Fair Oaks Orthopedics

Extensor Carpi Ulnaris Tendonitis 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, extending the wrist towards the pinky side of your hand.

ECU Tendonitis: Symptoms & Treatments

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.

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.

ECU tendonitis 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 severe 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.

Wrist Spain or Break?

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.

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 Tendonitis 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

Extensor Carpi Ulnaris Tendonitis 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.


At Fair Oaks Ortho, we believe that cost shouldn’t be an obstacle to highest-quality care available. That’s why we’re proud to accept insurance from most major providers in the state of Virginia. View our list of accepted medical providers, and don’t hesitate to reach out to our staff with any questions.

Cigna Orthopedic Medical Insurance Virginia

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

Get Directions

Mon 8:00 am – 4:30 pm
Tue 8:00 am – 4:30 pm
Wed 8:00 am – 4:30 pm
Thu 8:00 am – 4:30 pm
Fri 8:00 am – 4:30 pm
Sat Closed
Sun Closed

Fair Oaks Orthopedics

For over 30 years, Virginia Board Certified Physician, Dr. Stephen W. Pournaras, Jr. has provided excellent healthcare and treatment for his patients. As a multi-specialty orthopedic practice, offering the best for you medically to treat, heal and lead you to optimum recovery. We are dedicated to using state-of-the-art technology while building nurturing relationships with each of our patients.

Contact Us Today.

    Skip to content