Resisted wrist extension test
Resisting wrist extension with the elbow straight reproduces pain at the outer elbow in tennis elbow, helping confirm the tendon as the pain source.
Elbow assessment typically starts with a history of activity, grip demands, and symptom pattern, followed by palpation of the epicondyles and observation of active and passive range of motion.
Provocative tests that load the extensor or flexor tendons, along with nerve-specific tests, help confirm the likely source of symptoms among the joint, tendons, or nerve.
Assessment tests
Resisted wrist flexion test
Resisting wrist flexion with the elbow straight reproduces pain at the inner elbow in golfer's elbow.
Tinel's sign at the elbow
Tapping over the ulnar nerve behind the inner elbow that reproduces tingling in the ring and little fingers suggests nerve irritation.
Elbow flexion test
Holding the elbow fully bent for a period and noting whether it reproduces numbness or tingling helps support a diagnosis of ulnar nerve compression.
Valgus stress test
Applying a gentle outward-bending stress to the elbow evaluates the integrity of the inner ligament, particularly relevant in throwing athletes.
Red flags
These warrant prompt clinical review rather than unsupervised exercise progression.
Visible deformity after trauma
An obvious change in the elbow's shape following a fall or direct blow raises concern for fracture or dislocation and warrants urgent evaluation.
Inability to move the elbow after injury
A sudden loss of the ability to bend or straighten the elbow after trauma should be assessed promptly.
Rapidly spreading redness and warmth
Signs of spreading infection around a swollen elbow, especially with fever, require urgent medical attention.
Progressive hand weakness or muscle wasting
Worsening weakness or visible muscle loss in the hand can indicate significant nerve compression and warrants further evaluation.
This combination of history, palpation, and provocative testing generally allows clinicians to distinguish tendon, nerve, ligament, and joint sources of elbow pain without requiring imaging in most straightforward cases.
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