elbow special tests Flashcards
valgus stress
purpose: test integrity of ulnar collateral ligament
pt. pos.: seated with arms in anatomical position
prac. pos.: standing in front of pt. supporting arm, one hand at lateral elbow and other is placed on medial distal arm near wrist
procedure: valus stress is applied to elbow at 0 and at 30 degrees of flexion
positive: increased valgus movement with a diminished or absent end point
varus stress
purpose: test integrity of radial collateral ligament
pt. pos.: seated with arms in anatomical position
prac. pos.: standing in front of pt. supporting arm, one hand at lateral elbow and other is placed on medial distal arm near wrist
procedure: varus stress is applied to elbow at 0 and at 30 degrees of flexion
positive: increased varus movement with a diminished or absent end point
cozen’s test
purpose: lateral epicondylitis
pt. pos.: seated next to table, wrist and hand hanging off the edge. hand in a fist, pronated and radial deviated
prac. pos.: seated opposite pt. one hand stabilizing arm, other on dorsal hand resisting movement
procedure: pt moves into extension, supination, and ulnar deviation against resistance
positive: pain along lateral epicondyle of humerus; general muscular weakness and discomfort in the lateral elbow
Mill’s test
purpose: lateral epicondylitis
pt. pos.: standing or sitting
prac. pos.: standing next to pt., one hand on the elbow and the other on the posterior hand
procedure: forearm is passively pronated, radially deviated and wrist flexed and the elbow is taken into extension
positive: pain over the lateral epicondyle
Maudley’s test
purpose: lateral epicondylitis
pt. pos.: seated with hand flat on table
prac. pos.: seated next to pt. wit one finger over the pt.’s middle finger
procedure: instruct pt to extend middle finger against resistance
positive: pain over lateral epicondyle
Kaplan’s sign
purpose: lateral epicondylitis
pt. pos.: standing or sitting, elbow slightly flexed, forearm neutral and wrist slightly extended
prac. pos.: standing in front of pt. two fingers in the pt. hand
procedure: have the pt. grasp your two fingers or a dynamometer, put a strap or have someone constrict the forearm 1-2 inches distal to the elbow and recheck grip
positive: a decreased in pain and/ or an increase in grip strength following the strap
milking sign
purpose: test the integrity of the ulnar collateral ligament
pt. pos.: shoulder and elbow flexion with thumb pointing down. (as if reaching behind the head)
prac. pos.: standing behind pt. holding pt. thumb
procedure: apply a downward force to pt.’s thumb
positive: pain on the medial joint line
Andrew’s UCL test
purpose: determine integrity and laxity of the ulnar collateral ligament
pt. pos.: seated, facing away from the prac. shoulder is abducted and externally rotated, elbow fully flexed
prac. pos.: standing behind pt. one hand on the elbow (thumb on UCL) and other on the wrist
procedure: PT. is instructed to extend the elbow while the prac. provides a valgus force at the elbow
positive: pain and/or laxity at any point in the ROM
Table top Test
purpose: determine integrity and laxity of the ulnar and radial collateral ligament
pt. pos.: standing facing away from the table. forearm is supinated and shoulder externally rotated. arm is placed flat against the table
prac. pos.: stading to the side of the table. both hands placed around the elbow
procedure: prac. takes elbow into both valgus and varus forces
positive:
golfer’s elbow (medial epicondylitis Test #1
purpose: medial epicondylitis
pt. pos.: forearm supinated with wrist and elbow in extension and hand hanging off the end of the table
prac. pos.: standing next to pt.
procedure: pt. is instructed to pronate and flex wrist against resistance. opposite of Mill’s test
positive: pain in medial epicondyle region of humerus
Golfer’s elbow (medial epicondylitis) Test #2
purpose: medial epicondylitis
pt. pos.: forearm supinated with wrist in extension
prac. pos.: standing next to pt. hand on maintaining supination and wrist flexion
procedure: pt. is instructed to extend the elbow with arm in supination and wrist flexion
positive: pain in medial epicondyle region of humerus
bicep squeeze test
purpose: potential bicep rupture
pt. pos.: seated with arm resting in lap at approx. 60-80 degrees of flexion and arm in pronation
prac. pos.: standing or seated next to pt. with one hand over the musculotendinous juncture of the bicep and the other on the belly of the muscle
procedure: squeezing with both hands along the bicep
positive: if the arm does not supinate= indicative of a bicep rupture
tinel’s sign
purpose: determine abnormal pathology of a nerve, particularly the ulnar nerve
pt. pos.: seated or standing with elbow in slight flexion
prac. pos.: standing next to pt. supporting distal arm
procedure: while supporting distal arm, tap the ulnar nerve on the ulnar notch with index finger
positive: tinging along ulnar nerve distribution in forearm, hand, or fingers
wartenberg sign
purpose: test for ulnar nerve problem
pt. pos.: sitting with hands on table
prac. pos.: sitting across from pt.
procedure: instruct pt. to abduct fingers then bring them back together
positive: inability to adduct little finger is indicative of a ulnar nerve pathology
elbow flexion
purpose: cubital tunnel syndrome
pt. pos.: standin or sitting, with elbows in flexion and wrists extended
prac. pos.: sitting across from pt.
procedure: instruct pt. to hold position of full elbow flexion and wrist extension for 3-5 minutes
positive: numbness, tingling indicative of cubital tunnel syndrome (typically last finger and 1/2)
