Supinator

The Supinator is a deep muscle of the posterior forearm.

Anatomical Attachments:

• Origin: Attaches to the lateral epicondyle of the humerus and the proximal end of the radius.
• Insertion: Attaches to the anterior and posterior oblique lines of the proximal radius.

Action: Supinates the forearm.

Synergist: Brachioradialis, Extensor Carpi radialis brevis and longus, Abductor pollicis longus, Extensor pollicis brevis and longus, Extensor digitorum, Extensor digiti minimi, Extensor carpi ulnaris, Extensor indicis.

Antagonist: Pronator teres, Flexor carpi radialis, Palmaris longus, Flexor carpi ulnaris, Flexor digitorum superficialis, Flexor digitorum profundus, Flexor pollicis longus, Pronator quadratus.

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Nerve Supply: Radial Nerve (C6).

Nerve Entrapment: Entraps the deep radial nerve.

Vascular supply: Radial recurrent and the post interosseus of the ulnar artery.

• Primary: The pain refers to the superior inferior lateral aspect of the elbow, and to the dorsum of the thumb.
• Satellite or associated triggers: Triceps brachii, Extensor Carpi radialis longus and brevis, Brachioradialis, Brachialis, Biceps Brachii, and occasionally the Palmaris longus.

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Trigger Point Signs and Symptoms: Aching pain in the elbow or thumb.

Trigger Point Activating and Perpetuating Factors: Carrying a baby carrier, repetitive curls, using a swing blade or sickle, hoeing a garden.

Differential Diagnosis: Tennis elbow, Lateral Epicondylitis, entrapment of posterior interosseus nerve, (Segmental, Subluxation, Somatic dysfunction) C5 or C6 radiculopathy, DE Quervain’s stenosing tenosynovitis, Arthritis, Bone cancer, fracture, Bursitis, Dislocation/Subluxation, osteoarthritis, Rheumatoid Arthritis, Sprain/strain, Tendinitis, Tension Myalgia, Dupuytren’s contracture, Frostbite, Paronychia (Ingrown thumbnail), Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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