One of the most common causes of elbow pain is epicondylalgia, with pain at the lateral epicondyle occurring at least 3 times as often as on the medial side. Next to the common Cozen’s test, golfer’s elbow test, Mill’s test, and Kaplan’s test, Polkinghorn et al. (2002) came up with a more functional and easy-to-use test for both conditions. No studies have evaluated the so-called Polk’s test so far, which is why we give it a questionable clinical value in practice.
The mechanism of action of the Polk test is very straightforward. When the hand grasps an object, tension is placed on both the flexors and extensors of the wrist. The motion of lifting the object aggravates the tension on the primary affected muscle group with resulting mechanical strain at the sensitized musculotendinous attachment site.
Phase I of Polk’s test is designed to stress the wrist extensors and supinators such as the extensor carpi radialis brevis and longus, the brachioradialis, and the supinator. To perform the test, the patient is in sitting position and is instructed to lift an object of approximately 2.5kg or 5 pounds – in the original description, a heavy book – with the elbow flexed and the forearm pronated, so with the palm facing down.
This test is positive for lateral epicondylalgia if pain is felt in the lateral epicondyle as a result of the strain imposed upon the attachment site of the extensor/supinator muscles which originate in the lateral epicondyle, supracondylar line of the humerus and a portion of the proximal ulna. A patient with medial epicondylalgia will have no problem picking up an object this way.
Phase II of the Polk’s Test is designed to stress the wrist flexors and pronators such as the flexor carpi radialis, flexor carpi ulnaris, flexor digitorum superficialis, Palmaris longus, pronator quadratus, and pronator teres. To perform the test, the patient is instructed to pick up the book again, but now with a flexed elbow and the forearm supinated, so with the palm facing up. This test is positive for medial epicondylalgia if the pain is felt in the medial epicondyle as a result of the strain imposed upon the attachment site of the flexor/pronator muscles which originate in the medial epicondyle. A patient with lateral epicondylalgia in turn will have no problem picking up an object this way.
21 OF THE MOST USEFUL ORTHOPAEDIC TESTS IN CLINICAL PRACTICE
Other orthopedic tests to assess for tennis elbow and golfer’s elbow are:
What customers have to say about the Assessment E-Book
The Assessment E-Book This book helped me in my studying for my exam and in assessing my first patients. Awesome! Also for beginners!
The Assessment E-Book It’s an amazing Compilation! Congrats to all the work you have put in there. You’ll propably find all the test’s you’ve been looking for with propper explaination and source to doublecheck for you self. definetly a must have for every student, but it will also help an experienced practioner. Im looking forward to the lifelong updates on the topics.
Great work, guys
The Assessment E-Book A must-have for all physiotherapists, osteopaths and manual therapists. The authors conducted an extensive research on assessment tests in manual therapy. I find it very easy to read. The more I read the more I learn. Thank you!
The Assessment E-Book This book is great! It is very structured and detailed. It works extremely well on my Macbook and iPad.
The Assessment E-Book The best way to spend 80euros. Totally worth it. The amount of work you put behind this must have been absolutely huge. Every physical or physiotherapist should own it.
Congrats guys you’ve done an incredible job.
I’ve learnd a lot of new things and my approach to therapy in general have totally changed.
In one word: amazing. Keep going guys ! Best wishes from france.
The technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.
The technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.
The technical storage or access that is used exclusively for statistical purposes.The technical storage or access that is used exclusively for anonymous statistical purposes. Without a subpoena, voluntary compliance on the part of your Internet Service Provider, or additional records from a third party, information stored or retrieved for this purpose alone cannot usually be used to identify you.
The technical storage or access is required to create user profiles to send advertising, or to track the user on a website or across several websites for similar marketing purposes.