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Extensor carpi ulnaris lesions



  • Tendinopathy is thought to be an adaptive response of the tendon to repetitive stress and/or trauma and may progress through stages of increasing severity. It can be considered in 3 stages1
    • Reactive tendinopathy
      • Response to rapid increase in loading or from direct trauma
      • Leads to thickening of the tendon and increases stiffness
    • Tendon disrepair
      • A result of prolonged excessive loading
      • May lead to increase in vascularity and neuronal ingrowth
    • Degenerative tendinopathy
      • Chronic overloading leading to collagen tissue becoming disorganized which may lead to partial tears and ruptures (typically in elderly)
    • The mechanism of injury may vary between inflammation of the fluid-filled sheath surrounding the tendon (tenosynovitis), tendinopathy, tendon disruption and tendon instability2



  • Overuse as a result of repetitive loading of the muscle like that of sporting activity
    • Irritation caused by repetitive flexion and extension of the wrist, particularly in supination
  • Fall on the hand or lateral force applied to the wrist when the muscle is engaged in strong isometric contraction



  • Tenoperiost of the posterior aspect of lateral epicondyle of the humerus


Risk factors

  • If the patient is not prone to repetitive chronic overloading activities, inflammatory conditions such as rheumatoid arthritis can be considered



  • Resisted extension of the wrist with elbow extended – painful and weak
  • Resisted ulnar deviation – painful and weak
  • Palpation can be used to pinpoint the location of the lesion