Tests to Diagnose Lateral Epicondylitis A lateral epicondylitis test is used to help a doctor make a diagnosis based on signs and symptoms in conjunction with a physical exam. The anatomic basis of the injury to the extensor carpi radialis brevis origin appears to be multifaceted, involving hypovascular zones, eccentric tendon stresses, and a microscopic degenerative response. This was in comparison to the control group, where 79% of subjects still complained of symptoms of LE. Researchers from the University of Queensland studied the effectiveness of corticosteroid injection, multimodal physiotherapy or both, in patients with LE(8). Likelihood Ratio +/-Tennis Elbow Test. These include the Cozen, Maudsley and Mills tests (see table 1). Men and women are affected equally. Pain over the lateral aspect of the elbow joint indicates a positive test for LE. The patient is instructed to make a fist with wrist in extension with the therapist passively moving the wrist into radial deviation whilst maintaining pronation throughout. B – Starting position for eccentric contraction of affected forearm extensors. Pain responses to the cervical and thoracic provocation tests were significantly higher in the lateral elbow pain group. Of these cases, 80% relate to LE(1). The Mills test is used to help diagnose lateral epicondylitis, more commonly referred to as tennis elbow. Sensitivity assesses the proportion of positives that are correctly recognised (for example if the test is highly sensitive and the test result is negative you can be nearly certain that they don’t have the condition). Muscle strain injuries frequently occur in athletes. It is essential therefore to select an appropriately sized grip for the tennis player. The criteria for inclusion were: pain on the lateral side of the elbow, tenderness over the extensor origin in the forearm, a positive tennis elbow pain test (Mills’ sign) with pain the lateral epicondyle when the elbow is actively moved from flexion to full extension with the forearm in … This study suggests that daily eccentric loading exercises can reduce the symptoms of LE. Hereby giving evidence for the effectiveness of the movement itself. Sensitivity, Specificity. Sports Injury Bulletin brings together a worldwide panel of experts – including physiotherapists, doctors, researchers and sports scientists. Lateral epicondylitis is a painful and functionally limiting entity affecting the upper extremity and is frequently treated by hand surgeons. If you experience pain, tenderness, or discomfort in this area during any of these tests, you may have tennis elbow. We strip away the scientific jargon and deliver you easy-to-follow training exercises, nutrition tips, psychological strategies and recovery programmes and exercises in plain English. The ECRB is primarily a wrist extensor but also abducts the hand at the wrist joint. The forearm and wrist are maintained in pronation and flexion respectively whilst the elbow is extended slowly (as shown). Till date no studies have been reported on the diagnostic accuracy of these tests. This can be determined by the width of the fifth digit; in an optimally-sized tennis racquet grip, it should fit between the longest finger and the thenar eminence (see figure 3). Description 1. Both tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis) are painful conditions caused by overuse. A – Subject lifting bucket with force from non-affected arm to avoid the concentric phase on the involved arm. In one study, researchers surveyed the existing literature combining several RCTs(1). The bony bump on the outside of your elbow is known as the lateral epicondyle. Maudsley’s test had good sensitivity (88%) but poor specificity (0%). Follow ups were performed at four, eight and 26 weeks. Trevor Langford explores the recent thinking on lateral epicondylitis. Lateral epicondylitis commonly affects people over 30 years of age and those pursuing activities requiring repetitive movements of the forearm. Manual therapy in the form of friction massage and joint mobilisations to the lateral elbow are proposed as useful treatment tools. The physiotherapy consisted of mobilisations of the elbow joint, as well as progressive concentric and eccentric resisted exercises of the wrist extensors.