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The wrist is a series of small joints that connect the radius and ulna (the two bones in the forearm) to the carpals in the hand. Radial deviation is the tilting of the hand and wrist toward the thumb and radius. This motion is important in weight-bearing activities, such as gymnastics and yoga, where the wrist is forced into a position of extension. The muscles responsible for radial deviation include the flexor carpi radialis and extensor carpi radialis, which work together to cancel flexion and extension, pulling the hand and wrist toward the radius.
| Characteristics | Values |
|---|---|
| Definition | Radial deviation is the tilting of the hand and wrist toward the thumb and radius. |
| Muscles Involved | Flexor Carpi Radialis and Extensor Carpi Radialis |
| Function | These muscles work together to cancel flexion and extension, instead pulling toward the radius. |
| Related Conditions | Tennis Elbow (Lateral Epicondylitis) |
| Related Anatomy | Radiocarpal Joint, Radius, Ulna, Carpals, Flexor Retinaculum (Transverse Carpal Ligament), Extensor Retinaculum |
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What You'll Learn
Extensor carpi radialis longus and brevis
The extensor carpi radialis longus and brevis are two of the three radial muscles located at the lateral forearm. They are extensors of the forearm, running from or near the lateral epicondyle of the humerus to the wrist.
The extensor carpi radialis longus is a fusiform muscle that forms a flattened tendon, which runs distally over the lateral surface of the radius. In the lower third of the forearm, the tendon is crossed by the tendons of the abductor pollicis brevis and extensor pollicis brevis. The tendon of the extensor carpi radialis longus can be felt in the floor of the anatomical snuff box when movements of wrist extension and abduction are performed. This muscle is one of three primary wrist extensors and is most effective when the elbow is extended and when radial deviation is balanced by the primary ulnar deviator- extensor carpi ulnaris.
The extensor carpi radialis brevis is the shorter of the two muscles. It is an extensor muscle in the posterior superficial compartment of the forearm and is the prime dorsiflexor of the wrist. This muscle sits deep to the extensor carpi radialis longus and its tendon courses deep to the abductor pollicis and extensor pollicis brevis before passing under the extensor retinaculum on the dorsal aspect of the hand. The extensor carpi radialis brevis is one of seven superficial extensor muscles of the posterior forearm.
Together, the extensor carpi radialis longus and brevis muscles produce wrist extension and abduction (radial deviation). They also contribute to flexing the elbow joint and are active during fist clenching. The radial nerve damage leads to paralysis of the wrist extensors.
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Tennis elbow
The tendon usually involved in tennis elbow is the extensor carpi radialis brevis (ECRB) tendon, which attaches the ECRB muscle to the lateral epicondyle. The ECRB muscle helps stabilize the wrist when the elbow is straight, such as during a tennis groundstroke. When the ECRB muscle is weakened from overuse, microscopic tears can form in the ECRB tendon where it attaches to the lateral epicondyle, causing pain over the outside of the elbow.
The symptoms of tennis elbow include pain, burning, or an ache along the outside of the forearm and elbow. This pain may worsen and spread down to the wrist if the activity causing the condition is continued. Other symptoms include weakness when grasping, a weak grip, and pain when lifting and gripping small objects. The pain typically begins as mild and gradually worsens over time.
Treatment options for tennis elbow include activity modification, ice, medication, stretching, braces, and injections. Surgery is rarely required. Rest, medication to reduce inflammation, and exercises are often effective treatments.
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Radial deviation
The radial musculature consists of three muscles located at the lateral forearm, running from or near the lateral epicondyle of the humerus to the wrist. These muscles are the extensor carpi radialis longus, extensor carpi radialis brevis, and brachioradialis. The first two are prime movers in radial deviation, while the latter is a powerful flexor of the elbow.
The extensor carpi radialis brevis is particularly prone to microtraumata, inflammation, or tears in the tendon, causing pain at the lateral part of the elbow and a reduced ability to extend the hand. This condition is known as tennis elbow due to its prevalence among tennis players.
The radiocarpal joint is the intersection of the distal end of the radius and the proximal row of carpals, allowing the hand and wrist to move up and down, as well as side to side, causing radial and ulnar deviation. This joint is often hypermobile and susceptible to injury.
The tendons of the muscles involved in radial deviation are long and require thick bands at the wrist to anchor them, known as the flexor retinaculum and extensor retinaculum. These bands form the carpal tunnel, which is supported by the carpal bones and contains flexor tendons, the median nerve, and several arteries and veins.
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Ulnar deviation
Other conditions that can cause ulnar deviation include osteoarthritis, lupus, scleroderma, polymyositis, Sjögren's disease, and psoriatic arthritis. Osteoarthritis causes joint cartilage to wear away due to overuse or ageing. Lupus, an autoimmune disease, can affect any part of the body, including the joints, skin, and organs. Psoriatic arthritis is associated with psoriasis, a chronic autoimmune condition that causes flaky, painful patches of skin.
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Forearm anatomy
The forearm is the section of the upper limb from the elbow to the wrist, consisting of two long bones: the radius and ulna. The radius is positioned laterally, and the ulna is located medially. These two bones are held together by the intervening interosseous membrane. The forearm is divided into two muscular compartments: an anterior (flexor) and a posterior (extensor) compartment. Together, these compartments contain twenty muscles that act on the elbow and wrist joints, as well as the carpometacarpal, metacarpophalangeal, and interphalangeal joints of the hand.
The forearm muscles are essential for fine motor actions of the upper limb, allowing for complex movements of the arm, wrist, and fingers. The deep fascia of the forearm encircles the musculature related to the ulna and radius, and the intermuscular septum divides the compartments. The intermuscular septum originates from the anterior aspect of the radius and is continuous with the deep fascia. The anterior compartment contains the flexor muscles, and the posterior compartment contains the extensor muscles.
The radial musculature consists of three muscles located at the lateral forearm, which run from or near the lateral epicondyle of the humerus to the wrist. The three radial muscles are the extensor carpi radialis longus and brevis, and the brachioradialis muscle. The brachioradialis muscle is a powerful flexor of the elbow, acting most strongly when the forearm is in semi-pronation. The extensor carpi radialis longus and brevis, on the other hand, are poor flexors of the elbow, but they play a role in the extension and abduction (radial deviation) of the wrist joint.
The superficial muscles in the anterior compartment of the forearm include the flexor carpi ulnaris, palmaris longus, flexor carpi radialis, and pronator teres. These muscles all originate from a common tendon that arises from the medial epicondyle of the humerus. The flexor digitorum superficialis is the only muscle of the intermediate compartment, and it can be classified as either superficial or deep, depending on the individual. The deep layer of muscles in the anterior compartment includes the flexor digitorum profundus, flexor pollicis longus, and pronator quadratus.
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Frequently asked questions
Radial deviation is the tilting of the hand and wrist toward the thumb and radius.
The muscles involved in radial deviation are the flexor carpi radialis and extensor carpi radialis.
The flexor carpi radialis and extensor carpi radialis work together to cancel out flexion and extension, instead pulling the hand and wrist toward the radius.
Sports that require weight-bearing on the wrists, such as gymnastics, acrobatics, and yoga, and events in gymnastics like the balance beam, rings, pommels, and p-bars, require more radial deviation.
