Extensor Carpi Radialis Longus

Pointer Plus The Pointer Plus is an easy to use trigger point (TP) locator which incorporates a push button stimulation feature to immediately treat Trigger point pain.

The Extensor Carpi Radialis Longus is a superficial posterior muscle of the forearm.

Anatomical Attachments:

• Origin: Attaches to the inferior 1/3 lateral supracondylar ridge of the humerus and the lateral intermuscular septum.
• Insertion: Attaches to the dorsal surface of the base of the second metacarpal bone.

Action: Extends the wrist and abducts the hand.

Synergist: Brachioradialis, Supinator, Extensor Carpi radialis brevis, Abductor pollicis longus, Extensor pollicis brevis and longus, Extensor digitorum, Extensor digiti minimi, Extensor carpi ulnaris, Extensor indicis.

Antagonist: Pronator teres, Flexor carpi radialis, Palmaris longus, Flexor carpi ulnaris, Flexor digitorum superficialis, Flexor digitorum profundus, Flexor pollicis longus, pronator quadratus.

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Nerve Supply: Radial Nerve (C6, C7).

Vascular supply: Muscular branches of the radial and the radial recurrent arteries.

• Primary: The pain from the TrP is referred from the lateral epicondyle to the dorsum of the hand and the fleshy part between the thumb and the digit (anatomical snuff box).
• Satellite or associated triggers: Supinator, Brachioradialis and Triceps brachii.

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Trigger Point Signs and Symptoms: Pain is the chief complaint. Grip strength is diminished. This weakness is exacerbated with the hand in ulnar deviation. Pain is exacerbated with forced supination or pronation, such as twisting a butterfly nut, screwdriver, or door knob.

Trigger Point Activating and Perpetuating Factors: Repetitive forceful hand gripping, e.g. gardening, using hammers, writing for long periods, sewing by hand or knitting.

Differential Diagnosis: Epicondylitis, (Segmental, Subluxation, Somatic dysfunction) C5 C6 or C7 radiculopathy, Carpal tunnel syndrome, Tenosynovitis (De Quervain’s Disease), Rheumatoid Arthritis, Osteoarthritis, Neurogenic Arthropathy (Charcot’s Joint), Sprain/Strain of the elbow wrist or thumb, Bone fracture, Bone cancer, Ganglion Cyst, Thoracic Outlet Syndrome, Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.

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