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Myofascial pain patterns of the supinator muscle

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"Tennis Elbow" or "epicondylitis" as pain in the lateral epicondyle is often called, is frequently myofascial and due to trigger points (x's) in the supinator. Symptoms include elbow pain both with activity and at rest. Essential (solid red) and spillover (stippled red) referred pain from trigger points in the supinator project chiefly to the lateral epicondyle, frequently to the dorsal aspect of the web and base of the thumb, and sometimes to the forearm dorsally. Entrapment of the deep radial nerve within the belly of the supinator muscle may cause weakness with extension of the hand, fingers, and thumb, and sometimes dysesthesia of the wrist and distal forearm. (From Travell JG, Simon DG. Myofascial pain and dysfunction, supinator muscle, the trigger point manual. Volume 1. Baltimore: Williams & Wilkins, 1983:511, with permission.)