What is the protocol for the tennis elbow test?

What is the protocol for the tennis elbow test?

• A. With elbow extended and forearm pronated, resisted wrist or middle finger extension is applied
• B. With elbow extended and forearm pronated, resisted wrist extension is applied
• C. With elbow extended and forearm supinated, resisted elbow flexion
• D. With elbow extended and forearm neutral, resisted finger flexion

Answer: (A)

This test assesses lateral epicondylitis by stressing the wrist extensor tendons at the outer elbow. Position the elbow with it extended and the forearm pronated (palm down). Then have the patient try to extend the wrist against resistance (and the same resistance may be applied to the middle finger as well). If this reproduces pain around the lateral epicondyle, it supports a diagnosis of tennis elbow, caused by tendinopathy of the extensor muscles, especially the extensor carpi radialis brevis. Why the other options don’t fit: resisting elbow flexion with the forearm in a supinated position mainly loads the biceps and other flexors, not the lateral elbow tendons. Resisting finger or forearm movements in neutral or supination directions tends to stress different structures (such as forearm flexors on the medial side) and is not the standard protocol for tennis elbow.

This test assesses lateral epicondylitis by stressing the wrist extensor tendons at the outer elbow. Position the elbow with it extended and the forearm pronated (palm down). Then have the patient try to extend the wrist against resistance (and the same resistance may be applied to the middle finger as well). If this reproduces pain around the lateral epicondyle, it supports a diagnosis of tennis elbow, caused by tendinopathy of the extensor muscles, especially the extensor carpi radialis brevis.

Why the other options don’t fit: resisting elbow flexion with the forearm in a supinated position mainly loads the biceps and other flexors, not the lateral elbow tendons. Resisting finger or forearm movements in neutral or supination directions tends to stress different structures (such as forearm flexors on the medial side) and is not the standard protocol for tennis elbow.