Golfer’s Elbow Test: Difference between revisions

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'''Original Editor ''' - [[User:Tyler Schultz|Tyler Schultz]]<br>
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Original Editor -  
[[User:Tyler Shultz|Tyler Shultz]].


Lead Editors &nbsp;  
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} &nbsp;


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'''Edited April 2022''' - by [[User:Taylor Kittinger|Taylor Kittinger]] as part of the [[Arkansas Colleges of Health Education School of Physical Therapy Musculoskeletal 1 Project]]</div>


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== Purpose  ==
== Purpose  ==
The purpose of the Medial Epicondylalgia “Golfer’s Elbow” Test is to screen the patient for [[Medial Epicondylitis|medial epicondylalgia]] or "golfer[https://medisavvy.com/reverse-cozens-test/ ’]s elbow". 
== Clinical Presentation ==
Medial epicondylalgia is usually seen in those ages 35-55.<ref name=":0">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):[[Tel:993–1001|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<ref name=":0" />
|}
== Clinical Examination ==
[[File:Medial Epicondylitis.jpeg|330px|right]]
Findings on clinical examination include tenderness from the medial epicondyle to the pronator teres and flexor carpi radialis 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 epicondylalgia/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 epicondylalgia. 
'''Relevant Anatomy''' 
* [[Pronator Teres]]
* [[Flexor Carpi Radialis]]
* [[Palmaris Longus]]
* [[Flexor Digitorum Superficialis]]
* [[Flexor Carpi Ulnaris Muscle]] 
== Technique  ==
=== Passive Technique ===
'''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 passively supinates the patient[https://medisavvy.com/reverse-cozens-test/ ’]s forearm and fully extends the elbow, wrist and fingers.<ref name=":0" /><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 epicondylar region, the test is considered positive.<br>
{{#ev:youtube|TuqBS3d7cFs|250}}


The purpose of the Golfer's Elbow test is to screen the patient for medial epicondylalgia.<br>
=== Active Technique ===
'''Position:''' The patient can be seated or standing for this test.


== Technique<br> ==
'''Procedure:''' Patient actively flexes and pronates their wrist and forearm while the examiner resists this motion.<ref name=":0" />  


The patient can be seated or standing for this test.&nbsp; The therapist palpates the medial epicondyle and supports the elbow with one hand, while the other hand supinates the forearm and extends the wrist and elbow.<ref>Dutton, M. (2008). Orthopaedic: Examination, evaluation, and intervention (2nd ed.). New York: The McGraw-Hill Companies, Inc.</ref>&nbsp; If pain is reproduced in the area of the medial epicondyle, then this test is considered positive.<br>
'''Interpretation:''' If sudden pain or discomfort is reproduced along the medial epicondylar region, the test is considered positive.


{{#ev:youtube|u5H9iG8QhYA}}<ref>Physiotutors. Medial Epicondylitis Test⎟"Golfer's Elbow". Available from: https://www.youtube.com/watch?v=u5H9iG8QhYA</ref>
=== Special Considerations ===
Pain along the medial epicondylar region of the elbow may also be caused by structural damage to the [[Ulnar Nerve|ulnar nerve]], ulnar collateral nerve, or the ulnar collateral ligament. It is important to assess each of these structures prior to making any conclusions from this test alone. <ref>Konin JG, Lebsack D, Valier AS, Isear JA. Special tests for orthopedic examination. 4th ed. Thorofare: SLACK; 2015.</ref>


== Evidence  ==
== Evidence  ==
There are no current studies that provide diagnostic accuracy for the Medial Epicondylalgia “Golfer’s Elbow” Test. <ref>Zwerus EL, Somford MP, Maissan F, Heisen J, Eygendaal D, Van Den Bekerom MP. Physical examination of the elbow, what is the evidence? A systematic literature review. British journal of sports medicine. 2018 Oct 1;52(19):1253-60.</ref>


Provide the evidence for this technique here
== Resources  ==
Others tests to examine golfer's elbow:
* [https://medisavvy.com/reverse-cozens-test/ Reverse Cozen’s Test] ([[Cozen’s Test|Cozen­’s Test]])
* [[Polk's Test]]
* Diagnostic ultrasound <ref>Park GY, Lee SM, Lee MY. Diagnostic value of ultrasonography for clinical medial epicondylitis. Archives of physical medicine and rehabilitation. 2008 Apr 1;89(4):738-42.</ref>


