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Deltoid
0%
0/29
Extensor carpi ulnaris
Extensor carpi radialis
76%
22/29
Flexor carpi ulnaris
17%
5/29
Triceps
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The athlete in the question stem suffers from "tennis elbow", or lateral epicondylitis. This occurs as a result of repetitive, forceful use of the superficial extensor muscle groups, including the extensor carpi radialis. The extensor carpi radialis inserts at the lateral epicondyle and includes the brevis and longus muscle groups (ECRB and ECRL). The common extensor tendon becomes inflamed with repeated forced extension and flexion. Classically, this is observed in tennis players with repeated extension of the wrist during backhanded swings of the tennis racket, thus the designation "tennis elbow". It is often associated with improper technique. Lateral epicondylitis presents with pain over the lateral epicondyle that can radiate down the posterior forearm. Medial epicondylitis or "golfer's elbow" is associated with pain over the medial epicondyle, and is due to overuse of wrist flexors, such as flexor carpi ulnaris. Management typically involves a combination of rest, bracing and physical therapy with or without NSAID medications.Ma et. al review the clinical manifestations diagnosis and management of epicondylitis. They note the classic presentation of lateral elbow pain with wrist extension in cases of lateral epicondylitis. They further discuss options for management.Incorrect Responses:Answer 1: The deltoid acts to abduct the shoulder. Overuse of the deltoid would present with pain at the shoulder, and would arise secondary to repeated overhead activity. Answer 2: Extensor carpi ulnaris does act to extend the wrist, however, it is not the main muscle involved in lateral epicondylitis.Answer 4: Flexor carpi ulnaris acts to flex the wrist. Its overuse results in medial epicondylitis which would present with tenderness at the medial elbow.Answer 5: The triceps muscle acts to extend the forearm. It is not involved in wrist extension, and its overuse does not result in lateral epicondylitis.Bullet Summary:Lateral epicondylitis is due to overuse of the extensor carpi radialis muscle groups, and presents with pain and tenderness at the lateral elbow.
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