Push-up Sign/Active Apprehension
Purpose: To determine the presence of a lateral collateral ligament insufficiency of the elbow.
Test Position: Prone.
Performing the Test: The patient begins in the pushup position with the arms abducted to greater than shoulder width. Have the patient extend their elbows. A positive test is if there is apprehension with terminal extension of the involved elbow.
Diagnostic Accuracy: Unknown.
Importance of Test: According to Neumann, the lateral collateral ligament complex of the elbow involves the radial collateral ligament and the lateral (ulnar) collateral ligament. Both parts have a common attachment to the lateral epicondyle. The RCL blends with the annular ligament, while the lateral (ulnar) collateral ligament attaches to the supinator crest of the ulna. They help resist varus forces and also provide posterolateral stability. With posterolateral instability, apprehension is felt with external rotation of the forearm due to increased risk of subluxation of the humeroulnar and humeroradial joints.
Note: these tests should only be used by properly trained health care practitioners
Test Position: Prone.
Performing the Test: The patient begins in the pushup position with the arms abducted to greater than shoulder width. Have the patient extend their elbows. A positive test is if there is apprehension with terminal extension of the involved elbow.
Diagnostic Accuracy: Unknown.
Importance of Test: According to Neumann, the lateral collateral ligament complex of the elbow involves the radial collateral ligament and the lateral (ulnar) collateral ligament. Both parts have a common attachment to the lateral epicondyle. The RCL blends with the annular ligament, while the lateral (ulnar) collateral ligament attaches to the supinator crest of the ulna. They help resist varus forces and also provide posterolateral stability. With posterolateral instability, apprehension is felt with external rotation of the forearm due to increased risk of subluxation of the humeroulnar and humeroradial joints.
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. 180-181. Print.
"Users Guide to the Musculoskeletal Examination" by Timothy Flynn
Neumann, Donald. "Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation." 2nd edition. St. Louis, MO: Mosby Elsevier, 2010. 180-181. Print.
"Users Guide to the Musculoskeletal Examination" by Timothy Flynn