Triceps Brachii

Clinical Notes

• The radial nerve (C6–C8) passes through the radial groove on the posterior humerus between the lateral and medial heads of triceps. A mid-shaft humeral fracture can damage the radial nerve here, producing wrist drop (inability to extend the wrist and fingers) with preserved shoulder and elbow extension (the branches to triceps leave proximally). This is the classic "Saturday night palsy" location.

• Triceps tendinopathy — overuse from repetitive elbow extension (bench press, push-ups, throwing). Pain at the olecranon insertion that worsens with resisted extension.
• Olecranon bursitis — the olecranon bursa overlies the triceps insertion and can become inflamed from direct trauma (falling on the elbow) or repetitive friction. Presents as a visible fluid-filled swelling over the olecranon — do not compress it.
• Contributes to conditions/lateral-epicondylitis mimicry through lateral head TrP referral.
• The long head crosses the shoulder joint and can contribute to posterior shoulder tightness in conditions/adhesive-capsulitis — restricted shoulder flexion and internal rotation may involve long head shortening.

• In clients who do repetitive pushing (construction, weight training, desk work with keyboard pushing-away patterns), the triceps is often hypertonic with taut bands palpable in all three heads. The lateral head is the most commonly affected.
• In overhead athletes (throwing, swimming), the long head is often tender at its scapular attachment because it works eccentrically during the deceleration phase of throwing.
• TrPs in the medial head are frequently missed because the head is deep — the referred pain to the medial epicondyle and 4th/5th digits gets attributed to ulnar nerve involvement instead.

• Responds well to longitudinal stripping along each head individually. The lateral head is accessible with the client prone; the long head is accessed by rolling medially past the lateral head.
• TrP compression in the long head produces a deep ache that may refer distally toward the elbow. Hold until referral diminishes (30–90 seconds).
• Post-treatment, elbow flexion ROM typically improves immediately — useful for reassessment.

• The radial nerve passes through the radial groove between the lateral and medial heads on the posterior humerus. Avoid sustained deep pressure over the mid-posterior humerus where the nerve is superficial against bone. If the client reports tingling or numbness in the hand during posterior arm work, you are likely compressing the radial nerve — reposition immediately.
• The ulnar nerve passes posterior to the medial epicondyle in the cubital tunnel — when working the distal medial head near the medial epicondyle, avoid the groove posterior to the epicondyle.

• When a client presents with lateral elbow pain and the wrist extensor provocation tests are equivocal (mildly positive but not convincingly so), always palpate the lateral head of triceps. The lateral head TrP refers directly to the lateral epicondyle and is one of the most commonly overlooked contributors to lateral elbow pain. Treating the lateral head TrP alongside the wrist extensors often resolves cases that were not responding to extensor treatment alone.