Elbow injury is encountered less frequently than are other joint conditions. The bony architecture, muscle, ligament, and nerve anatomy are complex, and the forces leading to injury in the athlete’s elbow are unique. Appreciating the pathomechanics leading to injury and a detailed knowledge of elbow anatomy are the foundation for conducting a directed history and physical examination that achieves an accurate diagnosis. Recent advances in physical examination have improved our ability to accurately diagnose and treat athletic elbow disorders. This article reviews general and focused physical examination maneuvers of the elbow in a systematic anatomic fashion.
AdamsJE. Injury to the throwing arm: a study of traumatic changes in the elbow joints of boy baseball players. Calif Med. 1965;102:127-132.
2.
AhmadCSElAttracheNS. Valgus extension overload syndrome and stress injury of the olecranon. Clin Sports Med. 2004;23(4):665-676.
3.
AhmadCSLeeTQElAttracheNS. Biomechanical evaluation of a new ulnar collateral ligament reconstruction technique with interference screw fixation. Am J Sports Med. 2003;31(3):332-337.
4.
AndrewsJFleisigG. How many pitches should I allow my child to throw?USA Baseball News. April1996.
5.
AndrewsJR. Bony injuries about the elbow in the throwing athlete. Instr Course Lect. 1985;34:323-331.
6.
AntunaSAO’DriscollSW. Snapping plicae associated with radiocapitellar chondromalacia. Arthroscopy. 2001;17(5):491-495.
7.
BernsteinADBreslowMJJazrawiLM. Distal biceps tendon ruptures: a historical perspective and current concepts. Am J Orthop (Belle Mead NJ). 2001;30(3):193-200.
8.
CainELJrDugasJRWolfRSAndrewsJR. Elbow injuries in throwing athletes: a current concepts review. Am J Sports Med. 2003;31(4):621-635.
9.
CalfeeRPManskePRGelbermanRHVan SteynMOSteffenJGoldfarbCA. Clinical assessment of the ulnar nerve at the elbow: reliability of instability testing and the association of hypermobility with clinical symptoms. J Bone Joint Surg Am. 2010;92(17):2801-2808.
ChenFSDiazVALoebenbergMRosenJE. Shoulder and elbow injuries in the skeletally immature athlete. J Am Acad Orthop Surg. 2005;13(3):172-185.
12.
ConwayJEJobeFWGlousmanREPinkM. Medial instability of the elbow in throwing athletes: treatment by repair or reconstruction of the ulnar collateral ligament. J Bone Joint Surg Am. 1992;74(1):67-83.
13.
DinesJSFrankJBAkermanMYocumLA. Glenohumeral internal rotation deficits in baseball players with ulnar collateral ligament insufficiency. Am J Sports Med. 2009;37(3):566-570.
14.
EllenbeckerTSMattalinoAJElamEACaplingerRA. Medial elbow joint laxity in professional baseball pitchers: a bilateral comparison using stress radiography. Am J Sports Med. 1998;26(3):420-424.
15.
ElliottBFleisigGNichollsREscamiliaR. Technique effects on upper limb loading in the tennis serve. J Sci Med Sport. 2003;6(1):76-87.
16.
EricMKrivokucaDSavovicSLeksanIVucinicN. Prevalence of the palmaris longus through clinical evaluation. Surg Radiol Anat. 2010;32(4):357-361.
17.
FieldLDSavoieFH. Common elbow injuries in sport. Sports Med. 1998;26(3):193-205.
18.
FleisigGSAndrewsJRDillmanCJEscamillaRF. Kinetics of baseball pitching with implications about injury mechanisms. Am J Sports Med. 1995;23(2):233-239.
19.
HangDWChaoCMHangYS. A clinical and roentgenographic study of Little League elbow. Am J Sports Med. 2004;32(1):79-84.
20.
KimSJShinSJ. Arthroscopic treatment for limitation of motion of the elbow. Clin Orthop Relat Res. 2000;375:140-148.
21.
KingJWBrelsfordHJTullosHS. Analysis of the pitching arm of the professional baseball pitcher. Clin Orthop Relat Res. 1969;67:116-123.
22.
LeeMLRosenwasserMP. Chronic elbow instability. Orthop Clin North Am. 1999;30(1):81-89.
23.
MaffulliNChanDAldridgeMJ. Overuse injuries of the olecranon in young gymnasts. J Bone Joint Surg Br. 1992;74(2):305-308.
24.
MorreyBFAnKN. Articular and ligamentous contributions to the stability of the elbow joint. Am J Sports Med. 1983;11(5):315-319.
25.
MorreyBFAskewLJChaoEY. A biomechanical study of normal functional elbow motion. J Bone Joint Surg Am. 1981;63(6):872-877.
26.
MorreyBFTanakaSAnKN. Valgus stability of the elbow: a definition of primary and secondary constraints. Clin Orthop Relat Res. 1991;265:187-195.
27.
NorwoodLAShookJAAndrewsJR. Acute medial elbow ruptures. Am J Sports Med. 1981;9(1):16-19.
28.
NovakCBLeeGWMackinnonSELayL. Provocative testing for cubital tunnel syndrome. J Hand Surg Am. 1994;19(5):817-820.
29.
O’DriscollSW. Valgus extension overload and plica. In: LevineWN, ed. The Athlete’s Elbow. Rosemont, Ill: American Academy of Orthopaedic Surgeons; 2008:71-83.
30.
O’DriscollSWBellDFMorreyBF. Posterolateral rotatory instability of the elbow. J Bone Joint Surg Am. 1991;73(3):440-446.
31.
O’DriscollSWGoncalvesLBDietzP. The hook test for distal biceps tendon avulsion. Am J Sports Med. 2007;35(11):1865-1869.
32.
O’DriscollSWLawtonRLSmithAM. The “moving valgus stress test” for medial collateral ligament tears of the elbow. Am J Sports Med. 2005;33(2):231-239.
33.
ParkMCAhmadCS. Dynamic contributions of the flexor-pronator mass to elbow valgus stability. J Bone Joint Surg Am. 2004;86(10):2268-2274.
34.
RulandRTDunbarRPBowenJD. The biceps squeeze test for diagnosis of distal biceps tendon ruptures. Clin Orthop Relat Res. 2005;437:128-131.
35.
SafranMAhmadCSElattracheNS. Ulnar collateral ligament of the elbow. Arthroscopy. 2005;21(11):1381-1395.
36.
SingletonSBConwayJE. PLRI: posterolateral rotatory instability of the elbow. Clin Sports Med. 2004;23(4):629-642, ix-x.
37.
SpinnerRJGoldnerRD. Snapping of the medial head of the triceps and recurrent dislocation of the ulnar nerve: anatomical and dynamic factors. J Bone Joint Surg Am. 1998;80(2):239-247.
38.
SuzukiKMinamiASuenagaNKondohM. Oblique stress fracture of the olecranon in baseball pitchers. J Shoulder Elbow Surg. 1997;6(5):491-494.
39.
VeltriDMO’BrienSJFieldLD. The milking maneuver: a new test to evaluate the MCL of the elbow in the throwing athlete. J Shoulder Elbow Surg. 1995;4(1):S10.
40.
ViegasSF. Avulsion of the triceps tendon. Orthop Rev. 1990;19(6):533-536.
41.
WernerSLFleisigGSDillmanCJAndrewsJR. Biomechanics of the elbow during baseball pitching. J Orthop Sports Phys Ther. 1993;17(6):274-278.
42.
WilsonFDAndrewsJRBlackburnTAMcCluskeyG. Valgus extension overload in the pitching elbow. Am J Sports Med. 1983;11(2):83-88.
