Extensor carpi ulnaris muscle (2024)

Author: Jana Vasković, MDReviewer: Nicola McLaren, MSc
Last reviewed: November 03, 2023
Reading time: 5 minutes

Extensor carpi ulnaris muscle (1)

Recommended video: Posterior compartment of forearm muscles[16:54]

Attachments, innervation, functions and related clinical anatomy of the extensors of the forearm.

Extensor carpi ulnaris is a fusiform muscle in the posterior forearm. It spans between the elbow and base of the little finger.

This muscle belongs to the superficial forearm extensor group, along with anconeus, brachioradialis, extensor carpi radialis longus, extensor carpi radialis brevis, extensor digitorum and extensor digiti minimi muscles.

Like all the muscles of this compartment, extensor carpi ulnaris works as an extensor of the wrist. Moreover, due to its specific course, this muscle also acts to adduct the hand.

This article will discuss the anatomy and function of the extensor carpi ulnaris muscle.

Key facts about the extensor carpi ulnaris muscle
OriginLateral epicondyle of humerus, posterior border of ulna
InsertionBase of metacarpal bone 5
ActionWrist joint: Hand extension and adduction
InnervationPosterior interosseous nerve (C7, C8)
Blood supplyRadial recurrent artery, posterior interosseous artery

Contents

  1. Origin and insertion
  2. Relations
  3. Innervation
  4. Blood supply
  5. Function
  6. Sources

+ Show all

Origin and insertion

The extensor carpi ulnaris muscle originates from the lateral epicondyle of humerus, via the common extensor tendon, and adjacent fascia. The lateral epicondyle is a common origin for extensor carpi ulnaris, extensor digitorum, extensor carpi radialis brevis and extensor digiti minimi muscles.

Extensor carpi ulnaris comprises its most medial part. The muscle also has attachment to the posterior border of the ulna, via an aponeurosis which it shares with the flexor carpi ulnaris and flexor digitorum profundus muscles.

From its origin, the extensor carpi ulnaris muscle fibers curve inferomedially towards the ulnar side of the hand. Just proximal to the wrist, the muscle gives off a tendon that passes beneath the extensor retinaculum, through a groove on the posterior surface of the head and styloid process of ulna.

Within the retinacular space, the tendon has its own synovial sheath which presents the sixth and the most medial dorsal (extensor) compartment of the wrist. Shortly after entering the hand, the tendon passes over the dorsal surface of triquetral bone and inserts to the medial aspect of the base of metacarpal bone 5.

Relations

Extensor carpi ulnaris muscle

Musculus extensor carpi ulnaris

1/3

Synonyms: none

Extensor carpi ulnaris is the most medial muscle of the posterior forearm. At its superior attachment, the originating fibers of extensor carpi ulnaris form the most medial part of the common extensor tendon, sitting lateral only to the elbow’s anconeus muscle. As it descends down the forearm the muscle maintains this medial position. It is bounded by its counterpart in the anterior forearm, the flexor carpi ulnaris. Just above the level of the wrist, the dorsal cutaneous branch of the ulnar artery arises from between the extensor and flexor carpi ulnaris muscles.

Innervation

Extensor carpi ulnaris is innervated by the posterior interosseous nerve (C7, C8), a branch of the deep division of the radial nerve. The radial nerve stems from the posterior cord of the brachial plexus.

Blood supply

Blood supply to the extensor carpi ulnaris muscle is provided by branches of the radial recurrent and posterior interosseous arteries, which stem from the radial and ulnar arteries, respectively.

Radial nerve

Nervus radialis

1/3

Synonyms: none

Function

The oblique course of extensor carpi ulnaris orientates its direction of pull posterolaterally, meaning that its contraction results with a combined extension and adduction (ulnar deviation) of the hand.

Working together with extensor carpi radialis brevis and extensor carpi radialis longus, the extensor carpi ulnaris muscle contributes to a balanced extension of wrist without deviating the hand in the transverse plane. This action is important for activities of the hand, such as strongly clenching a fist or making a power grip. In this process, extension of the wrist blocks the forearm flexors from on acting upon it. Instead, these flexors remain able to act solely on the digits, flexing them to produce an effective grip such as that seen in a tennis backhand.

Similarly, synergistic action of flexor carpi ulnaris and extensor carpi ulnaris results in balanced adduction (ulnar deviation) of the hand at the wrist. That is, adduction without added flexion or extension. This action is necessary for processes like hammering, throwing, golfing and swinging a baseball bat. Extensor carpi ulnaris also contributes to the stability of the distal radioulnar joint.

Test your knowledge on the extensors of the forearm with this quiz.

Sources

All content published on Kenhub is reviewed by medical and anatomy experts. The information we provide is grounded on academic literature and peer-reviewed research. Kenhub does not provide medical advice. You can learn more about our content creation and review standards by reading our content quality guidelines.

References:

  • Cael, C. (2010). Functional anatomy: Musculoskeletal anatomy, kinesiology, and palpation for manual therapists. Philadelphia, PA: Wolters Kluwer Health/Lippincott, Williams & Wilkins.
  • Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). Clinically Oriented Anatomy (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
  • Netter, F. (2019). Atlas of Human Anatomy (7th ed.). Philadelphia, PA: Saunders.
  • Palastanga, N., & Soames, R. (2012). Anatomy and human movement: structure and function (6th ed.). Edinburgh: Churchill Livingstone.
  • Standring, S. (2016). Gray's Anatomy (41st ed.). Edinburgh: Elsevier Churchill Livingstone.

