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myofascialpain.com
Atlas · Upper Arm

Triceps Brachii

Posterior upper arm aching that worsens during pushing and elbow extension activities

Body region
Upper Arm
Trigger points
6
documented in this muscle
Common symptoms
25
patterns cataloged
Common causes
25
contributory factors

Trigger points

TrP 1

TrP1

Location. Back of upper arm

Pain referral. Back of arm, elbow, shoulder

  • Back of arm
  • Elbow
  • Shoulder
  • Upper back
  • Fourth and fifth fingers
TrP 2

TrP2 (Distal)

Location. Back of arm, near elbow

Pain referral. Back of elbow, posterior arm

  • Back of elbow
  • Posterior arm
  • Fourth and fifth fingers
TrP 3

TrP3 (Long Head)

Location. Posterior upper arm near shoulder, originating from infraglenoid tubercle of scapula

Pain referral. Back of upper arm near the shoulder

  • Posterior upper arm
  • Posterior shoulder
  • Medial epicondyle
  • Posterior forearm
  • Fourth and fifth fingers (occasionally)
TrP 4

TrP4

Location. Medial head of triceps near the elbow

Pain referral. Medial epicondyle and 4th-5th fingers

  • Medial epicondyle
  • Medial elbow
  • 4th and 5th fingers
  • Medial forearm
  • Olecranon area
TrP 5

TrP5

Location. Lateral head of triceps, mid-arm

Pain referral. Lateral elbow and posterior forearm

  • Lateral elbow
  • Posterior forearm
  • Lateral epicondyle area
  • Dorsal forearm near wrist
  • Posterolateral upper arm
TrP 6

TrP6

Location. Long head near axillary border, proximal attachment

Pain referral. Posterior shoulder and lateral 4th-5th fingers

  • Deep posterior shoulder
  • Axillary region
  • Medial upper arm
  • Lateral 4th and 5th fingers
  • Olecranon area

Symptoms patients report

Back arm pain. Posterior upper arm aching that worsens during pushing and elbow extension activities

Elbow pain. Posterior olecranon aching that intensifies with resisted elbow extension movements

Shoulder pain. Referred posterior shoulder ache from long head triceps trigger point activation

Weakness in pushing. Reduced push strength impairing push-ups, bench press, and overhead pressing activities

Finger symptoms. Ulnar finger paresthesia from distal triceps trigger point compression of ulnar nerve pathway

Back of arm pain near the shoulder. Posterior upper arm aching near the scapular origin of the triceps long head trigger points

Pain with overhead activities. Posterior shoulder pain during overhead movements as long head stabilizes the glenohumeral joint

Difficulty reaching behind the head. Restricted shoulder flexion with elbow flexion from shortened triceps long head taut bands

Elbow pain on the inner side. Referred medial epicondyle pain from triceps long head trigger points mimicking golfers elbow

Weakness in pushing movements. Reduced elbow extension force from long head trigger point inhibition during pushing tasks

Medial elbow pain. Medial triceps trigger point refers pain to medial epicondyle mimicking golfer elbow presentation

Ring and little finger numbness or aching. Referred pain to ulnar distribution from medial triceps through neural convergence pathways

Medial forearm pain. Pain descending along medial forearm from medial triceps trigger point referral pattern

Elbow stiffness. Taut medial triceps band restricts elbow flexion range creating extension bias stiffness

Golfer elbow-like symptoms. Medial epicondyle pain from triceps trigger point closely mimics medial epicondylitis presentation

Lateral elbow pain. Lateral triceps trigger point refers pain to lateral elbow mimicking lateral epicondylitis pattern

Posterior forearm ache. Referred pain descends along posterior forearm from lateral triceps trigger point activation

Weak elbow extension. Lateral head trigger point reduces triceps force output during elbow extension activities

Pain with pushing motions. Pushing demands triceps extension directly loading lateral head trigger point fibers

Difficulty fully extending elbow. Taut lateral triceps band creates restriction approaching terminal elbow extension range

Deep posterior shoulder ache. Long head triceps trigger point refers deep aching to posterior shoulder at infraglenoid origin

Tingling in ring and little fingers. Proximal triceps trigger point irritates ulnar nerve pathway causing distal finger paresthesia

Pain reaching overhead. Overhead reach lengthens long head triceps across trigger point creating shoulder and arm pain

Axillary tenderness. Trigger point proximity to axillary neurovascular bundle creates localized axillary region tenderness

