Stephen W. Pournaras, Jr., MD – Hand Surgeon Fairfax

3998 Fair Ridge Dr., Suite 100 Fairfax, Va 22033

Extensor Carpi Ulnaris (ECU) Tendinitis : Symptoms & Treatments
Fair Oaks Orthopedics - Fairfax VA
Stephen W. Pournaras, Jr., MD

Extensor Carpi Ulnaris (ECU) Tendinitis

What Are The Symptoms?

Extensor Carpi Ulnaris Tendinitis is an injury of your wrist where the extensor carpi ulnaris muscle becomes inflamed and irritated. This muscle extends from the outer portion of your forearm and attaches to the fifth metacarpal, functioning to extend the wrist towards the pinky side of your hand.

The pain you feel is caused by the continuous repetitive movements that place stress on the tendon that often leads tenderness, irritation, actual tearing. and eventually extensor carpi ulnaris tendinitis. ECU Tendinitis is a condition common among patients who play golf, tennis, any type of racquet sport or basketball.

Extensor Carpi Ulnaris Tendinitis Surgery

Initial treatment of immobilization in a long-arm cast for six weeks. Surgery is often necessary for patients who continue to have pain or instability after 4-6 weeks of splinting.

Surgical Reconstruction of the Tendon 

  • A small incision at the back of your wrist near the ulnar side.
  • The ECU tendon is exposed. Care is taken to prevent damage to the nerves
  • Removal and cleaning out the damaged tissue
  • K-wires are used to suture the separated ligament
  • The incision is closed and a bandage is applied.

Your wrist will be supported by a cast for a few weeks. Your physical therapist can teach you specific exercises to help you recover sooner. 

Regular follow up visits are necessary. You may return to normal activities after a few months with approval.

This surgery may be performed under local or general anesthesia.

Extensor Carpi Ulnaris Tendinitis
ECU Tendinosis Treatments 
Initially non-surgical treatment options include rest and a combination of non-steroidal anti-inflammatory medications to manage pain and inflammation. Your wrist can be supported by splinting or casting for about 6 weeks. You may have to do some exercises to your wrist as you heal.
  • Rest. Stopping any activity that causing pain and irritation.
  • Ice Packs
  • Splint/Brace
  • Anti-Inflammatory Medication
  • Modification Of Activities Contributing To Condition
  • Steroid Injections
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Symptoms Include:

  • Wrist pain and loss of grip strength.
  • Swelling and irritation
  • Stiffness
  • Decreased range of motion.
  • Pain and inflammation at the ulnar side of your wrist (below the little finger)
  • Snapping of the tendon while moving your wrist


ECU tendinitis symptoms become worse by combined wrist motion towards the pinky side and moving the palm up and down. If you play golf, when the wrist motion towards the pinky side occurs slightly just before hitting the ball, and as it occurs at a faster speed while the wrist is under high degrees of stress this will cause alot of pain. Golfers with a tendency toward ‘casting’ are at risk of developing this inflammation.

Pain in the wrist area may also be a sign of a more serious injury, it could indicate the rupture of the tendon sheath that holds the ECU tendon in place.

If the pain is more on the pinky side of the forearm than in the wrist, this may indicate a tear, and the tendon is no longer supported and can roll in and out of the tendon groove. This problem known as subluxation.

ECU subluxations are rare. They can be caused when the sheath that contains the ECU ligament gets pinched between the radius and ulna. This type of damage is most often caused by the repetitive motion associated with playing golf or tennis, but it can also be the result of trauma to your wrist or forearm.

If the patient’s symptoms do not improve with non-surgical treatments, surgery may be necessary to repair the ECU and surrounding tissues.


We know how important having pain-free hand and wrist motion and function is for our patients. As well as the ability to do daily activities, including work, self-care, sports. We are here to help you.  Our advanced care orthopedic practice specializes in hand & the upper extremities treatments and surgery, as we offer state-of-the-art non-surgical and surgical care to treat a full range of hand and wrist injuries and conditions.

Call Us Today To Make An Appointment.

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Our Fair Oaks Orthopedic practice offers the best orthopedic care as well as the latest physical and hand therapy services.

If you have a wrist injury that you need treatment for, please contact us at Fair Oaks Ortho. Dr. Stephen W. Pournaras  & our staff have a great knowledge of the complex network of blood vessels, nerves, muscles, ligaments, tendons, and bones that make up your hand and wrist.

Hand Surgeon Fairfax VA -Stephen W. Pournaras, Jr., MD - Fair Oaks Orthopedics

Our board-certified, fellowship-trained Orthopaedic Surgeon, Stephen W. Pournaras, Jr., M.D. utilizes the latest technology and cutting-edge procedures to treat a broad spectrum of orthopaedic conditions, sports injuries, and work-related injuries.

By preforming operative and non-operative procedures, our goal is to use the latest and most minimally invasive techniques that allows our patients a rapid return to a full and active life.

“What is important to us as a practice is superior patient outcomes and unmatched patient satisfaction. We pride ourselves in being patient advocates, going the extra mile to ensure that the care delivered to our patients is best of that medicine as to offer.”

“I believe in a team-oriented approach to treatment, which often involves physical and occupational therapists to maximize functional outcome for all my patients.” Dr.  Pournaras 

David Park is a certified physician assistant, specializing in Orthopaedics, is an interictal part of our practice since 2019. David is always working very closely with Dr. Pournaras by treating hand & upper arm extremities, side by side making sure you receive the best health care we have to offer.
David’s specialties include hand & wrist arthritis, trigger finger, ganglion cysts, fractures, and carpal tunnel syndrome, if you are in pain, contact our practice to schedule an immediate appointment to see him within 48 hours. David Park is loved by all and very knowledgeable with treating your condition.
Fair Oaks Ortho- providing you with the best in comprehensive orthopaedic care of the hand to shoulder (upper extremities). Make Your Appointment To See Certified Physician’s Assistant David (Da Yon) Park, Specializing In Orthopaedics & Chronic Issue Management.
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Fair Oaks Orthopedics – Fairfax VA

Suffering from pain can limit your daily activities and decreases your enjoyment of life.  Our commitment to support your journey towards recovery can help ease your mind. Learn more about our comprehensive range of advanced treatment options for hand, wrist, elbow, and shoulder designed to provide pain relief and heal as quickly, and as safely as possible.

We Accept Most Medical Insurance - Fair Oaks Orthopedics - Fairfax VA

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