Sarcomere length in wrist extensor muscles. Changes may provide insights into the etiology of chronic lateral epicondylitis

Acta Orthop Scand. 1997 Jun;68(3):249-54. doi: 10.3109/17453679708996695.


Since the etiology of tennis elbow (lateral epicondylitis) is poorly understood, we studied the anatomical changes in the extensor carpl radialis brevis (ECRB) muscle during elbow joint rotation. Specifically, we measured ECRB sarcomere length, using an intraoperative laser diffraction procedure that measures muscle sarcomere length with an accuracy of +/- 0.05 micron. We found an unexpected biphasic response in ECRB sarcomere length as the elbow was rotated from full extension to full flexion. The initial sarcomere length of 3.49 microns, with the elbow extended, was gradually changed to 3.68 microns, 3.34 microns, 3.81 microns, and 3.45 microns with progressive elbow flexion. Based on the very nonlinear mechanical properties of skeletal muscle, this "double lengthening" of the ECRB during progressive flexion would impose intense eccentric contractions on the muscle itself. Given that eccentric contractions cause muscle injury and subsequent inflammation, these findings may provide insights into the etiology of lateral epicondylitis.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Biomechanical Phenomena
  • Chronic Disease
  • Elbow Joint / physiopathology
  • Female
  • Humans
  • Image Processing, Computer-Assisted
  • Isometric Contraction / physiology*
  • Male
  • Middle Aged
  • Range of Motion, Articular / physiology
  • Sarcomeres / pathology*
  • Tennis Elbow / etiology*
  • Tennis Elbow / physiopathology
  • Wrist Joint / physiopathology*
  • Wrist Joint / surgery