Shoulder impingement-like symptoms. Long head dysfunction alters humeral head mechanics creating impingement-mimicking shoulder pain

Common causes

Push-ups. Repetitive concentric-eccentric elbow extension under body weight fatigues triceps muscle fibers

Bench press. Heavy resisted elbow extension during pressing overloads triceps beyond recovery capacity

Overhead throwing. Forceful elbow extension during throw acceleration phase strains triceps long head

Repetitive pushing. Sustained pushing activities create cumulative triceps microtrauma and trigger point formation

Sudden heavy lifting. Acute eccentric overload during unexpected heavy lift activates latent triceps trigger points

Push exercises. Repetitive pushing movements like bench press overload distal triceps near elbow insertion

Overhead activities. Sustained overhead arm positions require prolonged triceps contraction for elbow stabilization

Repetitive extension. Repeated elbow straightening activities cumulatively overload distal triceps muscle fibers

Tricep dips. Loaded shoulder extension with elbow extension maximally stresses triceps long head at its origin

Overhead pressing. Heavy overhead press demands sustained triceps long head activation for elbow lock-out phase

Throwing sports. Rapid elbow extension during throwing acceleration maximally activates the triceps long head

Gymnastics. Ring and bar support positions demand sustained isometric triceps contraction beyond normal endurance

Push-ups and bench press. Heavy pressing exercises demand maximal medial triceps force for elbow extension under load

Overhead triceps extensions. Isolated triceps exercises maximally load medial head fibers near elbow attachment

Leaning on elbow (student elbow). Direct olecranon compression during elbow leaning transmits pressure to medial triceps fibers

Repetitive pushing motions. Repeated elbow extension against resistance cyclically loads medial triceps creating trigger points

Hammering or pounding activities. Repetitive impact elbow extension during hammering overloads medial triceps at elbow region

Heavy bench press. Maximal pressing demands high lateral triceps force production creating overuse trigger points

Dips and push-ups. Bodyweight pressing exercises maximally load lateral triceps during extension phase

Repetitive pushing tasks. Repeated pushing motions cyclically load lateral triceps beyond recovery capacity

Prolonged desk work with arms extended. Sustained arm extension at desk maintains lateral triceps in contracted position

Swimming (especially freestyle). Freestyle recovery phase requires repeated long head triceps activation for arm elevation

Crutch use (axillary pressure). Crutch top compresses long head triceps near axillary border creating sustained ischemia

Sleeping with arm overhead. Sustained overhead arm position during sleep maintains long head in stretched position

Pull-ups and lat pulldowns. Pulling exercises require long head triceps co-contraction for shoulder joint stabilization

Treatment & self-care

immediate

Self-massage with tennis ball against a wall

Stand with your back to a wall and raise the affected arm overhead. Place a tennis ball between the wall and the back of your upper arm (triceps area). Lean into the ball with comfortable pressure and slowly roll it up and down the triceps by bending and straightening your knees. When you find a tender spot, hold sustained pressure for 20-30 seconds. Work from the back of the shoulder down to just above the elbow.

Duration
3-5 minutes per session
Frequency
1-2 times daily, especially after pushing activities
Expect
Reduced triceps tenderness and decreased posterior arm and elbow pain within a few days of consistent self-massage
immediate

Moist heat on the back of the upper arm

Apply a warm, damp towel or microwavable moist heat pack to the back of the upper arm, covering the entire triceps region from the shoulder to the elbow. Rest your arm in a comfortable position, slightly bent. The moist heat penetrates the muscle tissue to promote blood flow and relaxation. This is especially effective before stretching or self-massage.

Duration
15-20 minutes per application
Frequency
2-3 times daily, especially before stretching
Expect
Improved blood circulation and reduced muscle tightness in the triceps, enhancing the effectiveness of stretching and self-massage
exercise

Triceps overhead stretch

Raise the affected arm overhead and bend the elbow so your hand drops behind your head toward the opposite shoulder blade. Use your other hand to gently push the elbow further back until you feel a stretch along the back of the upper arm. Keep your head upright and avoid tilting it forward. Hold the stretch for 20-30 seconds, then release slowly.

