Purpose: UCL sprain/tear
How to perform:
Pt is sitting or standing with arms in anatomical position
Examiner than takes the pt’s arm and locks the elbow in extension
Examiner than takes 1 hand cupping it the elbow with the butt of their hand around the lat elbow. The other hand is on the medial side of the forearm
Examiner then applies a valgus force to the elbow when the pt is in 0° and 25°
(+): increased laxity &/or soft end feel &/or pain = Means: UCL sprain or tear
(-): no increased laxity &/or soft end feel &/or pain = Means: no UCL sprain or tear
Purpose: UCL sprain/tear
How to perform:
Pt sitting or standing with arm and 90° and elbow fully flexed
Examiner has 1 hand supporting underneath elbow and other hand is @ wrist
Hand holding elbow pushes elbow anteriorly while the hand at the wrist will slowly ext elbow as the elbow is being pushed anteriorly
(+): reproduction of max pain b/w 120° to 70° = Means: UCL sprain or tear
(-): no reproduction of max pain b/w 120° to 70° = Means: no UCL sprain or tear
Purpose: UCL sprain/tear
How to perform:
Pt is sitting with arm in 70° scaption with elbow in 70° flexion with forearm supinated
Examiner or pt holds/supports under the pt’s triceps
Examiner then grasps the pt’s thumb to pull back and down impairing valgus stress to elbow
(+): reproduction of symptoms &/or pain = Means: UCL sprain or tear
(-): no reproduction of symptoms &/or pain = Means: no UCL sprain or tear
Purpose: RCL sprain/tear
How to perform:
Pt sitting/standing with arms in anatomical position
Examiner than palpates to find RCL by cupping elbow with other hand on lateral side of forearm
Examiner then applies a varus force to elbow when the elbow is @ 0° and 15° of flexion
(+): increased laxity &/or soft end feel &/or pain = Means: RCL sprain/tear
(-): no increased laxity &/or soft end feel &/or pain = Means: no RCL sprain or tear
Purpose: common extensor tendinitis
How to perform:
ACTIVE test
Pt is in 90° elbow flx with arm by side, palm up in a fist
Examiner will place both hands around both sides of fist
Examiner will apply resistance as pt tries to pronate fist to radial deviation and finally to wrist extension
(+): pressure felt @ insertion and origin of extensors = Indicates common extensor tendinitis
(-): no pressure felt @ insertion and origin of extensors = Means: no common extensor tendinitis
Purpose: common extensor tendinitis
How to perform:
PASSIVE test
Pt is in 90° elbow flx with arm @ side with palm up relaxed
Examiner then passively pronates tested forearm then flexes the wrist to flexing the fingers and then finally to extend elbow
(+): point tenderness @ lateral epicondyle = Indicates common extensor tendinitis
(-): no point tenderness @ lateral epicondyle = Means no common extensor tendinitis
Purpose: common extensor tendinitis
How to perform:
Pt has affected elbow extended
Examiner then resists the 3rd digit as pt tries to extend
(+): reproduction of pain = Indicates common extensor tendinitis
(-): no reproduction of pain = Means no common extensor tendinitis
Purpose: common flexor tendinitis
How to perform:
PASSIVE test
Pt is sitting or standing relaxed with 90° elbow flx and palm down
Examiner then passively supinates forearm then extends wrist to extending the fingers and finally extending the elbows
(+): pain @ medial epicondyle = Indicates common flexor tendinitis
(-): no pain @ medial epicondyle = Means no common extensor tendinitis
Purpose: ulnar n pathology
How to perform:
Pt stands/sits with hand flat on table palm side down
Pt is instructed to spread fingers out as far as they can then to bring them back in
(+): inability to adduct pinky to remainder of hand after abduction of fingers = Indicates ulnar n pathology
(-): able to adduct pinky to remainder of hand after abduction of fingers = Means no ulnar n pathology
Purpose: ulnar n entrapment/cubital tunnel syndrome
How to perform:
Pt is standing or sitting
Pt then fully flexes elbow, extends the wrist, then has shoulder at 90° abduction + depression.
Pt holds position for up to 3-5 min
(+): tingling or paresthesia in ulnar n distribution of forearm & hand = Indicates ulnar n entrapment/cubital tunnel syndrome
(-): no tingling or paresthesia in ulnar n distribution of forearm & hand = Means no ulnar n entrapment/cubital tunnel syndrome
Purpose: anterior interosseus n pathology
How to perform:
Pt takes their index finger and thumb to create a pulp to pulp pinch
The with maintaining contact w/ both fingers, the pt goes from a pulp to pulp pinch to a tip to tip of the finger pinch
(+): Inability to pinch tip to tip from pulp to pulp pinch -= interosseous n pathology
(-): Inability to pinch tip to tip from pulp to pulp pinch = Means no anterior n pathology
Purpose: median n entrapment
How to perform:
Pt is sitting or standing with elbow fixed 90° arm next to body and hand in a hand shaking position
Pt then tries to pronate against examiner resistance and the examiner trying to pull him out of it
(+): unable to maintain position = Indicates median n entrapment
(-): able to maintain position = Means no median n entrapment
Purpose: fx
How to perform:
Just like Pott’s compression test
Pt is standing sitting with arms relaxed at side or on table
Examiner then applies a compressive force on both sides of pt
S forearm to elbow going up an down
(+): recreation of pain or point tenderness while compression is applied = Indicates possible fx
(-): No recreation of pain or point tenderness while compression is applied = Means no fx present
Purpose: biceps rupture
How to perform: Pt is sitting with shoulder abducted 90° and elbow flexed to 90° and arm supinated with thumb up position
Pt actively supinates forearm against resistance, the examiner then tries with their index finger to hook underneath distal biceps tendon
(+): no distal biceps tendon is found to be hooked = Indicates biceps rupture
(-): distal biceps tendon is found and is able to be hooked = Means no biceps rupture
Purpose: biceps rupture
How to perform:
Pt is sitting with arm resting slighltly pronated
Examiner then squeezes the MTJ of biceps
Examiner looks for slight supination rxn to the squeeze
(+): no mvt of supination when biceps MTJ is squeezed = Indicates biceps rupture
(-): supination occurs as biceps MTJ is squeezed = Means no biceps rupture
Purpose: posterolateral instability
How to perform:
Pt is prone on table or ground
Pt is then told to perform a push up off the table
(+): apprehension to push up/unable to/reproduction of pain = Indicates posterolateral instability of the elbow
(-): no apprehension to push up/unable to/reproduction of pain = Means no posterolateral instability of the elbow present