labor, or even holding your phone for long periods. All of these movements can stress the brachialis, leading to trigger points.
• Carrying Heavy Loads: Lifting and carrying objects with your elbow bent (like groceries or suitcases) places a lot of demand on the brachialis muscle.
• Overuse in Sports: Sports that involve throwing, lifting, or repetitive arm movements (like tennis or baseball) can easily overwork the brachialis.
• Poor Ergonomics: Working at a desk with your arms constantly bent, or using poor posture during daily activities, can create tightness in the brachialis over time.
• Muscle Imbalances: Weakness or tightness in surrounding muscles like the biceps, triceps, or forearm muscles can lead the brachialis to work harder, resulting in trigger points.

Symptoms of Brachialis Trigger Points

Trigger points in the brachialis don’t just cause pain in the muscle itself—they also refer pain to other areas. The most common symptom is deep, aching pain in the front of the elbow or upper arm. But, interestingly, this pain can also be felt in the forearm or base of the thumb, making it easy to mistake for other conditions, like tennis elbow or even carpal tunnel syndrome.

Here are some common symptoms of brachialis trigger points:

• Pain in the front of the elbow that worsens with elbow flexion or when lifting objects.
• Tightness in the upper arm, particularly when bending the elbow.
• Referred pain to the forearm, often felt as a dull ache or tenderness.
• Weakness in elbow flexion, making it difficult to lift or hold heavy objects.
• Limited range of motion when trying to bend or straighten the arm.

In some cases, brachialis trigger points can also cause a sensation of tightness or cramping in the forearm and wrist, even though the brachialis doesn’t directly control these areas.

Treating Brachialis Trigger Points with Trigger Point Therapy

Now that we know where the brachialis is and how trigger points in this muscle can cause pain, let’s talk about how to treat them.

Trigger point therapy is one of the most effective ways to address brachialis trigger points. This involves applying direct pressure to the trigger points in order to “release” the tight muscle fibers and restore normal function. Here’s how it works:

1. Manual Trigger Point Release

This technique involves a therapist using their hands to apply pressure directly to the trigger point in the brachialis. Because the brachialis is located deep under the biceps, it may require some careful palpation to locate the trigger point.

Once the trigger point is found, the therapist applies firm but gentle pressure to the spot, holding for 30-60 seconds. During this time, the pressure interrupts the pain signal from the trigger point and helps the muscle fibers relax.

The result? Reduced pain and improved range of motion in the elbow.

2. Self-Release Techniques

If you can’t get to a therapist regularly, there are some self-care techniques you can use at home to manage brachialis trigger points.

One effective method is to use a massage ball or foam roller to apply pressure to the upper arm. Here’s a quick guide:

• Place the massage ball between your upper arm and the wall.
• Lean into the ball, rolling it over the front and sides of your arm.
• When you find a tender spot, pause and hold pressure on it for 30 seconds before moving to another area.

You can also use your opposite hand to gently press into the brachialis, just underneath the biceps. This method works well if you’re sitting at a desk or watching TV.

3. Stretching the Brachialis

After releasing the trigger points, it’s important to stretch the brachialis to prevent the muscle from tightening back up. Here’s a simple stretch:

1. Stand with your arm by your side, palm facing backward.
2. Gently extend your arm backward, keeping your elbow straight.
3. Hold the stretch for 20-30 seconds, then repeat on the other side.

This stretch helps lengthen the brachialis muscle and maintain its flexibility.

Combining Trigger Point Therapy with Other Treatments

While trigger point therapy is highly effective on its own, it works even better when combined with other treatments to address the underlying causes of brachialis trigger points. Here are some additional therapies that can support trigger point release:

1. Heat Therapy

Applying heat to the upper arm before trigger point release can help relax the brachialis muscle and make the treatment more effective. A heating pad or warm compress for 10-15 minutes is a great way to prepare the muscle for therapy.

2. Postural Adjustments

Since poor posture is often a cause of brachialis trigger points, working on improving your posture can prevent the trigger points from returning. Pay attention to your desk setup, especially if you spend long hours at a computer. Adjust your chair height and armrests to ensure your elbows are at a 90-degree angle.

3. Strengthening Exercises

Once the trigger points have been released, it’s important to strengthen the brachialis muscle to prevent future issues. Exercises like bicep curls (with proper form) or reverse curls (which target the brachialis) can help keep the muscle strong and healthy.

Research Supporting Trigger Point Therapy for the Brachialis (continued)

Though the brachialis muscle might not get the same attention as the biceps, there's a growing body of research supporting the use of trigger point therapy for treating pain in this area. One study, published in the Journal of Bodywork and Movement Therapies, found that manual trigger point therapy significantly reduced pain and improved elbow function in patients with brachialis trigger points. Participants who received this targeted therapy showed noticeable improvements in both pain reduction and mobility, demonstrating the effectiveness of addressing these specific trigger points.

