Sex differences in wrist torque and endurance—Biomechanical factors associated with developing lateral epicondylitis of the humerus

Ikeda, Katsuo; Yoshii, Yukie; Kohyama, Sho; Ikumi, Akira; Ikeda, Reimi; Yamazaki, Masashi

doi:10.1002/jor.25506

Cited by 2 publications

(5 citation statements)

References 31 publications

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“…We did not directly evaluate the prognosis of the patients. Resistance to LE treatment is multifactorial, including biological, environmental, and psychological factors 5,11,29 . A lower affected/unaffected side ratio of the MS(S) of the wrist extensor or an extension/flexion ratio of the MS(S) is only one of the biological risk factors for refractoriness.…”

Section: Discussionmentioning

confidence: 99%

“…Muscles are prone to eccentric contraction when muscle performance declines, including low muscle strength, contraction velocity, and endurance. 11 In patients with LE, muscle contraction velocity of the extensor carpi radialis delays, 13 and the strength of the wrist extensor reduces relative to the strength of the flexor. 14,15 As wrist extensors and flexors co-contract in gripping, 16,17 this muscle strength imbalance of the wrist may result in repetitive eccentric contractions with each gripping motion.…”

Section: Rationalementioning

confidence: 99%

“…Uncontrolled conditions worsen histological severity with vascular fibroblast proliferation, mucoid degeneration, calcification, and ectopic ossification at the enthesis 7,9,10 . Decreased muscle strength and endurance of the wrist extensors are considered to be risk factors for the development of LE, because it induces an eccentric contraction of the wrist extensors in gripping with forearm pronation 11 . Although LE is considered a self‐limiting disease, about 10% of patients do not respond to conservative treatment and sometimes require surgery for refractory LE 9 …”

Section: Introductionmentioning

confidence: 99%

“…As LE exacerbates with repetitive eccentric contractions of wrist extensors, 7,8 female patients with LE would be expected to be more exposed to eccentric contractions than males. Muscles are prone to eccentric contraction when muscle performance declines, including low muscle strength, contraction velocity, and endurance 11 . In patients with LE, muscle contraction velocity of the extensor carpi radialis delays, 13 and the strength of the wrist extensor reduces relative to the strength of the flexor 14,15 .…”

Section: Introductionmentioning

confidence: 99%

“…5,11,29 A lower affected/unaffected side ratio of the MS(S) of the wrist extensor or an extension/flexion ratio of the MS(S) is only one of the biological risk factors for refractoriness. A longitudinal study with multivariate analysis would identify the risks more quantitatively.…”

mentioning

confidence: 99%

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Pathophysiology of sex difference in refractoriness in lateral epicondylitis: Biomechanical study of wrist torque

Ikeda,

Yoshii,

Kohyama

et al. 2023

Journal Orthopaedic Research

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Eccentric contractions of the wrist extensors worsen lateral epicondylitis (LE), whose pathophysiology may involve sex differences in wrist torque. This study aimed to investigate sex differences in wrist torque in patients with LE. The wrist extension and flexion torques of 22 patients with LE (11 males and 11 females) were measured. Maximum muscle output over time was measured for 20 s, initial torque was defined as muscle strength, and the degree of eccentric contraction was quantified and defined as the eccentric contraction index (ECI). The affected/unaffected side ratio of the wrist extensor, extensor/flexor ratio of muscle strength, and affected/unaffected side difference of ECI between sexes were statistically analyzed. Furthermore, correlations between wrist extensor torque, ECI, and Visual Analog Scale of pain during the examination were evaluated. Females were found to display lower affected/unaffected side ratios of the wrist extensor and wrist extension/flexion ratios for the affected side, compared with males; however, no differences were found in the wrist extension/flexion ratios for the unaffected side in both sexes. Additionally, females presented with larger differences between the affected and unaffected sides in the ECI. Based on correlations between wrist torques, ECI, and pain, females tended to suppress muscle output to prevent pain from eccentric contraction of wrist extensors more than males, which would induce an imbalance in muscle strength of the wrist extensors and flexors. This imbalance may result in chronic eccentric contraction of the wrist extensors with gripping, exacerbating LE.

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Section: Discussionmentioning

confidence: 99%

Section: Rationalementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Pathophysiology of sex difference in refractoriness in lateral epicondylitis: Biomechanical study of wrist torque

Ikeda,

Yoshii,

Kohyama

et al. 2023

Journal Orthopaedic Research

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Effects of Forearm Rotation on Wrist Flexor and Extensor Muscle Activities

Ikeda,

Kaneoka,

Matsunaga

et al. 2024

Preprint

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Background The forearm muscles coordinately control wrist motion, and their activity is affected by forearm rotation. Although forearm rotation has been implicated in the development of lateral and medial epicondylitis, its biomechanical background remains unknown. Therefore, the present study investigated the activity of wrist muscles in various forearm positions. Methods Surface electromyography of the extensor carpi radialis brevis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris was performed on 40 healthy upper limbs. We initially measured muscle strength and electromyographic activity (integrated electromyographic value per second) at maximum voluntary output towards wrist extension and flexion in a neutral position. We then assessed electromyographic activity under constant wrist torque (75% of maximum strength in the neutral position) in pronation, the neutral position, and supination. The percentage of maximum electromyographic activity was evaluated for each position. Results In wrist extension, the extensor carpi radialis brevis was activated during forearm pronation, while extensor carpi ulnaris activity did not change in any forearm position. In wrist flexion, the flexor carpi radialis was activated during forearm supination, while flexor carpi ulnaris activity was significantly lower with forearm pronation than in the neutral position. Conclusions Since muscle activation increases traction force at the tendon origin, forearm positions that increase muscle activity may be a biomechanical risk factor for the development of tendinopathy. The present results are consistent with epidemiological and pathological findings on lateral and medial epicondylitis. These results provide insights into wrist biomechanics and the pathophysiology of lateral and medial epicondylitis.

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Sex differences in wrist torque and endurance—Biomechanical factors associated with developing lateral epicondylitis of the humerus

Cited by 2 publications

References 31 publications

Pathophysiology of sex difference in refractoriness in lateral epicondylitis: Biomechanical study of wrist torque

Pathophysiology of sex difference in refractoriness in lateral epicondylitis: Biomechanical study of wrist torque

Effects of Forearm Rotation on Wrist Flexor and Extensor Muscle Activities

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