SPECIAL TESTS FOR

THE ELBOW
SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Handgrip Test

STRUCTURE: Median Nerve.

POSITION: The patient is seated; forearm supported on the table. The therapist is standing
with the stabilizing hand supporting the patient’s wrists.

APPLICATION: The therapist radially deviates the patient’s wrist (figure A). Repeat with wrist
in ulnar deviation (figure B). The therapist radially deviates patient’s wrist;
patient squeezes therapist’s hand. Repeat with wrist in ulnar deviation.

POSITIVE SIGN: Pain increases; grip strength decreases.

REFERENCE: C. p. 187-88

Figure A Figure B

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SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Pronator Teres Compression Test

STRUCTURE: Median Nerve involvement

POSITION: The patient is sitting with the elbow flexed and forearm fully supinated.The
therapist is standing or sitting

APPLICATION: The therapist resists pronation of forearm for 15-20 seconds.

POSITIVE SIGN: Weakness in pronation

REFERENCE: A. p. 164-165

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SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Lacertus Fibrosus Compression Test

STRUCTURE: If a radial head fracture is present this test will increase pain. Possible joint
dysfunction.

POSITION: The patient is sitting with the elbow flexed and forearm fully pronated.The
therapist is standing or sitting

APPLICATION: The therapist resists supination of the forearm.

POSITIVE SIGN: Limitation and pain with supination.

REFERENCE: A. p. 168-169

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SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Superficial Arch Compression Test

STRUCTURE: Median Nerve.

POSITION: The patient is sitting with the elbow flexed and forearm fully supinated; the
middle/long finger of the involved hand are slightly flexed at the PIP joint.
The therapist is standing/sitting in front of the patient.

APPLICATION: The therapist resists flexion of PIP joint of middle/long finger, holding for 15-20
seconds.

POSITIVE SIGN: Symptoms reproduced; weakness of flexor digitorum superficialis.

REFERENCE: G. p. 102
.

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SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Froment’s Sign

STRUCTURE: Ulnar nerve paralysis.

POSITION: The patient is sitting. The therapist is sitting or standing.

APPLICATION: Place a piece of paper between the patient’s index finger and thumb at the
level of the metacarpalphalangeal joints and have the patient squeeze hard.
The therapist attempts to pull the paper.

POSITIVE SIGN: The paper can be easily pulled out. The terminal phalanx of the thumb will flex
because of paralysis of the adductor pollicis muscle.

REFERENCE: A. p. 208-209
C. p. 194-195

Figure B

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SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Froment’s Pinch

STRUCTURE: Median Nerve/anterior interosseus nerve syndrome.

POSITION: The patient is seated. The therapist is standing next to the patient.Have the
patient make an “O” with thumb and distal phalanx of index finger; place a
sheet of paper between patient’s thumb and index finger.tanding.

APPLICATION: The therapist pulls paper away from patient’s hand.

POSITIVE SIGN: Distal phalanx of index finger collapses into hyperextension due to weakness of
the flexor pollicis longus and flexor digitorum profundus of the second finger.

REFERENCE: A. p. 206
C. p. 154
G. p. 96

ELB • 26 Copyright © 1998 by The Ola Grimsby Institute • 1.800.646.6128

SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Wartenberg’s Sign

STRUCTURE: Interosseous musculature. Positive test for ulnar nerve involvement.

POSITION: The patient is sitting with hands resting on the table.The therapist is standing/
sitting. The therapist passively abducts the patient’s fingers.

APPLICATION: Have the patient adduct the 2nd and 5th digits towards each other. Resist
adduction of the 2nd and 5th digits.

POSITIVE SIGN: Marked weakness of adduction of 2nd and 5th digits of the hand as compared to
the contralateral side.

REFERENCE: B. p. 79 ( without resistance)

C. p. 154

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SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Tinel Sign

STRUCTURE: Ulnar nerve. This test indicates the rate of regeneration of the sensory fibers of
the nerve.

POSITION: The patient is sitting with the affected elbow in an extended position.The
therapist is standing/sitting. The therapist's stabilizing hand supports the
wrist. The therapist's testing hand is on the medial aspect of the distal humerus
in the area of the ulnar nerve in the groove between the olecranon process and
the medial epicondyle.

APPLICATION: The ulnar nerve is tapped by the therapist in the groove between the olecranon
process and the medial epicondyle of the humerus.

POSITIVE SIGN: A tingling sensation occurs in the ulnar distribution of the forearm and the hand
distal to the point of compression of the nerve.

REFERENCE: A. p. 170-171
B. p. 56
C. p. 153

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SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Cozen’s Test (Test of epicondylitis)

STRUCTURE: Extensor Carpi Radialis Brevis

POSITION: The patient is sitting with the elbow flexed and the wrist held in pronated
position.The therapist is standing/sitting. The stabilizing hand is placed on the
posterior upper arm.

APPLICATION: The therapist resists wrist extension and radial deviation.

POSITIVE SIGN: Sudden severe pain in area of lateral epicondyle - (standard test for lateral
epicondylitis).

REFERENCE: A. p. 150-151
C. p. 151

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SPECIAL TESTS FOR THE ELBOW

SPECIAL TEST: Supratrochlear Lymph Node Palpation

STRUCTURE: Abnormalities of the Supratrochlear lymph nodes.

POSITION: The patient is sitting with the elbow flexed 90 degrees. The therapist is sitting/
standing

APPLICATION: The therapist pinches (with the thumb and index finger) 1 cm above the base of
the medial epicondyle. The node is palpable if it is enlarged.

POSITIVE SIGN: Lymph node will be enlarged and tender.

REFERENCE:
B. p. 45

ELB • 30 Copyright © 1998 by The Ola Grimsby Institute • 1.800.646.6128