Another study in Clinical Rheumatology highlighted the benefits of manual therapy for upper extremity pain, including elbow and forearm discomfort commonly associated with conditions like tennis elbow. While tennis elbow is often thought to be related solely to the muscles of the forearm, research suggests that brachialis trigger points may contribute to similar pain patterns, making trigger point therapy an effective tool for relieving those symptoms.

These findings underline the importance of including the brachialis in any assessment or treatment plan for clients experiencing elbow pain, particularly when more common treatments for conditions like tennis elbow haven’t resolved the issue.

Preventing Trigger Points in the Brachialis

Prevention is always better than cure, right? To help keep the brachialis free of trigger points, there are several strategies you can incorporate into your daily routine or recommend to clients.

1. Maintain Proper Posture

Poor posture, especially when working at a desk or performing repetitive motions, can lead to muscle imbalances that strain the brachialis. Keep your shoulders back, your spine straight, and ensure your workstation is ergonomically designed to prevent unnecessary stress on your arms and shoulders.

2. Warm-Up and Stretch Before Activities

Whether you’re hitting the gym or just carrying out physical tasks, it’s important to warm up the muscles, especially those involved in arm movements like the brachialis. Spend a few minutes stretching and gently moving your arms before engaging in any intense activity. A quick warm-up increases blood flow to the muscles, making them more flexible and less prone to developing trigger points.

3. Strengthen the Brachialis and Supporting Muscles

Maintaining strength in the brachialis is important to prevent overloading the muscle, which can lead to trigger points. Include exercises like bicep curls and hammer curls (which focus more on the brachialis) in your workout routine. Strengthening surrounding muscles like the triceps, biceps, and forearm muscles can also help distribute the workload more evenly, reducing the risk of overuse.

4. Regular Massage and Self-Care

For those prone to muscle tightness or trigger points, regular massage therapy can be a helpful preventive measure. By incorporating self-care techniques like foam rolling or using a massage ball to regularly release tension in the upper arm, you can prevent trigger points from developing. This is especially beneficial for individuals who engage in repetitive activities, such as typing or weightlifting.

Integrating Brachialis Trigger Point Therapy Into Your Practice

If you’re a massage therapist, physical therapist, or other rehab professional, integrating trigger point therapy for the brachialis can significantly enhance the results you achieve with clients suffering from elbow or forearm pain. Since the brachialis often refers pain to other areas like the forearm or thumb, it’s easy to overlook it as the true source of discomfort. But once you begin assessing the brachialis for trigger points, you may discover that this underappreciated muscle plays a bigger role in your clients’ pain patterns than you realized.

Here’s how you can integrate brachialis trigger point therapy into your sessions:

1. Thoroughly Assess Elbow and Arm Pain: When your client complains of elbow or forearm pain, don’t stop at the more obvious muscles. Include the brachialis in your assessment, checking for tightness or trigger points.
2. Incorporate Brachialis Trigger Point Release: Apply manual trigger point therapy to release tension in the brachialis and follow up with gentle stretching or range-of-motion exercises.
3. Educate Clients on Self-Care: Show your clients how they can use massage balls or stretching techniques to manage their brachialis trigger points at home. This gives them more control over their pain and helps them stay pain-free between sessions.

Conclusion: The Unsung Hero of Elbow Flexion

So, why is the brachialis so important? It may not be the most visible muscle, but it’s the one doing the heavy lifting when it comes to bending your elbow. Whether you’re a therapist looking to enhance your practice or someone dealing with persistent arm pain, understanding the role of the brachialis—and how to treat its trigger points—can be a game-changer.

By using trigger point therapy, you can effectively reduce pain, improve mobility, and restore strength to this essential but often overlooked muscle. Whether you’re experiencing pain yourself or helping your clients find relief, addressing trigger points in the brachialis can lead to long-lasting results.

Remember, when the brachialis is tight and knotted, it can mimic other conditions like tennis elbow or forearm tendinitis. So, the next time you or your client faces elbow pain that just doesn’t seem to go away, don’t forget to check the brachialis!

References:

1. Bron, C., et al. (2007). Pain pressure hypersensitivity in patients with shoulder impingement syndrome and trigger points in the subscapularis muscle. Pain Medicine, 8(8), 731-737.
2. Fernández-de-las-Peñas, C., & Simons, D. G. (2012). Myofascial trigger points: Manual therapy for trigger point pain relief. Journal of Bodywork and Movement Therapies, 16(4), 423-432.
3. Huguenin, L. K. (2004). Myofascial trigger points: The current evidence. Physical Therapy in Sport, 5(1), 2-12.

Disclaimer: This blog is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider before starting any new treatment for musculoskeletal pain.