A cross-sectional study comparing strength profile of dorsal and palmar flexor muscles of the wrist in epicondylitis and healthy men

Eur J Phys Rehabil Med. 2013 Aug;49(4):507-15. Epub 2012 Nov 9.


Background: Strength training has been proposed by several authors to treat Lateral Epicondylitis. However, there is still a lack of information concerning muscle weakness and its relationship to imbalances and fatigability of forearm muscles during dynamic conditions in subjects after epicondylitis recovery.

Aim: To analyze the relationship between lateral humeral epicondylitis, and forearm muscle strength and fatigue.

Setting: Rehabilitation specialized center

Population: Cross-sectional study in eight former epicondylitis men free of symptoms and actively working at the moment of the evaluation and eight healthy men volunteers.

Methods: Isokinetic tests were performed at different velocities in order to assess strength in concentric and eccentric contractions. Additionally, a long-term concentric test was carried out in order to analyze strength during endurance. The following variables were analyzed: Average torque of dorsal and palmar flexors of the wrist and ratio of agonist/antagonist for non-endurance contractions; length of initial and final plateaus and the slope of average torque decay during the endurance test.

Results: In both groups, average torque produced by palmar flexor muscles was higher than that produced by dorsal flexor muscles. Patients showed higher strength in palmar flexor muscles, whereas dorsal flexor strength was similar for both populations. Palmar flexor vs. dorsal flexor ratio was significantly higher in patients for eccentric contractions. Regarding fatigue, results showed that torque decreased earlier in patients. CONCLUSIONS AND CLINICAL REHABILITATION IMPACT: Both palmar flexor force and palmar/dorsal ratio in eccentric exercise were significantly higher in patients. This finding indicates a muscular imbalance in patients underlying the epicondylitis condition. Additionally, former patients fatigued earlier. Findings indicate that muscle imbalances and fatigability might be related to lateral epicondylitis. This information may be useful in the design and monitoring of programs intended for lateral epicondylitis rehabilitation. More studies are necessary to conclude if these differences are cause or consequence of the epicondylitis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Forearm / physiology
  • Forearm / physiopathology
  • Humans
  • Male
  • Muscle Contraction / physiology
  • Muscle Fatigue / physiology*
  • Muscle Strength / physiology*
  • Muscle Strength Dynamometer
  • Muscle Weakness / etiology
  • Muscle Weakness / physiopathology*
  • Muscle, Skeletal / physiology
  • Muscle, Skeletal / physiopathology
  • Physical Endurance / physiology
  • Rehabilitation Centers
  • Resistance Training / methods*
  • Spain
  • Tennis Elbow / physiopathology
  • Tennis Elbow / rehabilitation*
  • Wrist / physiology
  • Wrist / physiopathology*