ECU Tendinopathy and Subluxation

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What is it?

The extensor carpi ulnaris tendon runs in a groove behind the ulna and helps stabilise the wrist during rotation. Injury to its sheath allows snapping or painful inflammation.

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Symptoms and progression

Pain and swelling on the ulnar wrist with forearm rotation are common. Some patients feel the tendon visibly snap out of place.

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Diagnosis

Dynamic ultrasound is helpful to show tendon displacement. MRI assesses associated TFCC injury.

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Non‑surgical treatment

Immobilisation, therapy and injection are first‑line.

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Surgery – ECU sheath reconstruction

Surgery involves repairing or rebuilding the torn sheath to stabilise the tendon. The wrist is protected for several weeks, followed by gradual rehabilitation. Snapping usually resolves, but full strength recovery can take months. Risks include stiffness, recurrence and nerve irritation.

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What does the rehabilitation/recovery involve?

To find out more about rehabilitation and recovery after surgery please see our Rehabilitation Protocols here.

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