Normal Elbow — Baseline Resisted Testing
A healthy elbow tolerates resisted wrist motion without pain.
- 0/10: Medial pain score (no tenderness)
- 0/10: Lateral pain score (no tenderness)
- Normal: Grip strength (pain-free)
- Non-tender: Epicondyle palpation (both sides)
Why baseline matters
A pain-free baseline rules out both conditions confidently.
Resisted test principle
Resisted contraction stresses the tendon origin directly.
Two independent origins
Flexors originate medially, extensors originate laterally.
Resisted Wrist Flexion Test
Resisted flexion isolates the flexor-pronator tendon origin.
- Medial epicondyle: Test target (common flexor origin)
- Wrist flexion: Provoking motion (against resistance)
- ≥4/10 pain: Positive threshold (at medial site)
- Golfer's elbow: Suggests (medial epicondylitis)
Test technique
Examiner resists active wrist flexion with elbow extended.
Positive finding
Sharp pain at the medial epicondyle confirms involvement.
Anatomic basis
Flexor carpi radialis and pronator teres originate here.
Resisted Wrist Extension Test
Resisted extension isolates the extensor tendon origin.
- Lateral epicondyle: Test target (common extensor origin)
- Wrist extension: Provoking motion (against resistance)
- ≥4/10 pain: Positive threshold (at lateral site)
- Tennis elbow: Suggests (lateral epicondylitis)
Test technique
Examiner resists active wrist extension with elbow extended.
Positive finding
Sharp pain at the lateral epicondyle confirms involvement.
Anatomic basis
Extensor carpi radialis brevis originates at this site.
Pain Zone Mapping
Precise pain location separates the two conditions cleanly.
- Golfer's elbow: Medial zone (flexor-pronator origin)
- Tennis elbow: Lateral zone (extensor origin)
- Yes: Overlap possible (combined presentation)
- Direct palpation: Mapping method (plus resisted tests)
Palpation confirms testing
Point tenderness should match the positive resisted test.
Ruling out mimics
Ulnar nerve or radial tunnel signs alter the picture.
Bilateral comparison
Comparing both elbows highlights the asymmetric finding.
Differential Confirmed
Combined test and location findings finalize the diagnosis.
- Medial+: Golfer's elbow (flexion positive)
- Lateral+: Tennis elbow (extension positive)
- Combined: Both positive (rare presentation)
- Alt. diagnosis: Neither positive (consider other cause)
Diagnostic synthesis
Test side plus pain zone together confirm the condition.
Referral pathway
Confirmed side directs condition-specific treatment referral.
Diagnostic tool only
This simulator stops at diagnosis, not treatment selection.