Special Tests

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
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Steps: Athlete is sitting with elbow in relaxed position supported by table; Examiner stabilizes involved elbow with one hand and places the palm of the other hand on the dorsal espect of the patients hand just distal to the proximal interphalangeal joint of the third digit
Positive Test: Pain along the lateral epicondyle region of the humerus or objective muscle weakness
Positive Test Implications: Lateral epicondylitis
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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
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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
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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

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
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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
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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
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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
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