• James Park, PT, DPT

Extensor Carpi Ulnaris (ECU) Injury

Updated: May 4

The extensor carpi ulnar (ECU) muscle plays a key role not only in the active movements of wrist extension and ulnar deviation but also in providing stability to the ulnar side of the wrist. The ECU tendon relies on specific stabilizing structures to hold it in the correct positions to perform its different functions. These structures can be injured in a variety of different athletic activities such as tennis, golf, rugby and weightlifting. Injuries to the ECU can range from tenosynovitis, tendinopathy, and instability (an injury that I suffered a few weeks ago after shanking a return of serve).

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Things to Pay Attention To:

1. Visible ECU tendon subluxation commonly occurs through active supination with the affected wrist held tightly in maximal flexion and ulnar deviation.

2. Pain on palpation of the ECU tendon where it passes into the ulnar groov

3. Pain during resisted active wrist extension with ulnar deviation.

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Recommendations:

1. Get checked out by a physical therapist or orthopedist that specializes in wrist injuries, figure out what’s going on, and get a clear game plan on how to get back to playing.

2. Early diagnosis of an acute traumatic unstable ECU tendon may be managed by reduction of the subluxed tendon and immobilization for a period of up to 6 weeks. Reduction is achieved by positioning the wrist in radial deviation and the forearm in pronation.

3. Localized eccentric work incorporated into overall strengthening program.





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