Polk's Test

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Original Editors - Sanne Delporte

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Definition/Description

Polk’s test is an easy to learn, easy to perform and simple to interpret test that can help the clinician differentiate between lateral and medial epicondylitis.
It aids the clinician in establishing a working diagnosis and also serves as an educational tool for the patient in helping them to better understand their condition and avoid the specific activities that aggravate the injury [1].

Clinically Relevant Anatomy

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Purpose

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Technique

With the patient seated with the elbow flexed, the patient is instructed to lift an object of approximately 2,5 kg. For the purposes of the test, most any suitable object will prove adequate. An appropriately weighted sand bag, hand weight, heavy purse or thick book will usually suffice fot the purpose at hand [1].

The test is performed in 2 separate phases.

Phase 1: diagnosis of lateral epicondylitis
The patient graps the object with the palm facing the floor (pronation of the forearm) and is instructed to attempted to lift it up. Pain produced in the elbow, typically in the region of the lateral epicondyle, upon this maneuver is suggestive of lateral epicondylitis.
In absence of lateral epicondylitis however, the patient usually performs this maneuver quite easy and without pain [1].

Phase 2: diagnosis of medial epicondylitis
This phase involves the seated patient , with flexed elbow, grasping the object with the palm up (supination of the forearm) and attempting to lift the object. Elbow pain, usually in the region of the medial epicondyle, produced with this maneuver is suggestive of medial epicondylitis.
In absence of medial epicondyilits, the patient performs this maneuver quite comfortably [1].

The mechanism of the Polk’s test is very straightforward. When the hand grasps an object, tension is placed on both the flexors and the extensors of the wrist. The motion of lifting the object, aggravates the tension on the primary affected muscle group with resulting mechanical strain at the inflamed musculotendinous attachment site [1].

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Clinical Bottom Line

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Recent Related Research (from Pubmed)

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