== References<br> ==
== References  ==


<references />   
<references />   


[[Category:Special_Tests]]
[[Category:Special_Tests]]
[[Category:Assessment]]
[[Category:Elbow - Assessment and Examination]]
[[Category:Musculoskeletal/Orthopaedics]]
[[Category:Elbow]]
[[Category:Primary Contact]]
[[Category:Sports Medicine]]
[[Category:Athlete Assessment]]
[[Category:Elbow - Special Tests]]
[[Category:Arkansas Colleges of Health Education School of Physical Therapy Musculoskeletal 1 Project]]

Latest revision as of 16:51, 31 January 2024

Original Editor - Tyler Schultz

Top Contributors - Saimat Lachinova, Kim Jackson, Rachael Lowe, Taylor Kittinger, Admin, Cindy John-Chu, Aminat Abolade, Mohit Chand, Tony Lowe, Tyler Shultz, George Prudden, Sweta Christian, Kai A. Sigel, Claire Knott, Wanda van Niekerk and Amanda Ager  

Edited April 2022 - by Taylor Kittinger as part of the Arkansas Colleges of Health Education School of Physical Therapy Musculoskeletal 1 Project


Purpose[edit | edit source]

The purpose of the Medial Epicondylalgia “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[1]

Clinical Examination[edit | edit source]

Medial Epicondylitis.jpeg

Findings on clinical examination include tenderness from the medial epicondyle to the pronator teres and flexor carpi radialis muscles.[5] Pain may indicate medial epicondylalgia/golfer’s elbow.[6] In addition to tenderness, provocative special test is employed to assess for medial epicondylalgia. 

Relevant Anatomy

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 passively supinates the patient’s forearm and fully extends the elbow, wrist and fingers.[1][7] 

Interpretation: If sudden pain or discomfort is reproduced along the medial epicondylar region, the test is considered positive.

Active Technique[edit | edit source]

Position: The patient can be seated or standing for this test.

Procedure: Patient actively flexes and pronates their wrist and forearm while the examiner resists this motion.[1]

Interpretation: If sudden pain or discomfort is reproduced along the medial epicondylar region, the test is considered positive.

Special Considerations[edit | edit source]

Pain along the medial epicondylar region of the elbow may also be caused by structural damage to the ulnar nerve, ulnar collateral nerve, or the ulnar collateral ligament. It is important to assess each of these structures prior to making any conclusions from this test alone. [8]

Evidence[edit | edit source]

There are no current studies that provide diagnostic accuracy for the Medial Epicondylalgia “Golfer’s Elbow” Test. [9]

Resources[edit | edit source]

Others tests to examine golfer's elbow:

References[edit | edit source]

  1. ↑ 1.0 1.1 1.2 1.3 Dutton M, Dutton's Orthopaedic Examination, Evaluation, and Intervention. 5th ed. New York: McGraw Hill; c2020.
  2. ↑ Hayter CL, Giuffre BM. Overuse and traumatic injuries of the elbow. Magnetic Resonance Imaging Clinics. 2009 Nov 1;17(4):617-38.
  3. ↑ 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
  4. ↑ 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):[[1]]. Available from: http://dx.doi.org/10.1097/01.jom.0000085888.37273.d9
  5. ↑ Chumbley EM, O'Connor FG, Nirschl RP. Evaluation of overuse elbow injuries. American Family Physician. 2000 Feb 1;61(3):691-700.
  6. ↑ Copas, D.,Talbot, J. C. Clinical assessment of the elbow. J Orthop Trauma., 2016; 30(4): 291-300.
  7. ↑ Magee, D. J. Orthopedic Physical Assesment E-book. 6th ed. Elsevier Health Sciences, 2014.
  8. ↑ Konin JG, Lebsack D, Valier AS, Isear JA. Special tests for orthopedic examination. 4th ed. Thorofare: SLACK; 2015.
  9. ↑ Zwerus EL, Somford MP, Maissan F, Heisen J, Eygendaal D, Van Den Bekerom MP. Physical examination of the elbow, what is the evidence? A systematic literature review. British journal of sports medicine. 2018 Oct 1;52(19):1253-60.
  10. ↑ Park GY, Lee SM, Lee MY. Diagnostic value of ultrasonography for clinical medial epicondylitis. Archives of physical medicine and rehabilitation. 2008 Apr 1;89(4):738-42.
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