The Elbow Exam Basics

Ulnar Collateral Ligament

Valgus Stress Test

  • Technique

    • Patient seated or standing

    • Examiner in front or to affected side of patient

    • Examiner places outside hand on the lateral aspect of the patient's elbow and stabilizes or gently presses toward patient.  The inside hand grasps the patient's wrist and pulls away from the patient.  This should be done with the forearm in supination and pronation.

    • A positive result occurs when the maneuver elicits pain and/or there is increased medial opening or valgus angle produced (greater than the opposite side). 

    • A negative result occurs when there is no pain or increase in laxity.

Radial Collateral Ligament

Varus Stress Test

  • Technique

    • Patient seated or standing

    • Examiner in front or to affected side of patient

    • Examiner places inside hand on the medial aspect of the patient's elbow and stabilizes or gently presses away from patient.  The outside hand grasps the patient's wrist and pulls toward from the patient.  This should be done with the forearm in supination and pronation.

    • A positive result occurs when the maneuver elicits pain and/or there is increased lateral opening or various angle produced (greater than the opposite side). 

    • A negative result occurs when there is no pain or increase in laxity.

Tennis Elbow Test

  • Technique

    • Patient seated or standing with the affected elbow fully extended, forearm pronated, and wrist fully extended

    • Examiner in front or to affected side of patient

    • Examiner applies resistance to wrist extension 

    • A positive result occurs when the maneuver elicits pain 

    • A negative result occurs when there is no pain is elicited by the maneuver

Golfer's Elbow Test

  • Technique

    • Patient seated or standing with the affected elbow fully extended, forearm supinated, and wrist fully flexed

    • Examiner in front or to affected side of patient

    • Examiner applies resistance to wrist flexion

    • A positive result occurs when the maneuver elicits pain 

    • A negative result occurs when there is no pain is elicited by the maneuver

 

Cubital Tunnel Syndrome/Ulnar neuropathy

Tinel's Test

  • Technique

    • Patient seated or standing with the affected elbow resting in flexion

    • Examiner in front or to affected side of patient

    • Examiner repeatedly taps over the ulnar nerve in the ulnar grooved with fingers or a reflex hammer

    • A positive result occurs when the maneuver elicits pain and/or recreation of symptoms in the elbow or down the arm to the ring or small fingers

    • A negative result occurs when there is no symptoms are elicited