Assessment of the risk and biomechanical consequences of lateral epicondylalgia by estimating wrist and finger muscle capacities in tennis players

Previous studies suggested that a pronounced weakness of the extensor muscles relative to the flexor muscles could increase the risk of occurrence of lateral epicondylalgia. This study investigates this hypothesis by estimating the ratio of extensor to flexor muscle capacities among healthy non-players (n = 10), healthy tennis players (n = 20), symptomatic players (n = 6), and players who have recovered from lateral epicondylalgia (n = 6). Maximum net joint moments in flexion or extension were measured during seven tasks involving the voluntary contraction of wrist and fingers. Using these data, the muscle capacities of the main muscle groups of the hand (wrist flexors, wrist extensors, finger flexors, finger extensors, and intrinsic muscles) were estimated using a musculoskeletal model. These capacities were then used to compute the extensor/flexor capacity ratios about the wrist and the finger joints. Compared to healthy non-players, healthy players presented higher extensor muscle capacities and greater capacity ratios showing that playing tennis generates specific adaptations of muscle capacities. Interestingly, symptomatic players, similar to those of non-players, showed more imbalanced ratios than healthy players. These results confirm that the ratio of extensor/flexor muscle capacities seems to be associated with lateral epicondylalgia and can be further used to understand its incidence and consequences.