Tennis Elbow, Extensor Carpi Radialis Brevis, Everything You Need To Know - Dr. Nabil Ebraheim
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- Опубліковано 2 лис 2017
- Dr. Ebraheim’s educational animated video describes Extensor Carpi Radialis Brevis muscle ECRB - tennis elbow.
The muscle that is involved in the condition of tennis elbow is the extensor carpi radialis brevis muscle. The name of this muscle suggests it is small, however it is an important muscle that is involved in multiple unique conditions.
The ECRB muscle originates from the lateral epicondyle of the humerus (common extensor tendon). The ECRB muscle is inserted into the base of the dorsal aspect of the 3rd metacarpal. The ECRL muscle is inserted into the base of the 2nd metacarpal bone.
The ECRB muscle gets its nerve supply from the radial nerve.
The function of the ECRB is to extend and abduct the hand at the wrist joint.
The ECRB is located in the 2nd dorsal compartment on the radial side of the lister’s tubercle.
There are several conditions that are associated with ECRB muscle.
1-Tennis elbow (lateral epicondylitis)
It is an overuse injury that causes inflammation, tendinosis and lateral elbow pain at the origin of the ECRB tendon. Tennis elbow affects about 50% of all tennis players. It is the most common cause of elbow symptoms in patients that complain of elbow pain.
Tennis elbow involves the ECRB tendon origin. The pathology of the ECRB tendon in tennis elbow shows disorganized collagen, vascular hyperplasia and fibroblast hypertrophy. The condition usually starts by micro-tears of the origin of the ECRB which is precipitated and aggravated by repetitive wrist extension and forearm pronation.
About 5% of patients may have associated radial tunnel syndrome. In tennis elbow, the patient will complain of point tenderness around the lateral epicondyle. In radial tunnel syndrome, the point of tenderness will be about 3-4 cm distal and anterior to the lateral epicondyle. This should be in the differential diagnosis of tennis elbow.
Treatment of tennis elbow
•Activity modififcatin
•Anti-inflamatory medications
•Physical therapy especially eccentric exercise.
•Injection: steroid injection or may use PRP. Ultrasound guidance may be helpful.
•Surgery is the last resort. Release and debridement of the ECRB origin.
2-Intersection syndrome
Inflammation at the crossing of the first dorsal compartment and the second dorsal compartment that contains the ECRB. It occurs due to repetitive wrist extension. The tenderness is on the dorsoradial aspect of the forearm approximately 5 cm proximal to the wrist joint. This is the area of inflammation of the ECRL/ECRB as they intersect with APL and the EPB.
Treatment
•Rest
•Splinting
•Steroid injection
•Rarely surgery
3-The ECRB muscle is important in dorsal approach to the radius. The Thompson dorsal approach to the proximal radius may be used for exposure of the posterior aspect of the radial shaft. The incision is made in between the two muscles of the ECRB and the extensor digitorum.
4-In tennis elbow surgery, excessive release of the ECRB tendon (origin) during tennis elbow surgery can cause injury to the ulnar humeral ligament and cause posterolateral elbow instability. Note the proximity of the origin of the ECRB tendon to the ulnar humeral collateral ligament. The ligament is close to the tendon and can be injured due to excessive release of the origin of the ECRB tendon.
5-Tendon transfer in high radial nerve palsy. In high radial nerve palsy, injury to the radial nerve results in wrist drop due to paralysis of the wrist extensors. The pronator teres transfer to the ECRB is a very popular tendon transfer in high radial nerve palsy used to restore wrist extension.
High radila nerve palsy - pronator teres transfer to the ECRB to restore wrist extension.
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After many years of shoulder problems I find Mr Ebraheims channel very helpful with understanding my present problem and I am sure other listening to him will agree that he is an excellent lecturer.
Thank you Dr.Ebraheim sharing your knowledge.
Nice video content! Forgive me for butting in, I would love your thoughts. Have you heard about - Parlandealey Flexible Elbow Process (just google it)? It is an awesome one of a kind product for learning how to cure tennis elbow without the headache. Ive heard some unbelievable things about it and my mate got excellent results with it.
hi everyone ,if anyone else needs to find out about how do you cure tennis elbow try Freds Elbow Helper ( search on google ) ? Ive heard some incredible things about it and my buddy got cool results with it.
Thank you so much. This is so helpful
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Doctor can you make a video on triangular fibrocartlige complex in sports injury and how to take care of it. مشكووور
I have been using a tens machine to relieve the pain of my tennis elbow...been getting better after 2 years
Masha ALLAH.. Good explanation.. Jazak Allah
thank you ...
That's very informative and simple to study from , thank you so much 5/8/2018 😊
Also do not forget your Occupational Therapists who are paramount in helping you with your tennis elbow symptoms with activity modification, splinting of the wrist in neutral, and ergonomic instruction as most of these types of injuries are repetitive in nature from work-related strains or can be acute. In the 25+ years I've been treating tennis elbow, I've only seen a very small percent of actual tennis players. Most of my patients have been plumbers, roofers, carpenters and a majority of "weekend warriors" who injure themselves with forceful repetitive motions of wrist in extension, like pulling off carpet or tile. A counter-force brace at the elbow really helps to dampen the rotational forces with sup/pronation. I've suffered this condition myself and it usually heals, but takes a lot of time and patience.
It is very helpful, thank you very much !
Thank you a lot
that was awesome!
Good, thanks
Thanks
There is one mistake in the video. It's said that near the attachment of ECRB presents Ulnar Humeral Collateral Ligament (UHCL). but according to the Netter's atlas, this ligament is called Radial collateral ligament. And Ulnar collateral ligaments is on the medial aspect of the elbow.
Thank you.
Yep, good pick-up of the radial/ulnar transposition terminology: It is the Radial Collateral Lig.
I’m not a tennis player i am a strongman competitor and I need this muscle healed soon!
Your wife's boyfriend told me you have problem with your elbow.
Hope you getting well soon...
Well done explanation (11-18-21)
Godd infomation
archers get tennis elbow frequently. The archers must hold up the weight of the bow and push against the draw weight with the fore arm . In a lot of females the elbow joint protrudes and the string when released will hit the elbow or on the forearm . to avoid this some coaches advocate to practice how to rotate or twist the joint into a vertical alignment mostly by griping a doorframe and then twist the elbow while the hand holds position as holding a bow . will this put stress on the ecrb ligament as the muscle is stretched around the joint by torque rather than contraction(like twisting towel )it must be better to stretch the muscles along its natural working axis ?
How about forearm pain like someone is stabbing at your arm
Saish