Effects of flexor-pronator muscle loading on valgus stability of the elbow with an intact, stretched, and resected medial ulnar collateral ligament

Udall, John H.; Fitzpatrick, Michael J.; McGarry, Michelle H.; Leba, Thu-Ba; Lee, Thay Q.

doi:10.1016/j.jse.2009.03.008

Cited by 90 publications

(74 citation statements)

References 23 publications

(37 reference statements)

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“…In order to achieve forearm pronation, 30-40 N were applied to the Pronator Teres. The Pronator Teres has been found to cause significant elbow varus movement, relieving valgus stresses (Lin et al, 2007;Udall et al, 2009). This further validates our results, which show that in all positions, the actively flexed arm tracked in less valgus when pronated than when supinated.…”

Section: Discussionsupporting

confidence: 88%

Development of an active elbow flexion simulator to evaluate joint kinematics with the humerus in the horizontal position

Ferreira

Johnson

King

2010

Journal of Biomechanics

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Section: Discussionsupporting

confidence: 88%

Development of an active elbow flexion simulator to evaluate joint kinematics with the humerus in the horizontal position

Ferreira

Johnson

King

2010

Journal of Biomechanics

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“…In a cadaveric biomechanical study, Udall et al 13) reported that the FDS is the biggest contributor among the FPMs, and other biomechanical studies 8,10) demonstrated that the FCU is the primary stabilizer for achieving elbow valgus stability. Several electromyographic studies have shown that the FPMs originating on the MEC, such as the PT, the flexor carpi radialis (FCR), the FDS, and the FCU, demonstrated very high activity during the late cocking and acceleration phases 3,6,7,12) .…”

Section: Discussionmentioning

confidence: 99%

Ultrasonographic Assessment of the Flexor Pronator Muscles as a Dynamic Stabilizer of the Elbow Against Valgus Force

Otoshi

Kikuchi

Shishido

et al. 2014

FJMS

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: Flexor pronator muscles (FPMs) play a key role in stabilizing the elbow joint against valgus forces. However, no studies have investigated the in vivo kinematics of FPMs against these forces on the elbow. This study aimed to clarify the in vivo contribution of each FPM as a dynamic stabilizer in a clinical situation.Twelve healthy volunteers participated in this study. Verbal informed consent was obtained from all subjects. The elbow was flexed to 90 degrees, and the forearm was placed in the neutral position. Manual valgus stress was applied to the elbow joint until maximal shoulder external rotation was achieved. The width of the ulnohumeral joint space and the ulnar shift of the sublime tubercle were measured before and after isometric contraction of FPMs using ultrasonography.The horizontal distances were decreased 1.1±0.6 mm after forearm pronation, 0.6±0.5 mm after wrist palmar flexion, 0.1±0.4 mm after wrist ulnar flexion, and 0.2±0.5 mm after finger flexion. Significant changes were observed during forearm pronation, wrist palmar flexion, and finger flexion but not during wrist ulnar flexion (p<0.05). The sublime tubercle was significantly shifted 0.5±0.1 mm medially after forearm pronation, 0.2±0.1 mm medially after wrist palmar flexion, and 0.1±0.1 mm laterally after wrist ulnar flexion and finger flexion (p<0.05). The FPMs, especially the pronator teres and the flexor carpi radialis, function as dynamic stabilizers against elbow valgus stress. The results of this study may be useful in developing injury prevention and rehabilitation strategies for throwing injuries of the elbow.

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“…According to some authors (Park and Ahmad 2004), the flexor carpi ulnaris (FCU) would be the major contributor to the medial stability of the elbow due to its more favorable position, as it overlaps more than the other epicondylar muscles to the ulnar collateral ligament between 30 and 120 of elbow flexion. Other authors suggest that the flexor digitorum superficialis (FDS) is the main valgus stress stabilizer since, though its position is less favorable, it has a more consistent muscle belly compared to FCU and therefore higher power as a stabilizer (Udall et al 2009). …”

Section: Medial Epicondylitismentioning

confidence: 99%

Elbow Rehabilitation

Fusaro¹,

K.²,

Sforza³

et al. 2014

Sports Injuries

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The elbow in a sports population is one of the joints most frequently involved in pathologic events.Injuries can be acute, like traumatic ruptures of tendons or ligaments, but more often are the consequence of chronic overload or of repetitive microtrauma, which can cause a damage of the microscopic structure of a tendon with degeneration of cells and of intercellular matrix. This process goes under the term of tendinosis.In both of these conditions, rehabilitation plays an important role in recovering functional activity and athletic skills. For the rehabilitation team, this aim always represents a challenge, as treatments need to be continuously remodeled and fine-tuned on the needs and features of the single subject, even during the same session. This challenge becomes even more involving when we are dealing with athletes, as it is necessary not simply restoring a functional motion arc but also regaining the complete performance of athletic gesture.

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Effects of flexor-pronator muscle loading on valgus stability of the elbow with an intact, stretched, and resected medial ulnar collateral ligament

Cited by 90 publications

References 23 publications

Development of an active elbow flexion simulator to evaluate joint kinematics with the humerus in the horizontal position

Development of an active elbow flexion simulator to evaluate joint kinematics with the humerus in the horizontal position

Ultrasonographic Assessment of the Flexor Pronator Muscles as a Dynamic Stabilizer of the Elbow Against Valgus Force

Elbow Rehabilitation

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