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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