Pronator Teres: Pain & Trigger Points

The pronator teres is a small muscle at your forearm and can trigger wrist pain if it gets too tense or carries active trigger points.

On this page I will tell you all you need to know to work on this muscle and to eventually free it from excessive tension and trigger points, respectively.

You will learn about this muscles’ pain zones, attachment points, functions, trigger point activation, palpation and last but not least about its self-massage.

1.1 Pain Patterns & Symptoms

1.1 Pain patterns

If you overload your pronator teres, it develops excessive tension and will be eventually afflicted with trigger points.

It then can trigger pain in the ulnar region of your wrist and your whole volar forearm.

The red in the picture shows you how common it is to experience pain in the respective area.

The deeper the red, the more common the pain is if trigger points are active.

1.2 Impaired or painful movements

With excessive tension and/or trigger points in the pronator teres, you might have pain and difficulties when supinating your cupped hand in order to receive the change at a counter, for example.

This supination motion is the opposite of this muscles’ function.

Hence it gets elongated/stretched if a supination is performed.

This stretch can be very painful as it creates mechanical stress might be too much for the anyway tight muscle.

2. Attachment Points

This muscle possesses has two muscles heads.

The humeral head originates from the medial epicondyle of the humerus and the ulnar head from the coronoid process of the ulna. Together they insert at the mid of the radius.

The X in the picture below is a common area for trigger point development. The ulnar origin and the radial attachment point are not visible in the picture.

3. Function of the Pronator Teres

This muscle supports the pronation of the forearm – palms down position –  and thus helps its main pronator, the pronator quadratus.

It’s especially active if the pronation is fast or if there is external resistance added – e.g. using a screwdriver –.

Beside the pronation, it supports the flexion of your elbow if external resistance – e.g. carrying box of water – is present.

4. Pronator Teres: Trigger Point Activation

What creates excessive tension and what activates trigger points in the pronator teres?

It is mainly too much load/stress on the muscle.

Too much load can be placed voluntarily by repetitive use of the muscle or involuntarily by external forces.

An example for voluntary overuse: Loosening up screws with your right or tightening them up with your left hand is a common scenario that causes problems. Especially if it is your daily business or if you are not used to this kind of work.

Involuntary overload is mostly caused by a fracture at your elbow or wrist.

The pronator teres is affected as it connects your ulna and radius, the two bones of your forearm. The displacement and the mechanical forces during the accident display the overload.

The surrounding muscles in the affected/broken area tighten up in order to stabilize the damaged structure and to create a protective tone. Additionally, the stress that made the bone(s) break, can activate trigger points, too.

Self-massage can eliminate those points and lower excessive muscle tension.

It also helps to prevent these conditions, once they are gone.

I want to relieve my pain

5. Palpation of the Pronator Teres Muscle

The easiest way to palpate it, is by feeling it during contraction.

Place one or two fingers just above your medial epicondyle and start to pronate your forearm.

Every time your palm is facing downwards, you can feel a little muscle contracting. This is your pronator teres.

Well done so far! Now it’s time to proceed with your massage.

1

Forearm in the supinated position. Muscle is not contracted.

2

Forearm in the pronated position. Muscle is contracted.

6. Self-massage of the Pronator Teres Muscle

I recommend using the thumb technique or the press and move technique.

The first one is brilliant in order to get rid of trigger points, while the latter is great for relieving muscle tension in general.

  • With the thumb technique, just palpate the muscle and search for tender spots.
  • If you find one, stroke over it 10 – 15 times. Don’t rub around! Push in the muscle and only pull over the tender area.

The press and move massage implies that you press on the muscle and then move it.

  • Hence, pronate your forearm – palms down position –, place two or three fingers on the muscle and then slowly supinate and pronate your forearm for about 10 – 15 times.

References

  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1999. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print