Golfer’s Elbow Test: Difference between revisions
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== Purpose == | == Purpose == | ||
The purpose of the Medial Epicondylitis (Golfer[https://medisavvy.com/reverse-cozens-test/ ’]s Elbow) Test is to screen the patient for [[Medial Epicondylitis|medial epicondylalgia]] or "golfer[https://medisavvy.com/reverse-cozens-test/ ’]s elbow". < | The purpose of the Medial Epicondylitis (Golfer[https://medisavvy.com/reverse-cozens-test/ ’]s Elbow) Test is to screen the patient for [[Medial Epicondylitis|medial epicondylalgia]] or "golfer[https://medisavvy.com/reverse-cozens-test/ ’]s elbow". | ||
== Clinical | |||
== Clinical Presentation == | |||
Medial epicondylalgia is usually seen in those ages 35-55.<ref>Dutton M, Dutton's Orthopaedic Examination, Evaluation, and Intervention. 5th ed. New York: McGraw Hill; c2020.</ref> Patients report medial elbow and proximal forearm pain with activities requiring wrist flexion and forearm pronation. The condition is seen in athletes who are involved in sports that require repetitive valgus and flexion at the elbow, such as golfers, tennis players, swimmers, pitchers, and javelin throwers.<ref>Hayter CL, Giuffre BM. Overuse and traumatic injuries of the elbow. Magnetic Resonance Imaging Clinics. 2009 Nov 1;17(4):617-38.</ref> <ref>Cappadona JG, Pearce DA, Ciccotti MG. Tennis and golfer’s elbow: a 2-sided challenge; tests that reproduce symptoms help to confirm the diagnosis. J Musculoskelet Med [Internet]. 2002;19:330+. Available from: <nowiki>https://go.gale.com/ps/i.do?p=AONE&u=googlescholar&id=GALE%7CA90792204&v=2.1&it=r&sid=AONE&asid=5abc6471</nowiki></ref> This condition can also present in individuals with repetitive occupational tasks such as lifting and passing heavy objects. <ref>Descatha A, Leclerc A, Chastang JF, Roquelaure Y, Study Group on Repetitive Work. Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors. J Occup Environ Med [Internet]. 2003;45(9):993–1001. Available from: <nowiki>http://dx.doi.org/10.1097/01.jom.0000085888.37273.d9</nowiki></ref> | |||
{| class="wikitable" | |||
|Age | |||
|Mechanism of Injury | |||
|Area of Symptoms | |||
|Symptoms | |||
|Observations | |||
|- | |||
|35-55 | |||
|Gradual overuse or direct trauma | |||
|Anteromedial aspect of elbow at proximal attachment of the wrist flexor mass | |||
|Aggravated by activities involving wrist flexion and pronation | |||
|Possible swelling over medial elbow | |||
|} | |||
== Clinical Examination == | |||
[[File:Medial Epicondylitis.jpeg|330px|right]] | [[File:Medial Epicondylitis.jpeg|330px|right]] | ||
Findings on clinical examination include tenderness | Findings on clinical examination include tenderness from the medial epicondyle to the pronator teres and flexor carpi radial muscles.<ref>Chumbley EM, O'Connor FG, Nirschl RP. Evaluation of overuse elbow injuries. American Family Physician. 2000 Feb 1;61(3):691-700.</ref> Pain may indicate medial epicondylitis/golfer[https://medisavvy.com/reverse-cozens-test/ ’]s elbow.<ref>Copas, D.,Talbot, J. C. [https://www.sciencedirect.com/science/article/pii/S1877132716300422 Clinical assessment of the elbow.] J Orthop Trauma., 2016; 30(4): 291-300.</ref> In addition to tenderness, provocative special test is employed to assess for medial epicondylitis. | ||
'''Relevant Anatomy''' | '''Relevant Anatomy''' | ||
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'''Procedure:''' The therapist palpates the medial epicondyle and supports the elbow with one hand, while the other hand passivelly supinates the patient[https://medisavvy.com/reverse-cozens-test/ ’]s forearm and fully extends the elbow, wrist and fingers.<ref>Dutton, M. Orthopaedic: [https://www.amazon.com/Orthopaedic-Examination-Evaluation-Intervention-Hardcover/dp/B00BT0022G Examination, evaluation, and intervention.] 2nd ed. New York: The McGraw-Hill Companies, Inc, 2008.</ref><ref>Magee, D. J. [https://books.google.lv/books?id=_wcyAgAAQBAJ&printsec=frontcover&hl=ru#v=onepage&q&f=false Orthopedic Physical Assesment E-book.] 6th ed. Elsevier Health Sciences, 2014.</ref> | '''Procedure:''' The therapist palpates the medial epicondyle and supports the elbow with one hand, while the other hand passivelly supinates the patient[https://medisavvy.com/reverse-cozens-test/ ’]s forearm and fully extends the elbow, wrist and fingers.<ref>Dutton, M. Orthopaedic: [https://www.amazon.com/Orthopaedic-Examination-Evaluation-Intervention-Hardcover/dp/B00BT0022G Examination, evaluation, and intervention.] 2nd ed. New York: The McGraw-Hill Companies, Inc, 2008.</ref><ref>Magee, D. J. [https://books.google.lv/books?id=_wcyAgAAQBAJ&printsec=frontcover&hl=ru#v=onepage&q&f=false Orthopedic Physical Assesment E-book.] 6th ed. Elsevier Health Sciences, 2014.</ref> | ||
'''Interpretation:''' If sudden pain or discomfort is reproduced along the medial aspect of the elbow in the region of the medial epicondyle, | '''Interpretation:''' If sudden pain or discomfort is reproduced along the medial aspect of the elbow in the region of the medial epicondyle, this test is considered positive.<br> | ||
{{#ev:youtube|TuqBS3d7cFs|250}} | {{#ev:youtube|TuqBS3d7cFs|250}} | ||
Revision as of 20:57, 14 April 2022
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Purpose[edit | edit source]
The purpose of the Medial Epicondylitis (Golfer’s Elbow) Test is to screen the patient for medial epicondylalgia or "golfer’s elbow".
