Atlas · Forearm

Anconeus

Localized posterior lateral elbow pain from anconeus trigger point near olecranon

Body region

Forearm

Trigger points

documented in this muscle

Common symptoms

patterns cataloged

Common causes

contributory factors

Illustrated overview

Anconeus · Anatomy 1. Anatomical view of the illustrated muscle. — **Anconeus · Anatomy 1**
Anatomical view of the illustrated muscle.
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Trigger points

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1. Anconeus

Location. Back of elbow, outer

Anconeus — Trigger point map — Trigger point map

Anconeus — Referred pain map — Referred pain map

Pain referral. Back of elbow, outer elbow

Pain Pattern

Back of elbow
Outer elbow
Posterior forearm

What This Pain Feels Like

A sharp, localized ache at the back and outer aspect of the elbow that feels like a deep bone bruise right near the point of the elbow. The pain is often mistaken for lateral epicondylitis (tennis elbow) but sits slightly more posterior and closer to the olecranon. Fully straightening the arm against resistance, doing push-ups, or leaning on the elbow reliably reproduces the discomfort. Patients often report a nagging stiffness that makes the last few degrees of elbow extension feel blocked or painful.

What Patients Report

Pain at back of elbow
Pain when extending arm
Elbow stiffness

What Makes It Worse

Elbow extension
Push-ups
Throwing

Browse related exercises (1)

Symptoms patients report

Elbow pain Localized posterior lateral elbow pain from anconeus trigger point near olecranon

Difficulty extending elbow Restricted terminal elbow extension from anconeus trigger point limiting full straightening

Posterior elbow discomfort Aching behind lateral epicondyle from anconeus trigger point referral pattern activation

Common causes

Repetitive elbow extension Sustained or repeated elbow straightening overloads small anconeus stabilizer muscle fibers

Push-ups Repeated elbow extension against body weight creates cumulative anconeus muscle microtrauma

Throwing Rapid elbow extension during throwing acceleration phase overloads anconeus deceleration control

Tennis Repetitive racket swinging with elbow extension overloads posterior compartment stabilizers

Treatment & self-care

Immediate Relief

Pincer pressure release on anconeus

With your affected arm relaxed and slightly bent, use the thumb and index finger of the opposite hand to locate the small triangular muscle just below and behind the lateral epicondyle (the bony bump on the outer elbow). Apply a firm pincer grip over the muscle belly and hold sustained pressure on any tender nodule for 20-30 seconds. You may feel referral pain toward the back of the elbow. Release slowly and repeat on additional tender spots.

Duration: 3-5 minutes per session
Frequency: 2-3 times daily
Expect: Goal: More comfortable elbow movement during light daily tasks

Immediate Relief

Ice massage over the olecranon region

Freeze water in a paper cup. Peel back the rim to expose the ice surface. With your elbow slightly bent, rub the ice in slow circular motions over the back and outer aspect of the elbow, covering the anconeus area. Keep the ice moving to avoid frostbite. The area will progress through cold, burning, aching, and then numbness.

Duration: 5-8 minutes per session (stop when area feels numb)
Frequency: After activities that aggravate the elbow, up to 3 times daily
Expect: Goal: More comfortable elbow movement during light daily tasks

Caution Do not apply ice directly to skin without movement; keep the ice moving in circles to prevent ice burn

Exercises

Eccentric elbow extension with light weight

Hold a very light dumbbell with the upper arm overhead only if the shoulder is comfortable. Use the opposite hand to help straighten the working elbow. Then, keeping the upper arm steady, slowly bend the elbow over 4-5 seconds to lower the weight behind the head. This lowering phase eccentrically loads the elbow extensors. Assist the return to the straight-elbow position and stop for sharp pain.

Duration: 3 sets of 10 repetitions
Frequency: Once daily, progressing to every other day as strength improves
Expect: Goal: Build elbow-extension strength and tolerance for pushing

Exercises

Forearm pronation and supination strengthening

Hold a hammer or weighted object by its handle with your elbow bent at 90 degrees and resting on a table. Slowly rotate your forearm so the weight tips inward (pronation), then slowly rotate outward (supination). The anconeus assists in stabilizing the elbow during these rotations, and controlled loading helps restore its function. Perform the movements slowly over 3-4 seconds each direction.

Duration: 2 sets of 15 repetitions in each direction
Frequency: Every other day
Expect: Goal: More controlled palm-up and palm-down movement under manageable resistance

Lifestyle Changes

Activity modification for elbow loading

Reduce or temporarily eliminate activities that require forceful or repetitive full elbow extension, such as push-ups, bench dips, or overhead pressing. When performing push-ups, stop 10-15 degrees short of full lockout to reduce anconeus strain. Avoid leaning on your elbows at desks or on armrests. When carrying objects, keep elbows slightly bent rather than locked straight.

Duration: Ongoing during acute phase (2-4 weeks)
Frequency: Daily awareness during all arm activities
Expect: Goal: Less provocative elbow loading while retaining comfortable activity

Professional Treatment

Professional evaluation for persistent posterior elbow pain

If posterior elbow pain persists beyond 4 weeks of self-care or is accompanied by clicking, locking, or swelling, consult an orthopedic specialist or sports medicine physician. They can perform specific tests to differentiate anconeus trigger points from olecranon bursitis, triceps tendinopathy, loose bodies, or posterior impingement syndrome. After assessment, discuss whether manual therapy or dry needling is a suitable adjunct to the rehabilitation plan.

Duration: Initial evaluation: 30-45 minutes
Frequency: Follow-up as recommended, typically 1-2 sessions per week for 3-4 weeks
Expect: Goal: Clarify muscle, tendon, joint or nerve contributions to elbow symptoms and tailor treatment

Caution Seek prompt evaluation if elbow locking, significant swelling, or inability to straighten the arm develops

Differential diagnosis

Triceps tendinitis
Elbow bursitis

Associated Trigger Points

Triceps brachii
Wrist extensors

Key Takeaways

Localized posterior lateral elbow pain from anconeus trigger point near olecranon
Restricted terminal elbow extension from anconeus trigger point limiting full straightening
Aching behind lateral epicondyle from anconeus trigger point referral pattern activation