Treatment of the Traumatic Injury of the Cubital Posterior Tendon

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They comprise from 3 to 9% of all athletic wrist and hand injuries for temporary or long term.
Tendonitis of the Extensor Cubital (De Quervain’ Disease) is the second most common type of closed tendon injuries suffered by sportspersons. Cubital tendinitis is an inflammation of the tendon at the back of the wrist and it is caused by repetitive rotations and backward flexions of the wrist. This injury is most common among basketball players, as well as among racket sport players.
SYMPTOMS
  • Edema all along the cubital styloid.
  • Pain when the cubital posterior tendon is palpated.
  • Swelling of the soft tissues.

In order to determine the type of injury suffered prosupination of the wrist should be performed to determine if there is luxation or not of the tendon. If there is tendon luxation, there will be a “crack” produced by the friction between tendon and cubital styloid.


Functional rehabilitation consist in reinforcing the extending muscles of the hand

REINTRODUCTION TO SPORT
After a sustained period of rest, and if there is no pain when pro-supination movement is performed, functional rehabilitation can begin. This consists of reinforcing the extensor muscles of the hand. It must be noted that initially that exercises should be performed with a limited range of motion, stopping as soon as pain appears. Motion range can progressively increase as the individual adapts and the musculature becomes stronger.  If a degree of muscular stiffness is noticed, do decontracting massage and stretching exercises to the affected areas. The return to sportive activity can be done gradually and spaced out over time so as to not overstress the injured area and allow time for the patient’s adaptation. The time required until reaching an optimal performance can vary depending on the seriousness of the injury, but four weeks is usually enough.

EXERCICES

Reverse Wrist Curl
This exercise is useful to strengthen the extensor muscles of the wrist. This can be done with the thumb below or over the barbell. In the latter case, the degree of strength required is higher because as the athlete is forced to do a stronger “hold” of the barbell. It is recommended the first variant, which is less demanding.

Wrist Twist
This exercise will strengthen specifically the musculature responsible for the forearm supination. If the twist is extended until the 180º degrees, one can also work on the pronation musculature. It may be better do this later, when the wrist is strong enough.

These exercises are performed twice per week, establishing a routine that includes four sets of 12 to 14 repetitions each, with 60 to 90 seconds rest pauses between each.

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