Which statement about the tennis elbow test protocol is true?

Which statement about the tennis elbow test protocol is true?

• A. Involves elbow extended with forearm pronated and applying resistance to the wrist or middle finger extension
• B. Involves elbow extended with forearm pronated and applying resistance to the elbow flexion
• C. Involves elbow extended with forearm neutral and applying resistance to finger flexion
• D. Involves elbow flexed with forearm pronated and applying resistance to wrist extension

Answer: (A)

Provoking pain by loading the extensor tendons at the lateral epicondyle through resisted wrist extension with the elbow extended and forearm pronated. This position lengthens and tensions the common extensor tendon, especially the extensor carpi radialis brevis, so applying resistance to wrist extension (or middle finger extension) reproduces or worsens the pain if tennis elbow is present. That’s why this described protocol is the correct one. Resisting elbow flexion would bias the flexor muscles instead of the extensors; having the forearm in neutral or pronation changes the tendon tension, but the combination of elbow extension, forearm pronation, and resisted wrist (or finger) extension specifically targets the lateral elbow. An elbow flexed position also reduces the stretch on the extensor origin, making it less likely to reproduce the pain.

Provoking pain by loading the extensor tendons at the lateral epicondyle through resisted wrist extension with the elbow extended and forearm pronated. This position lengthens and tensions the common extensor tendon, especially the extensor carpi radialis brevis, so applying resistance to wrist extension (or middle finger extension) reproduces or worsens the pain if tennis elbow is present. That’s why this described protocol is the correct one.

Resisting elbow flexion would bias the flexor muscles instead of the extensors; having the forearm in neutral or pronation changes the tendon tension, but the combination of elbow extension, forearm pronation, and resisted wrist (or finger) extension specifically targets the lateral elbow. An elbow flexed position also reduces the stretch on the extensor origin, making it less likely to reproduce the pain.