Changes in medial elbow joint space with differences in contraction strength of flexor-pronator muscle under elbow valgus stress

Abstract

Background: The relationship between contraction strength of the flexor-pronator muscles (FPMs) and elbow valgus braking function has not been clarified.

Hypothesis/purpose: The purpose of this study was to investigate changes in medial elbow joint space when there is a difference in contraction strength of FPMs under elbow valgus stress.

Methods: Subjects were 20 healthy male university students, and the elbow joint on the nondominant hand side was used for measurements. The body position for limb measurement was sitting in a chair, with the shoulder abducted 60° and in 90° of external rotation, with 90° of elbow flexion. At first, maximum voluntary contraction (MVC) of the FPMs by grip motion was measured using a hand grip dynamometer under 60-N valgus stress. Contraction strengths of 10% MVC, 30% MVC, and 50% MVC were used. Ultrasonographic images of the medial elbow joint space (JS) were taken in the starting limb position. Using the Telos device system, load was then gradually increased by +10 N/s, and at the time of 60-N valgus stress, an image of the JS was taken. Furthermore, the subject adjusted to the set contraction strength (for about 5 sec) with 60-N valgus stress applied, and an image of the JS was taken while maintaining the set contraction strength. Each MVC condition (10% MVC, 30% MVC, and 50% MVC) was performed randomly. Three ultrasonographic images were taken within 10 seconds, and the average value of the three images was adopted as the JS.

Results: Compared with the JS under 60-N valgus stress, the JS was significantly reduced under 60-N valgus stress + 50% MVC. No significant difference was observed between the starting limb position and 60-N valgus stress + 50% MVC.

Conclusion: FPMs may require muscle activity ≥50% MVC to brake 60-N elbow valgus stress.

Keywords: Ulnar collateral ligament; elbow valgus stress; flexor-pronator muscles; medial elbow joint space; muscle contraction strength; ultrasonography.