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Upper Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo
The presence of extra tendons of extensor carpi radialis brevis should be checked when planning for tendon transfer surgery (Albright and Linburg 1978). Mitsuyasu et al. (2004) suggest that a variant origin of the extensor carpi radialis brevis may affect the severity of, or ability to develop, lateral epicondylitis (tennis elbow).
Radial nerve palsy following humeral shaft fracture: a theoretical PNF rehabilitation approach for tendon and nerve transfers
Published in Physiotherapy Theory and Practice, 2022
Lauren Fader, John Nyland, Hao Li, Brandon Pyle, Kei Yoshida
During Phase II, the individual performs high-frequency (hourly), low-intensity donor muscle group activation “fisting,” and low-intensity PNF isometric “position and hold” exercises. Long-term treatment effectiveness is directly related to the motor learning developed during this phase. Early use of high intensity manually resisted scapular PNF patterns at the ipsilateral and contralateral upper extremity may facilitate involved side proximal-to-distal overflow to the wrist and finger extensors, and thumb extensors-abductors. Manually resisted scapular PNF patterns may be safely applied with high intensity at both upper extremities as no direct load is applied to the healing humerus fracture site. Distally, at the involved upper extremity hand and wrist, a passive rhythmic initiation PNF technique can be used within specific ranges of motion in conjunction with verbal cues to open the hand, and extend the wrist, or close the hand, and flex the wrist following a quick stretch stimulus (Adler, Beckers, and Buck, 2008; Saliba, Johnson, and Wardlaw, 1993). Manually applied wrist, metacarpophalangeal, or interphalangeal joint approximation, or slight traction may improve joint stability or mobility, respectively. These techniques should improve extensor carpi radialis brevis generated wrist extension-abduction, extensor digitorum communis generated proximal and distal interphalangeal joint and wrist extension, extensor digiti minimi generated little finger metacarpophalangeal joint extension, and extensor carpi ulnaris generated wrist extension-adduction.
Prevalence of lateral epicondylosis in veteran manual wheelchair users participating in adaptive sports
Published in The Journal of Spinal Cord Medicine, 2022
Andrea K. Cyr, Berdale S. Colorado, Michael J. Uihlein, Kristin L. Garlanger, Sergey S. Tarima, Kenneth Lee
Lateral epicondylosis (LE) or “tennis elbow” is a degenerative process related to the repetitive wrist and arm motions.1,2 Prior studies estimate that the prevalence of LE in the general population is about 1.3%, but the prevalence of LE is in manual wheelchair users in generally unknown.3 Biomechanically, the extensor carpi radialis brevis tendon that inserts at the lateral epicondyle is under maximal force during forearm pronation, wrist flexion and ulnar deviation.2 Widely accepted physical exam maneuvers for LE include the Cozen’s test and Mill’s test.2 A previous study validated these tests with comparisons to ultrasonographic findings suggestive of LE, concluding that Cozen’s test was effective at ruling out LE (sensitivity 84%, specificity 0%) whereas Mill’s test was an appropriate maneuver to rule-in LE (sensitivity 53%, specificity 100%).2
Ultrasonographic comparison of the lateral epicondyle in wheelchair-user (and able-bodied) tennis players: A pilot study
Published in The Journal of Spinal Cord Medicine, 2021
Vivian Roy, Leah Lee, Michael Uihlein, Ishan Roy, Kenneth Lee
Although LE is a clinical diagnosis, ultrasound is being increasingly used as supportive evidence to confirm physical exam findings. Maffulli et al. performed ultrasound examinations on the elbows of 41 tennis players with a focus on evaluating key ultrasonographic characteristics, including enthesopathy of the proximal tendon, tendonitis of the extensor carpi radialis brevis (ECRB), peritendonitis of the tendon lining, bursitis of the inferior surface of the ECRB, and intramuscular hematoma within the muscle belly.7 A more recent study by Teggeler et al. focused on thickness measurements of the common lateral extensors of the elbow in able-bodied tennis players under ultrasound.8 The study found that LE can successfully be evaluated using musculoskeletal ultrasonography for diagnostic purposes, with a high inter- and intra-rater reliability.8 In a 2014 systematic review of the use of gray-scale ultrasound for diagnosing LE, Dones et al. found that the presence of hypoechogenicity as well as cortical bone changes at the lateral epicondyle were indicative of stress at the common extensor tendon.9 Given these studies, our project protocol has been designed in a similar fashion using ultrasonographic techniques. We hypothesized that rates of LE would be lowest in the able bodied non-tennis players and highest in the wheelchair tennis players.