Patients with wrist pain secondary to overuse are commonly seen in Sports Medicine clinics.
Patients with wrist pain secondary to overuse are commonly seen in Sports Medicine clinics. Tendinopathy of the wrist is characterized by disorganization of the collagen bundles of a tendon, neovascularization, and hypercellularity. The process of developing symptoms secondary to tendinopathy is typically described as a “tendinopathic iceberg”.
The graph shown below show that patients will be developing the tendon disorganization over time until they finally perceive symptoms. Tendinopathic iceberg image Historically, the symptoms associated with tendinopathy are typically associated with a change in training regimen. An increase in intensity or an increase in frequency can precipitate symptoms.
Principle of transitions in developing tendinopathy. This review will focus on the diagnosis and treatment of extensor carpi ulnar (ECU) tendinopathy . The ECU tendon is a common source of ulnar-sided wrist pain.
The tendon is found in the sixth dorsal extensor compartment and will insert on the fifth metatarsal base. The tendon will be under the most strain during supination of the forearm during tennis with the two-handed backstroke. The pathology of the ECU tendon is secondary to tenosynovitis, degeneration of the tendon, and partial tearing (4,5).
The physical exam of the wrist begins with inspection. After inspecting for any area of erythema, atrophy, skin lesion, or anatomical abnormality, the provider moves on to palpation. Pain to the ECU tendon is typically found at the distal and volar ulna styloid.
If you are experiencing symptoms that may be related to extensor carpi ulnaris tendinopathy, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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