Clinical Presentation[edit | edit source]
Medial epicondylalgia is usually seen in those ages 35-55.[1] Patients report medial elbow and proximal forearm pain with activities requiring wrist flexion and forearm pronation. The condition is seen in athletes who are involved in sports that require repetitive valgus and flexion at the elbow, such as golfers, tennis players, swimmers, pitchers, and javelin throwers.[2] [3] This condition can also present in individuals with repetitive occupational tasks such as lifting and passing heavy objects. [4]
| Age | Mechanism of Injury | Area of Symptoms | Symptoms | Observations |
| 35-55 | Gradual overuse or direct trauma | Anteromedial aspect of elbow at proximal attachment of the wrist flexor mass | Aggravated by activities involving wrist flexion and pronation | Possible swelling over medial elbow |
Clinical Examination[edit | edit source]
Findings on clinical examination include tenderness from the medial epicondyle to the pronator teres and flexor carpi radial muscles.[5] Pain may indicate medial epicondylitis/golfer’s elbow.[6] In addition to tenderness, provocative special test is employed to assess for medial epicondylitis.
Relevant Anatomy
- Pronator Teres
- Flexor Carpi Radialis
- Palmaris Longus
- Flexor Digitorum Superficialis
- Flexor Carpi Ulnaris Muscle
Technique[edit | edit source]
Passive Technique[edit | edit source]
Position: The patient can be seated or standing for this test.
Procedure: The therapist palpates the medial epicondyle and supports the elbow with one hand, while the other hand passivelly supinates the patient’s forearm and fully extends the elbow, wrist and fingers.[7][8]
Interpretation: If sudden pain or discomfort is reproduced along the medial aspect of the elbow in the region of the medial epicondyle, this test is considered positive.
Active Technique[edit | edit source]
Position: The patient seated for this test.
Procedure: Patient flex the elbow, turns the hand palm up (forearm supination). The examiner then grasps the patient’s wrist and elbow and attempts to straighten out the elbow (forced extension) against the patient’s resistance (resisted elbow-wrist flexion). [9]
Interpretation: If sudden pain or discomfort is reproduced along the medial aspect of the elbow in the region of the medial epicondyle, then this test is considered positive.
Evidence[edit | edit source]
No studies on diagnostic accuracy for medial epicondylitis test were found.
Resources[edit | edit source]
Others tests to examine golfer's elbow:
References[edit | edit source]
- ↑ Dutton M, Dutton's Orthopaedic Examination, Evaluation, and Intervention. 5th ed. New York: McGraw Hill; c2020.
- ↑ Hayter CL, Giuffre BM. Overuse and traumatic injuries of the elbow. Magnetic Resonance Imaging Clinics. 2009 Nov 1;17(4):617-38.
- ↑ Cappadona JG, Pearce DA, Ciccotti MG. Tennis and golfer’s elbow: a 2-sided challenge; tests that reproduce symptoms help to confirm the diagnosis. J Musculoskelet Med [Internet]. 2002;19:330+. Available from: https://go.gale.com/ps/i.do?p=AONE&u=googlescholar&id=GALE%7CA90792204&v=2.1&it=r&sid=AONE&asid=5abc6471
- ↑ Descatha A, Leclerc A, Chastang JF, Roquelaure Y, Study Group on Repetitive Work. Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors. J Occup Environ Med [Internet]. 2003;45(9):993–1001. Available from: http://dx.doi.org/10.1097/01.jom.0000085888.37273.d9
- ↑ Chumbley EM, O'Connor FG, Nirschl RP. Evaluation of overuse elbow injuries. American Family Physician. 2000 Feb 1;61(3):691-700.
- ↑ Copas, D.,Talbot, J. C. Clinical assessment of the elbow. J Orthop Trauma., 2016; 30(4): 291-300.
- ↑ Dutton, M. Orthopaedic: Examination, evaluation, and intervention. 2nd ed. New York: The McGraw-Hill Companies, Inc, 2008.
- ↑ Magee, D. J. Orthopedic Physical Assesment E-book. 6th ed. Elsevier Health Sciences, 2014.
- ↑ Polkinghorn, B. S. A novel method for assessing elbow pain resulting from epicondylitis. J Chiropr Med, 2002; 1(3):117-121.
