commentary forearm extensor Health RSI trigger point therapy

Trigger Point Therapy Update

I thought I’d write a post as a follow up to my trigger point therapy post since its been a while since I updated you on my status.

Let me start off by saying that trigger point therapy has been a fantastic tool for finding muscle knots in my arms, relieving and deactivating those knots through massage, and generally helping me understand a large part of what is going on with my arms. In the process of the trigger point therapy, however, I experienced (and still have) some ulnar compression going on in the nerve of the right hand which manifests itself in numbness in the outside edge of the pinkie (I don’t know whether this is related to the therapy or not) and I have currently greatly reduced trigger point massage to focus on the ulnar issue.

Does this put me off trigger point therapy? No! On the contrary it is one of the best methods I have encountered in understanding my RSI condition (and other painful soft tissue conditions), and potentially fixing it long term.

I am a 15 year sufferer so my condition is most likely a bad case, but what I have found with trigger point therapy is that you can deactivate a lot of the larger trigger points (muscle knots). I have also noticed that I still have many sites of smaller, much deeper tissue that still generate a lot of referred pain. As these are deeper down in the forearm, they are harder to access, massage and deactivate. I am also amazed at how many trigger points that I have found in many areas of the forearms. It is apparent that computer use, repetitive injury and continual adjustments to try to ease the pain when using a computer can lead to muscle knots forming in all kinds of places in the forearm. It’s not much wonder that such conditions are hard to diagnose, treat and recover from.

So in summary, I have currently backed off from trigger point massage due to the ulnar nerve numbness, but I am still 100% bought into this therapy for helping RSI.

10 replies on “Trigger Point Therapy Update”

“I experienced (and still have) some ulnar compression going on in the nerve of the right hand which manifests itself in numbness in the outside edge of the pinkie (I don’t know whether this is related to the therapy or not)”

It’s quite common to have numbness when treating trigger points. Funnily enough, I’m dealing with some numbness in my thumb right now caused by a new;y emerged trigger points in my scalenes. Check out the following
The Trigger Point Therapy Workbook By Clair Davies, p111

I’ve been treating myself for about a month using the Trigger Point Workbook for arm/hand pain and weakness. I’m finding my symptoms to be greatly reduced. However, I am now experiencing numbness in my thumb and a bit up my wrist and arm. It is pretty clearly related to my treating the scalene muscles. I’m wondering what you’re doing to treat your nerve compression and if you’ve found some relief.

Hi Jason,
I still have numbness going on on the ulnar nerve down the pinkie (outside mainly) and occasionally to the next finger too haven’t found a method to relieve it.
I also can wake up at night with the pinkie completely numb. I do believe these symptoms came from an elbow RSI from kayaking, rather than trigger point therapy though, as I have other symptoms about the elbow (and lower tricep areas).
I didn’t try any heavy massaging of the scalenes since 1. they were hard to locate, and 2. they felt weird to massage!
Anyhow, hope your numbness goes away soon!

The numbness in the thumb is definitely related to the scalenes. I have experienced the same thing – when treating trigger points in the scalene muscles, it can affect the bundle of nerves coming out of the neck region and into the arms. Numbness in the thumbs is very typical and I had this for a couple of months. I’m now fully recovered from RSI. My advice is to keep treating the scalene trigger points – the numbness will eventually go