Illustrations:

  • Extensor carpi ulnaris muscle (Musculus extensor carpi ulnaris) - Yousun Koh
  • Adduction (ulnar deviation) of hand - Paul Kim

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Extensor carpi ulnaris muscle (2024)

FAQs

What does the extensor carpi ulnaris muscle do? ›

The extensor carpi ulnaris serves two functions. It extends the hand at the wrist joint by acting along extensor carpi radialis longus and extensor carpi radialis brevis. Along with the flexor carpi ulnaris, the extensor carpi ulnaris adducts the hand at the wrist.

What causes extensor carpi ulnaris pain? ›

Continual repetitive movements that places stress on the tendon of this muscle, often leads pain, irritation, and eventually extensor carpi ulnaris tendinitis. ECU Tendinitis is a condition common among people who play racquet sports or basketball.

What are the symptoms of ECU injury? ›

If you have this condition, you may have wrist pain, loss of grip, or stiffness in your pinky. Some report a “popping” sound when using the wrist.

How do you treat extensor carpi ulnaris? ›

Conservative treatment consists of rest, immobilizing the wrist with a splint, applying ice and taking non-steroidal anti-inflammatory medication such as ibuprofen or naproxen. Golfers with this injury should avoid forceful, repetitive, or sustained thumb motion away from the hand or wrist.

What is the best exercise for the extensor carpi ulnaris? ›

The Tennis Elbow Stretch is very effective in preventing and treating extensor carpi ulnaris injuries. Hold your arm out in front of you, straighten it, rotate your arm inwards (so your elbow crease faces down towards the floor) and bend your wrist back. Hold this position to create a stretch.

How do you treat flexor carpi ulnaris pain? ›

Initial treatment consists of medication and ice to relieve the pain and reduce the inflammation, stretching and strength- ening exercises, and modification of the activity that initially caused the problem.

How long does ECU tendonitis take to heal? ›

In patients with subluxation of the ECU tendon and disorganisation of the tendon subsheath along the medial side of the head of the ulna, recovery takes two to three months. If the tendon subsheath has not detached, the ECU tendon remains stable and the healing process is more rapid, taking four to six weeks.

How do you test for ECU tendonitis? ›

The examiner grasps the patient's thumb and long finger with one hand, palpates the ECU tendon with the other hand, and then has the patient radially deviate the thumb against resistance. Recreation of pain induced along the dorsal ulnar aspect of the wrist is considered a positive result.

How to treat ulnar tendonitis? ›

Treatment options
  1. Taking anti-inflammatory medication (if appropriate), such as naproxen or ibuprofen or newer non-steroidal anti-inflammatory drugs (NSAIDS), or steroid injections to ease pain.
  2. Casting or splinting to rest the wrist.
  3. Hand Therapy (exercises to mobilise, strengthen tendons and ligaments in the wrist)

What are the symptoms of a bad ECU? ›

These may include poor engine performance, stalling, misfiring, rough idling, poor fuel economy, check engine light, or no start condition. Some of these symptoms may also indicate other issues, such as faulty sensors, wiring, or spark plugs, so you need to rule them out before blaming the ECU.

Can ECU heal on its own? ›

Many cases of ECU subsheath rupture can successfully be treated without surgery. However, especially for athletes, surgery may be required to repair the sheath to hold the tendons in place if significant damage has occured. Your doctor can advise on whether surgery may be right for you.

How can I fix my ECU problem? ›

Inspect Wiring and Connections: Ensure that all wiring and connectors related to the ECU are in good condition, free from damage or corrosion. Reset the ECU: Sometimes, minor issues can be resolved by resetting the ECU. Disconnect the car battery for a few minutes and then reconnect it to see if the problems persist.

How do you repair extensor carpi ulnaris subluxation? ›

ECU subluxation can be a challenging diagnosis as a cause of wrist pain. Surgery is indicated for patients who do not respond to conservative measures. Perform a tension-free repair of the torn subsheath, if possible. A flap of extensor retinaculum can be used to recreate the ECU subsheath with good long-term outcome.

What happens if flexor carpi ulnaris is damaged? ›

Flexor carpi ulnaris tendonitis may cause trigger points to develop around your wrist and up your forearm, causing pain when touched. Moreover, if this tendon becomes too tight, it may impinge on your ulnar nerve and cause more severe pain as a result.

How can I test my wrist for tendonitis at home? ›

Finkelstein's test.

This test includes making a fist with the fingers covering the thumb and then bending the wrist toward the little finger. Pain on the thumb side of the wrist is a positive indication of tendonitis in the wrist area.

What is the function of the ECU in the wrist? ›

The extensor carpi ulnaris (ECU) muscle plays a key role not only in the active movements of wrist extension and ulnar deviation but also in providing stability to the ulnar side of the wrist. Its position relative to the other structures in the wrist changes with forearm pronation and supination.

What movement does the flexor carpi ulnaris muscle perform? ›

The flexor carpi ulnaris (FCU) is a superficial flexor muscle of the forearm that flexes and adducts the hand (see Image. Anterior Forearm Compartment Muscles). This muscle is the most powerful wrist flexor and the only anterior forearm compartment muscle completely innervated by the ulnar nerve.

What is the problem with flexor carpi ulnaris? ›

Flexor carpi ulnaris tendonitis may cause trigger points to develop around your wrist and up your forearm, causing pain when touched. Moreover, if this tendon becomes too tight, it may impinge on your ulnar nerve and cause more severe pain as a result.

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