Duration
20-30 seconds per repetition, 3 repetitions
Frequency
2-3 times daily, especially after pushing exercises or prolonged desk work
Expect
Improved triceps flexibility and reduced posterior arm stiffness within 1-2 weeks of consistent stretching
exercise

Eccentric triceps extension

Sit or stand with a light weight (2-5 pounds) held in the affected hand overhead with the arm straight. Slowly bend the elbow to lower the weight behind your head over a count of 5 seconds, controlling the descent. Use your other hand to help push the weight back to the starting position so the triceps only works during the lowering phase. This eccentric loading promotes healing of the trigger point.

Duration
10-12 repetitions, 2 sets
Frequency
Once daily, with a rest day if significant soreness develops
Expect
Strengthened triceps with reduced trigger point sensitivity over 3-4 weeks, leading to less pain during pushing and pressing activities
lifestyle

Avoid prolonged elbow flexion and optimize keyboard position

Avoid resting with your elbows bent in a tight position for extended periods, such as sleeping with arms folded or propping your chin on your hands. At your desk, position your keyboard and mouse so your elbows rest at approximately 90-100 degrees with forearms supported. Use a chair with armrests to reduce sustained triceps tension. When performing pushing exercises, ensure proper form and avoid locking the elbows forcefully at the end of each repetition.

Duration
Ongoing ergonomic adjustments
Frequency
Throughout each day and during all exercise sessions
Expect
Reduced chronic triceps strain and fewer trigger point flare-ups within 2-3 weeks as sustained stressors are minimized
professional

Professional referral for elbow pain radiating to the hand

If posterior arm or elbow pain persists for more than 3 weeks despite self-care, or if you notice tingling or numbness in the ring and little fingers, consult a physical therapist or orthopedic specialist. Describe the posterior arm pain and any radiating symptoms toward the hand. These symptoms may indicate ulnar nerve involvement at the elbow that requires specific evaluation and treatment beyond trigger point therapy alone.

Duration
Initial evaluation: 30-45 minutes
Frequency
Follow-ups as recommended, typically weekly for 4-6 sessions
Expect
Accurate diagnosis distinguishing triceps trigger points from ulnar nerve entrapment or triceps tendinopathy, with a targeted treatment plan that typically resolves symptoms within 4-8 sessions
immediate

Triceps pressure release near the elbow

Sit with the affected arm resting on a table. Using the thumb of your opposite hand, press into the back of the upper arm about two to three inches above the point of the elbow (olecranon). Search for the most tender spot in the distal triceps muscle belly. Apply sustained, firm pressure for 30-60 seconds while breathing slowly. You can also use a lacrosse ball against a wall: stand with your back to the wall, position the ball on the tender spot, and lean into it with controlled pressure.

Duration
3-5 minutes per session
Frequency
2-3 times per day
Expect
Gradual reduction in posterior elbow pain and improved pushing comfort within 1-2 weeks
immediate

Overhead triceps stretch

Raise the affected arm overhead and bend the elbow so your hand drops behind your head toward the opposite shoulder blade. Use your other hand to gently push the elbow further back and down until you feel a comfortable stretch along the back of your upper arm. Hold for 30 seconds without bouncing. Repeat 3 times. For a deeper stretch, hold a towel in the affected hand and grasp the other end with your opposite hand behind your lower back, gently pulling downward.

Duration
3-4 minutes per session
Frequency
3-4 times per day, especially before and after push-type exercises
Expect
Improved triceps flexibility and reduced posterior elbow stiffness within 5-7 days
exercise

Triceps and posterior chain wall push-up progression

Stand facing a wall at arm’s length. Place your hands on the wall at shoulder height with a narrow grip (hands about 6 inches apart) to emphasize the triceps. Slowly bend your elbows, bringing your chest toward the wall over 3 seconds, then push back over 2 seconds. Perform 12-15 repetitions for 3 sets. As this becomes easy, progress to a countertop, then an elevated surface, and eventually the floor. Keep elbows close to your body throughout.

Duration
5-7 minutes per session
Frequency
Every other day
Expect
Improved functional triceps strength and reduced pain during daily pushing activities within 3-4 weeks
lifestyle

Modify pushing activities and elbow loading

Identify and temporarily reduce activities that heavily load the triceps — bench press, overhead press, push-ups, dips, and pushing heavy objects. When these activities are necessary, warm up the triceps thoroughly first with light stretching and movement. Avoid locking the elbows forcefully at the end of pressing movements. At night, avoid sleeping with the elbow fully bent, which keeps the triceps in a shortened position. Use an elbow extension splint at night if needed.

