Common Flexor Tendon Tear Following Yoga and Local Corticosteroid Injections: A Case Report

Severe tearing of the tendons around the elbows is rare, even in athletes; especially tearing of the common flexor tendon of the wrist. We report the case of a 52-year-old housewife who complained of bilateral medial elbow pain after forcefully extending her wrist and elbow while practicing yoga. Repeated corticosteroid injections were administered over her right medial elbow at an orthopedic clinic. Her pain was relieved temporarily but recurred later. She visited our rehabilitation outpatient department, and physical examination revealed weakness during right wrist flexion and forearm pronation. Hence, sonography was performed, which showed a hypoechoic area and soft tissue indentation within the right common flexor tendon. Subsequent magnetic resonance imaging revealed a focal area with a hyperintense signal around the medial epicondyle on fast short-inversion-time inversion recovery images. Both imaging studies indicated a complete tear of the common flexor tendon, and surgical exploration confirmed the imaging findings. We speculated that the infrequent presentation of a medial elbow injury may be attributable to preceding valgus stress and eccentric loading of the elbow during yoga and further tendon weakening after repeated corticosteroid injections.