Golfer’s Elbow Test: Difference between revisions
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'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} </div> | '''Original Editor ''' - [[User:Tyler Schultz|Tyler Schultz]]<br> | ||
'''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}} | |||
'''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> | |||
<br> | <br> | ||
== Purpose == | == Purpose == | ||
The purpose of the Medial | 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 | |||
== 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]] | [[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 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 == | == Technique == | ||
| Line 16: | Line 50: | ||
'''Position:''' The patient can be seated or standing for this test. | '''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 | '''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 | '''Interpretation:''' If sudden pain or discomfort is reproduced along the medial epicondylar region, the test is considered positive.<br> | ||
{{#ev:youtube| | |||
{{#ev:youtube|TuqBS3d7cFs|250}} | |||
=== Active Technique === | === Active Technique === | ||
'''Position:''' The patient seated for this test. | '''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.<ref name=":0" /> | |||
''' | '''Interpretation:''' If sudden pain or discomfort is reproduced along the medial epicondylar region, the test is considered positive. | ||
=== 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> | |||
== Resources == | == Resources == | ||
Others tests to examine golfer's elbow: | Others tests to examine golfer's elbow: | ||
* [https://medisavvy.com/reverse-cozens-test/ Reverse Cozen’s Test] ([[Cozen’s Test|Cozen’s Test]]) | * [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 == | == References == | ||
| Line 40: | Line 80: | ||
[[Category:Special_Tests]] | [[Category:Special_Tests]] | ||
[[Category:Assessment]] | [[Category:Assessment]] | ||
[[Category:Elbow - Assessment and Examination]] | |||
[[Category:Musculoskeletal/Orthopaedics]] | [[Category:Musculoskeletal/Orthopaedics]] | ||
[[Category:Elbow]] | [[Category:Elbow]] | ||
[[Category: | [[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, Aminat Abolade, Cindy John-Chu, 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]
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
- 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 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:
- Reverse Cozen’s Test (Cozen’s Test)
- Polk's Test
- Diagnostic ultrasound [10]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 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):[[1]]. 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.
- ↑ Magee, D. J. Orthopedic Physical Assesment E-book. 6th ed. Elsevier Health Sciences, 2014.
- ↑ Konin JG, Lebsack D, Valier AS, Isear JA. Special tests for orthopedic examination. 4th ed. Thorofare: SLACK; 2015.
- ↑ 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.
- ↑ 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.
