Kin 1-Lateral and Medial Epicondylalgia

Cozen’s Test

• Purpose: Lateral Epicondylitis

• Procedure:

  • Start with Pt’s elbow in flexion

  • Ask Pt to pinpoint pain (palpate as reference marker—should be lateral epicondyle)

  • Pt make a fist, extend wrist, radially deviate

  • PT tries to pull Pt into wrist flexion + ulnar deviation

  • If no pain, increase intensity by extending the arm, repeat procedure

• Positive Test: Reproduction of pain at lateral epicondyle

Maudsley’s Test

• Purpose: Lateral Epicondylitis

• Procedure:

  • Ask Pt to pinpoint pain (palpate as reference marker—should be lateral epicondyle)

  • Pt seated with 90 degrees shoulder flexion, elbow extended, forearm pronated, fingers extended 

  • Stabilize forearm (at elbow) and use other hand to apply resistance at the DIP of the third finger (into flexion)

• Positive Test: Reproduction of pain at lateral epicondyle

Mill’s Test

• Purpose: Lateral Epicondylitis

• Procedure:

  • Ask Pt to pinpoint pain (palpate as reference marker—should be lateral epicondyle)

  • Pt seated with elbow flexed and ~70 degrees shoulder ABD

  • Stabilize forearm (at elbow)

  • Passively flex wrist, then ulnarly deviate

  • If no pain, increase intensity by extending the arm and flexing the shoulder to ~90 degrees, repeat procedure

• Positive Test: Reproduction of pain at lateral epicondyle

Dynamic/Moving Valgus Stress Test

• Purpose: MCL/LCL Integrity/Stability

• Procedure:

  • Pt seated with elbow flexed (90 degrees), arm ABDucted 90 degrees, externally rotated 90 degrees

  • Pt’s palm facing head

  • PT standing behind Pt’s  arm, hand behind Pt’s arm and other hand on wrist

  • Apply pressure on arm forward and pressure on wrist back toward you

  • Test patient from 70-120 degrees elbow flexion

• Positive Test: No end feel or increased laxity

Valgus Stress Test

• Purpose: Medial Collateral Ligament Stability/Integrity

• Procedure:

  • Pt lying supine with PT on inside of Pt’s axilla

  • Unlock elbow 20-30 degrees

  • Palpate joint line (where ulna meets radius)

  • Stabilize distally and apply valgus force (elbow toward body, wrist away)

• Positive Test: No end feel or increased laxity

Varus Stress Test

• Purpose: Lateral Collateral Ligament Stability/Integrity

• Procedure:

  • Pt lying supine with PT on inside of Pt’s axilla

  • Unlock elbow 20-30 degrees

  • Palpate joint line (where ulna meets radius)

  • Stabilize distally and apply varus force (elbow away from body, wrist toward)

• Positive Test: No end feel or increased laxity

Golfer’s Elbow Test

• Purpose: Medial Epicondylitis

• Procedure:

  • Passive:

    • Pt seated with arm resting on table with hand hanging off

    • Pt flexes elbow to 90 degrees with forearm supinated

    • Pt grabs thumb and flexes wrist

    • PT stabilizes forearm and grab metacarpals and then pull Pt into wrist extension/radial deviation

• Positive Test: Reproduction of pain at medial epicondyle