im a pro guitarist suffering from the same ailments you’ve described. ive been using trigger point therapy for over a year now and its is the ONLY method ive found to relieve and sort of forearm pain and hand pain. what you must realize is that every muscle is interconnected all the way from your finger tips to the muscle of your upper back, neck and chest, down to the muscle of your pelvis. I have found that regardless of the symptom in the hand wether its numbness or some sort of pain, ALL muscles from your core out must be released. this sometimes means very deep hard pressure to areas of your neck and shoulder girdle but it is the ONLY way to ever have a chance to regain 100% functionality of your arm and hand. You can literally massage you’re forearm for months (i did) and get ZERO relief unless the muscles closer to your core are released. They are choking the blood/nerve supply to your arm and if these muscles are not released the spasms or trigger points will never be able to let go of there contracted state. get a massage ball (i prefer a baseball) some sort of elevation off the wall, and lean all your body weight into these troubled areas. You need to push harder than you think. Get the muscles to MOVE under your skin, you’ll know if you did it right because you will feel better! im going back to school to be a doctor so i can help people with this problem because modern medicine FAILS MISERABLY in treating this condition. is a good source for info and they sell therapy kits ive bought them they help!

As a myofascial pain therapist I often encounter people with this entrapment like numbness on the pink-side. Most times they also have anterior shoulder pain. Try treating the infraspinatus muscle (shoulder blade), you’ll probably find that it is responsible for your symptoms.

I’ve also had numbness in the pinkie area (I also have rsi – 3 years and counting) and I went to a physio who told me it was the ulnar nerve being compressed/ stuck in its sheath. I had to do a series of upper body neural mobilisation techniques everyday (I still do – plus general pelvic and spine alignment exercises). This worked for me and the numbness went away. I also found out that the foot cramp i had also related back to nerves, which i’m still working on. I did this over 6 months and my neural stuff is improving, though I’ve realised that my overall rsi wasn’t. But just last week I realised I had more trigger points than I thought (had trigger point therapy last year so thought I had got rid of them) and so I’m starting to do the massage techniques again. Hopefully the combined effort will get rid of it once and for all. Can always contact me for the neural info sheets he gave me if you are curious.

Ulnar nerve entrapment does cause that numbness in the pinkie.

My RSI started with pain in the fingers like arthritis, than progressed to numbness in the pinkie and ring finger, and as i started to treat with TrP’s and perhaps my condition worsened i eventually got numbness in my thumb, pointer, and even middle fingers. Working in the brachial plexus can definitely upset nerves, but i think they need to be addressed so just proceed carefully.

Deactivating TrPs often triggers others, or perhaps they just become more apparent. You need to understand you’ll very possibly make it worse and find layers of pain – so proceed cautiously and intelligently. It needs to be done, but it can often be much more difficult than you first thought.

Anyway the Pinkie can be relieved by working on:
Your Serratus Posterior and Teres Minor/ Major (under your shoulder blade accessed only by moving your hands, and on the outer edge). Use a la crosse ball on a wall, or the floor. I advise the Trigger Point Therapy Workbook for details on how to find and release them, and also search youtube or google.
The Pec Minor and Scalenes as well. It took me many months to realize i was working the pec minor wrong, the location was broader than i first realized.
Your entire rotator cuff should be addressed as there are probably many issues going on in there. i noticed my subscap in particular was very distressed.

I have been having persistent numbness in both hand pinkies. I am a software engineer and use computer keyboard a lot. I suppose this has caused the numbness. I have been reading about trigger points but I do not know how to locate trigger points related to ulnar nerve and related numbness.

Can you please mention exactly where your trigger points located? I was unable to locate any solid information on the internet for ulnar nerve entrapment.


Trigger points for general hand pain RSI can be all over the forearm extensors, generally because of wrist lifting and fingers in claws which are the most common keyboard RSI pain. I have had occasional ulnar issues with numbness in the pinkies, but this I believe was due to me moving wrists out to the side perhaps to reach side/num pad/del keys etc on a keyboard. Try to minimise this movement, there are hand braces designed to do just that. As for trigger points, you are describing a nerve related issue rather than muscle related one, although I guess swollen or knotted muscles could lead to pinching of nerves from further up the arm. If it were me I would be looking at muscle of the tricep just above the tendon attach point to the outer elbow. See if there is any tightness sore points in the soft muscle around there. I’m not a doctor, so please don’t treat my advice as such and be careful with self diagnosis.

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