Cozen's Test
Purpose: To determine the presence of lateral epicondylalgia.
Test Position: Standing or sitting.
Performing the Test: Stabilize the patient’s forearm and instruct the patient to make a fist, pronate the forearm, radially deviate, and extend the wrist. Next the clinician palpates the lateral epicondyle with the stabilizing hand and applies a flexion force against the patient’s resistance. A positive test is reproduction of lateral elbow pain.
Diagnostic Accuracy: Unknown.
Importance of Test: According to Neumann, the common proximal attachment site of the wrist extensors is on or near the lateral epicondyle of the humerus and dorsal border of the ulna. The distal attachments of the extensor carpi radialis longus and brevis are the 2nd and 3rd metacarpals respectively. These muscles are responsible for wrist extension and radial deviation. The extensor carpi ulnaris attaches to the 5th metacarpal and is responsible for wrist extension and ulnar deviation. With tendinopathy, any stretch or contraction of the tissues can potentially reproduce pain. The starting position of the test (elbow flexion, wrist extension, radial deviation, and pronation) places the muscles in a shortened position. The combination of resisted contraction and palpation of the origin of the muscles reproduce the patient's symptoms.
Note: these tests should only be used by properly trained health care practitioners
Test Position: Standing or sitting.
Performing the Test: Stabilize the patient’s forearm and instruct the patient to make a fist, pronate the forearm, radially deviate, and extend the wrist. Next the clinician palpates the lateral epicondyle with the stabilizing hand and applies a flexion force against the patient’s resistance. A positive test is reproduction of lateral elbow pain.
Diagnostic Accuracy: Unknown.
Importance of Test: According to Neumann, the common proximal attachment site of the wrist extensors is on or near the lateral epicondyle of the humerus and dorsal border of the ulna. The distal attachments of the extensor carpi radialis longus and brevis are the 2nd and 3rd metacarpals respectively. These muscles are responsible for wrist extension and radial deviation. The extensor carpi ulnaris attaches to the 5th metacarpal and is responsible for wrist extension and ulnar deviation. With tendinopathy, any stretch or contraction of the tissues can potentially reproduce pain. The starting position of the test (elbow flexion, wrist extension, radial deviation, and pronation) places the muscles in a shortened position. The combination of resisted contraction and palpation of the origin of the muscles reproduce the patient's symptoms.
Note: these tests should only be used by properly trained health care practitioners
References:
Neumann, Donald. "Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation." 2nd edition. St. Louis, MO: Mosby Elsevier, 2010. 232. Print.
Neumann, Donald. "Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation." 2nd edition. St. Louis, MO: Mosby Elsevier, 2010. 232. Print.