Duration
Ongoing activity modification
Frequency
Continuous during aggravating activities
Expect
Decreased posterior elbow pain and reduced trigger point flare-ups within 2-3 weeks
professional

Professional evaluation for persistent posterior elbow pain

If posterior elbow pain does not respond to 3-4 weeks of self-care, consult a sports medicine physician or physical therapist. They can differentiate distal triceps trigger points from triceps tendinopathy, olecranon bursitis, posterior impingement syndrome, or ulnar nerve entrapment. Treatment may include dry needling of the distal triceps trigger points, instrument-assisted soft tissue mobilization, or ultrasound-guided evaluation.

Duration
Initial evaluation: 30-45 minutes
Frequency
Follow-ups every 2-4 weeks as needed
Expect
Professional trigger point treatment typically provides significant relief within 2-4 sessions
immediate

Overhead triceps stretch (arm behind head)

Raise the affected arm overhead, then bend the elbow so your hand drops behind your head toward the opposite shoulder blade. Use the opposite hand to gently pull the elbow further behind your head until you feel a stretch along the back of the upper arm. Keep your head upright and avoid arching your lower back. Hold the stretch steadily without bouncing.

Duration
30 seconds per stretch, 3 repetitions
Frequency
3-4 times per day
Expect
Improved overhead reach and reduced posterior arm tightness within 5-7 days
immediate

Foam roller on posterior upper arm

Lie on your side with a foam roller positioned under the back of your upper arm. Support your head with your lower hand. Roll slowly from just below the shoulder to just above the elbow, pausing on any tender spots for 20-30 seconds. Apply moderate pressure by adjusting how much body weight you transfer onto the roller. Breathe steadily and allow the muscle to relax into the pressure.

Duration
2-3 minutes per arm
Frequency
1-2 times per day
Expect
Decreased taut band tenderness and improved tissue mobility within 1-2 weeks
exercise

Controlled triceps dips or push-ups

Begin with wall push-ups or chair-assisted dips at a comfortable depth. Lower your body slowly over 3-4 seconds, then push up over 2 seconds. Start with 2 sets of 8-10 repetitions. Gradually increase depth and difficulty as pain allows. The goal is controlled eccentric loading of the triceps long head to promote healing.

Duration
5-10 minutes per session
Frequency
Every other day
Expect
Increased triceps strength and reduced trigger point sensitivity within 3-4 weeks
exercise

Triceps extension with resistance band

Anchor a resistance band overhead (on a door frame hook or pull-up bar). Face away from the anchor, grip the band with the affected hand behind your head, elbow bent. Slowly straighten your arm forward and down until fully extended, then return slowly to the starting position. Perform 12-15 repetitions for 2-3 sets. Choose a band tension that allows completion with only mild effort at the end.

Duration
5-8 minutes per session
Frequency
3 times per week
Expect
Improved triceps endurance and reduced pain during pushing tasks within 3-4 weeks
lifestyle

Avoid prolonged overhead arm positions

Identify tasks that keep your arms overhead for extended periods — painting ceilings, overhead shelving, sleeping with arms above the head. Break these tasks into shorter intervals with rest periods every 10-15 minutes. When sleeping, keep arms below shoulder level using a body pillow or adjusting sleep position. Use a step stool to bring overhead tasks to a more neutral arm height.

Duration
Ongoing modification
Frequency
Continuous during aggravating activities
Expect
Reduced posterior arm pain and fewer flare-ups within 2-3 weeks of consistent habit changes
professional

Professional evaluation for persistent posterior arm pain

If symptoms persist beyond 4 weeks of self-care, consult a physical therapist or sports medicine physician. They can rule out radial nerve entrapment, cervical radiculopathy (C7), or triceps tendinopathy, and provide targeted treatments such as dry needling, instrument-assisted soft tissue mobilization, or a structured rehabilitation program.

Duration
Initial evaluation: 45-60 minutes
Frequency
Follow-ups every 2-4 weeks as needed
Expect
Accurate diagnosis and professional treatment typically yields significant improvement within 3-6 sessions
Key Takeaways
  1. Posterior upper arm aching that worsens during pushing and elbow extension activities
  2. Posterior olecranon aching that intensifies with resisted elbow extension movements
  3. Referred posterior shoulder ache from long head triceps trigger point activation
  4. Reduced push strength impairing push-ups, bench press, and overhead pressing activities
  5. Ulnar finger paresthesia from distal triceps trigger point compression of ulnar nerve pathway