Supinator: Pain & Trigger Points

On this page I will guide you through the insertions, functions, pain zones, overload movements, impaired movements, palpation and massage of this muscle.

In a nutshell: All the information you need to understand why this muscle might be troubling you and how to deal with it.

1. Pain Patterns & Symptoms of the Supinator Muscle

1.1 Pain patterns

If this muscle contains trigger points or is too tight, it gets tender and can trigger pain at the lateral epicondyle of your humerus – outer side of your elbow joint – which is often diagnosed as tennis elbow pain.

Furthermore, it might leave you with pain at the backside of your hand – area between thumb and index finger –.


1.2 Impaired or painful movements

If this muscle is excessively tight and/or contains trigger points, you might feel pain when using the muscle and even afterwards at rest.

Thus, all the movements that occur with the activities displayed above may be painful and/or impaired.

2. Attachment Points

The supinator muscle has attachment points at the lateral epicondyle of the humerus, at the ventral and lateral ligaments that connect the ulna and the radius and the ventral part of the capsule of the humeroulnar joint.

It wraps around the radius and inserts at the ulna.

The X in the picture displays the area where trigger points commonly develop in this muscle.

3. Function of the Supinator Muscle

As the name already suggests, this muscle supinates the forearm, which means it turns it in a way that the thumb is facing outwards.

If there is no external resistance and/or the elbow is straight, it is the main supinator of your forearm.

As soon as the elbow gets flexed and if any external resistance is added, the biceps brachii will support supination of the forearm – this is only the case if the elbow is at least slightly bent –.

Furthermore, this muscle supports elbow flexion.


Supination at the forearm


Flexion at the elbow with forearms in a "half supinated" position.


Flexion at the elbow with forearms in a pronated position.

Maximal activation of this muscles occurs with …

  • resisted supination of the forearm while the elbow is straight or…
  • during flexion of the elbow while the forearm is pronated.

In both cases, the reason for the strong involvement of this muscle is that the biceps brachii cannot support the movements as it can only supinate the forearm if the elbow is at least slightly bent, and flex the elbow if the forearm is supinated.

4. Trigger Point Activation of the Supinator Muscle

This muscle can get overloaded if activated maximally or in a repetitive manner. As a result, trigger points and pain can develop.

Maximal activation occurs, as already stated, if the elbow gets flexed while the forearm is pronated, or the forearm gets forcefully supinated while the elbow is straightened.

Among others, examples for those movements are:

  • You resist a dogs’ hard pull on a leash
  • Hard screw driving
  • Pronated barbell curls for forearm training
  • Carrying items with a pronated forearm (and bent elbow)

For prevention, it is advisable to supinate and bend your elbow while carrying objects.

Surely, if this is not suitable, it also helps to switch your working hand every now and then.

5. Supinator: Palpation

Feeling this muscle is a little tricky as it lies deep in the forearm and is covered by the brachioradialis muscle. Still, it is possible.

Still, it is possible.

  • Sit down on a chair and slightly flex your elbow.
  • Make sure it is supported in order to keep your elbow flexors “relaxed”.
  • Push with your fingers the brachioradialis to the side, and aim to the outer side of your forearm.
  • If you push too far to the inner side of your cubital fossa, you will hit a nerve. So, stop your palpation if you feel any burning sensation while palpating this area and get back on track.
  • Now start to supinate and pronate your hand in a repetitive manner.
  • Feel the little muscle that is contracting with every supination. That is your supinator.

Note: You might have to readjust your fingers slightly while doing the pronation/supination movement.

It is normal to “feel around” for some time when searching for a muscle, especially when you are new to this.

You might need to practice a little bit until you find this muscle, but with some patience it will happen.

6. Self-massage of the Supinator Muscle

For massage I recommend using your fingertips or a massage ball.

6.1 Massage with your fingers

  • Just place the fingers on the muscle like you just did and search for tender spots.
  • As soon as you find one, apply pressure with your fingers and execute very short and slow massage strokes.
  • 10 – 15 strokes per massage session are more than enough.
  • Alternatively, you might just palpate the muscle, then pressurize it with your fingers and making it move 10 – 15 times by just pronating and supinating your forearm in an alternating manner.

6.1 Massage with a massage ball

Another possibility is to massage the supinator with a ball.

  • As it is lies deep to the brachioradialis, it will be important to use a hard ball in order to really “get on to” it.
  • A hard ball is the massager to go.
  • Of course, the massage with a ball will lead to a simultaneous massage of the brachioradialis.
  • However, this is nothing to bother about as it won’t do you any harm.


  • 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. The Lower Extremities. Baltimore, MD: Williams & Wilkins, 1993. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print