Polk's Test

Welcome to Vrije Universiteit Brussel's Evidence-based Practice project. This space was created by and for the students in the Rehabilitation Sciences and Physiotherapy program of the Vrije Universiteit Brussel, Brussels, Belgium. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Sanne Delporte

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Search Strategy

I would recommend to consult PubMed. The keyword I used to become references were:
- 'Polk's test' (1 free full text) 

It’s also very helpful to check the references of each usable article.

Other sites to consult are Web of knowledge, Sholar.google.com and Books.google.com.

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_Epicondylitis 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 (level of quality D).

Clinically Relevant Anatomy

Wrist extensor group
- M. extensor digitorum
- M. extensor digiti minimi
- M. extensor carpi ulnaris
All these muscles have the same origin: the lateral epicondyle.

Wrist flexor group
- M. pronator teres
- M. flexore digitorum superficialis
- M. flexor carpi radialis
- M. flexor carpi ulnaris
- M. palmaris longus
All these muscles have the same origin: the medial epicondyle.

Purpose

The use of Polk’s test may help the clinician to diagnostically differentiate between Lateral_Epicondylitis en Medial_Epicondylitis, 2 of the most common causes of elbow pain.
Polk’s test also helps to definitively indentify the method of lifting that is best to be avoided by the patient (level of quality D).

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 an object, aggravates the tension on the primary affected muscle group with resulting mechanical strain at the inflamed musculotendinous attachment site (level of quality D).

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].

Key Research

add links and reviews of high quality evidence here (case studies should be added on new pages using the case study template)

Resources

add appropriate resources here

Clinical Bottom Line

add text here

Recent Related Research (from Pubmed)

see tutorial on Adding PubMed Feed

References

see adding references tutorial.