- Seated or standing
- Elbow extended, forearm pronated, and the wrist extended.
- The patient is asked to keep the wrist extended while the examiner pulls the wrist into flexion.
MODIFICATION (see the video below)
- Note: This is my own modification of the Cozen’s test. I haven’t seen this written anywhere, or seen any research noting its effectiveness in diagnosis lateral epicondylitis. From my experience, this modified maneuver is more sensitive.
- Roll up a towel or patient gown, such that it fills up their hands in girth.
- Have the patient grasp the towel firmly with both hands out in front of them. Then, with their involved side hand, reach over so their firm grasp is with the hand now in flexion (instead of neutral). With a firm grip with both hands, the patient should now twist the towel backwards into wrist extension with their involved side.
Positive Sign / Significance
- Pain in the region 1-2cm distal to the lateral epicondyle = Lateral epicondylitis (tennis elbow)
- The extensor carpi radialis brevis (ECRB) is the muscle/tendon most involved.