Читать книгу Musculoskeletal Disorders - Sean Gallagher - Страница 32

The pathology associated with medial epicondylitis is similar to that of lateral epicondylitis; however, different activities may provide the requisite stress on the flexor tendons compared to those affecting the extensor tendons. As with medial epicondylitis repetitive activity leads exposure to forceful and repetitive activities is thought to lead to recurrent microtears in the tendon leading to the development of tendinosis. Although it was thought that the pronator teres and flexor carpi radialis were originally thought to be most commonly affected, more recent literature suggests all muscles may be equally affected, with the possible exception of the palmaris longus (Kiel & Kaiser, 2019). As the tendon undergoes repetitive microtears, there is remodeling of the collagen fibers and increased mucoid ground substance. Focal necrosis or calcification can occur. Subsequently, collagen strength decreases leading to increased fragility, scar tissue formation, and thickening of the tendon. Although less common, acute trauma can also cause medial epicondylitis from a sudden violent contraction of the muscles (Kiel & Kaiser, 2019).