Elbow Special Tests

Elbow Flexion Test

Steps

• Athlete is sitting or standing
• Athlete maximally flexes the elbow and holds the position for 3 to 5 minutes

Positive Test
Radiating pain into the median nerve distribution in the athlete's arm and/or hand

Positive Test Implications
Cubital fossa syndrome

Medial Epicondylitis Test/Golfer's Elbow Test

Steps

• Athlete is sitting or standing and makes a fist with the involved side
• Examiner faces the athlete and palpates along the medial epicondyle with one hand and grasps the athlete's wrist with the other hand
• Examiner passively supinates the forearm and extends the elbow, wrist and fingers

Positive Test
Complaints of discomfort along the medial aspect of the elbow

Positive Test Implications
Medial epicondylitis

Lateral Epicondylitis Test/Resistive Tennis Elbow Test/Cozen's Test

Steps

• Athlete is sitting
• Examiner stabilizes the involved elbow while palpating along the lateral epicondyle
• With closed fist, the athlete pronates and radially deviates the forearm and extends the wrist against the examiner's resistance

Positive Test
Pain along the lateral epicondyle region of the humerus or objective muscle weakness as a result of complaints of discomfort

Positive Test Implications
Lateral epicondylitis

Tinel's Sign Test

Steps

• Athlete is sitting with the elbow in slight flexion
• Examiner grasps athlete's wrist (laterally) with distal hand
• Examiner stabilizes the wrist and taps on the ulnar nerve in the ulnar notch with the index finger

Positive Test
Tingling along the ulnar distribution of the forearm, hand and fingers

Positive Test Implications
Ulnar nerve compromise

Varus Stress Test

Steps

• Athlete is sitting with elbow flexed to 20 to 30 degrees
• Examiner stands with the distal hand around the athlete's wrist (laterally) and the proximal hand over the athlete's elbow joint (medially)
• Examiner stabilizes the wrist and applies a varus stress to the elbow with the proximal hand

Positive Test
Lateral elbow pain and/or increased varus movement with diminished or absent endpoint

Positive Test Implications
Radial (lateral) collateral ligament sprain

Valgus Stress Test

Steps

• Athlete is sitting with the elbow flexed to 20 to 30 degrees
• Examiner stands with distal hand around the athlete's wrist (medially) and the proximal hand over the athlete's elbow joint (laterally)
• Examiner stabilizes the wrist and applies a valgus stress to the elbow with the proximal hand

Positive Test
Medial elbow pain and/or increased valgus movement with a diminished or absent endpoint

Positive Test Implications
Ulnar (medial) collateral ligament sprain

Lateral Epicondylitis Test/Passive Tennis Elbow Test (Cozen's Test)

Steps

• Athlete is sitting with elbow fully extended
• Examiner passively pronates the forearm and flexes the athlete's wrist

Positive Test
Pain along the lateral epicondyle region of the humerus

Positive Test Implications
Lateral epicondylitis

Pinch Grip Test

Steps

• Athlete is sitting or standing
• Examiner instructs athlete to pinch the tips of the thumb and index finger together

Positive Test
Inability to touch the tips of the thumb and index finger together or touching the pads of the thumb and index finger together

Positive Test Implications
Pathology of the anterior interosseous nerve between the two heads of the pronator muscle