The Elbow - CatsTCMNotes
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The Elbow
Important Anatomical Facts
Median nerve and brachial artery lie medial to the biceps
tendon and superficial to brachialis muscle
The radial nerve and its branch posterior interosseus nerve lie
lateral to the biceps tendon
Ulnar nerve at the elbow lies behind (posterior) to the medial
epicondyle
The main extensor muscles of the hand originate from lateral
epicondyle
The main flexor muscles of the hand originate from medial
epicondyle
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Tennis Elbow
Golfer’s Elbow:
Commonest cause for elbow
Similar history but the pain is
pain
35-50 age group
Pain on lateral side of elbow
History of lifting heavy
object, recent excessive over
activity- dusting, sweeping,
playing tennis
at the site of flexor tendons
origin
Less common than tennis
elbow
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Elbow Tests
Flex the elbow and
fully pronate the
hand. Pain over
lateral epicondyle.
•Pain can also be
elicited by pronating
the arm with elbow
fully extended.
•The chair test: Ask the
patient to attempt the chair
(3.5kg) with the elbows
extended. Difficulty or pain
confirms tennis elbow.
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Thomsen’s Test: Ask the patient to
clench the fist, dorsiflex the wrist and
extend the elbow. Then force to palmar
flex the wrist against resistance. Severe
pain over lateral epincondyle . Same can
be done with extended middle finger trying
to flex it against resistance.
Golfer’s elbow: Flex the
elbow,supinate the hand, and then
extend the elbow. Pain occurs over
medial epicondyle
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