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Massage Today
March, 2007, Vol. 07, Issue 03

Ulnar Deviation

By Ben Benjamin, PhD

Question: What muscle-tendon unit is tested by resisted ulnar deviation of the wrist?

Answer: The flexor carpi ulnaris.

The flexor carpi ulnaris originates at the medial epicondyle of the humerus and the medial border of the olecranon.

It inserts on the palmar surface of the pisiform, the hamate and the base of the fifth metacarpal bone. It flexes and adducts the hand at the wrist. Injury to this structure can cause pain both at the medial elbow and in the forearm.

Dr. Benjamin tests the flexor carpi ulnaris muscle-tendon unit on a patient. - Copyright – Stock Photo / Register Mark To test the flexor carpi ulnaris muscle-tendon unit, instruct the client to adduct the wrist (i.e., to move the hand toward the ulnar side) as far as possible and to hold it there. Place one hand on the radial side of the wrist and the other on the medial aspect of the hand, just proximal to the fifth digit. Now ask the client to hold the hand in that position as you apply equal pressure in the opposite direction.

If the client feels pain at the medial elbow during this test, it's likely that the flexor carpi ulnaris attachment at the elbow is strained. This structure often is injured in carpenters who use a hammer throughout the day. The hammering motion places constant stress on the flexor carpi ulnaris muscle.

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