The Golfer’s Elbow Test assesses whether loading or stretching the wrist flexor-pronator group reproduces familiar medial elbow pain. A positive result may increase suspicion of medial epicondylalgia when it matches the client’s history, palpation and functional symptoms. Current peer-reviewed diagnostic accuracy evidence for this exact test appears limited, so it should be interpreted as one part of a broader medial elbow assessment. A 2023 review notes that medial epicondylitis is associated with repeated eccentric loading of the common flexor tendon and may coexist with ulnar neuritis.
A client reports pain on the inside of the elbow when gripping, swinging a golf club, throwing, climbing, lifting or doing pulling exercises. The pain may be localised near the medial epicondyle and increase with resisted wrist flexion or forearm pronation.
The Golfer’s Elbow Test can help assess whether flexor-pronator loading reproduces familiar medial elbow pain. It does not confirm medial epicondylalgia, but it can support assessment reasoning when combined with palpation, grip strength, wrist flexion strength, pronation strength, ulnar nerve screening and functional loading.
Test name: Golfer’s Elbow Test
Also known as: Medial Epicondylalgia Test, Medial Epicondylitis Test
Body region: Medial elbow and flexor-pronator origin
Purpose: Assess medial elbow pain response to flexor-pronator loading or stretch
Positive finding: Familiar medial elbow pain during resisted wrist flexion/pronation or passive wrist extension with elbow extension, depending on the variation used
Negative finding: No familiar medial elbow pain during the test
Best used with: Palpation, grip strength, wrist flexion strength, pronation strength, Tinel’s Test, elbow valgus stress and functional loading
Key limitation: Diagnostic accuracy evidence for the exact test appears limited
The Golfer’s Elbow Test is a medial elbow pain provocation test. It is commonly performed by loading the wrist flexor-pronator group through resisted wrist flexion, resisted pronation or by stretching the wrist flexors with the elbow extended.
Because different versions exist, the exact method used should be recorded.
The test is used when medial epicondylalgia, flexor-pronator tendinopathy or medial elbow overload is part of the assessment reasoning.
It may be relevant for golfers, throwers, climbers, gym clients, racquet sport athletes, manual workers and clients with medial elbow pain during gripping or wrist flexor loading.
The test assesses symptom response to loading or stretching the wrist flexor-pronator origin. It does not directly assess tendon structure and does not confirm medial epicondylalgia.
Medial elbow pain may also be influenced by ulnar nerve irritability, UCL-related symptoms, medial joint irritation, cervical referral, gripping load, pain sensitivity or training history.
This test may be useful for clients with medial elbow pain during gripping, pulling, wrist flexion, forearm pronation, golf, throwing, climbing, manual work or gym-based pulling tasks.
Use when medial elbow symptoms are present and flexor-pronator loading or stretching is safe and relevant.
Use caution with acute trauma, suspected fracture, severe pain, major swelling, recent surgery, ulnar nerve symptoms, obvious instability or high irritability.
Chair or treatment table
Pain scale
Measurz recording workflow
Optional grip dynamometer
Optional comparison-side notes
Position the client sitting with the arm supported.
The elbow may be extended or slightly flexed depending on the selected test variation. The forearm position should be standardised and recorded.
Stand or sit beside the tested arm.
Stabilise the forearm or elbow with one hand. Use the other hand to resist wrist flexion or pronation, or to guide a controlled stretch variation.
Prevent shoulder, trunk or elbow compensation.
For a resisted version, ask the client to flex the wrist or pronate the forearm while you apply opposing resistance. For a stretch version, gently extend the wrist and fingers with the elbow extended if tolerated.
Ask the client to report pain location, intensity, symptom quality and whether the symptoms are familiar.
A positive test is reproduction of familiar medial elbow pain.
A negative test is no familiar medial elbow pain during the selected manoeuvre.
Stop if pain increases sharply, symptoms spread, neurological symptoms appear, the client cannot tolerate the position or guarding dominates.
Record the exact version used. Do not treat general forearm effort as a positive finding.
A positive Golfer’s Elbow Test may increase suspicion of medial epicondylalgia or flexor-pronator involvement when it reproduces familiar medial elbow pain and matches palpation, history and functional loading findings. It does not confirm medial epicondylalgia on its own.
A positive result may also reflect ulnar nerve irritability, UCL-related symptoms, medial joint irritation, cervical referral or general load sensitivity. Interpretation is stronger when symptoms are localised, familiar and consistent across related flexor-pronator tests.
A negative test may reduce suspicion when medial elbow pain is not reproduced by resisted wrist flexion, pronation, stretch or palpation. It does not fully exclude medial epicondylalgia, especially when symptoms occur only under higher load, fatigue or sport-specific conditions.
At the time of writing, high-quality peer-reviewed diagnostic accuracy evidence reporting sensitivity, specificity or likelihood ratios for the Golfer’s Elbow Test as a stand-alone test appears limited.
Condition or presentation: suspected medial epicondylalgia or medial epicondylitis
Population: not clearly established for this exact clinical test
Test variation: resisted wrist flexion/pronation or passive wrist flexor stretch
Reference standard: not consistently established
Sensitivity: not available
Specificity: not available
Positive likelihood ratio: not available
Negative likelihood ratio: not available
Key limitations: limited diagnostic accuracy research, variable test descriptions and overlap with ulnar nerve or UCL-related symptoms
A systematic review of elbow physical examination evidence included medial epicondylitis among target conditions, but available evidence for many elbow tests remains limited and variable. A 2023 review describes medial epicondylitis as a flexor-pronator origin condition that is often seen in overhead throwing athletes and manual labourers, and notes that ulnar neuritis can coexist in a meaningful proportion of cases.
Reliability depends on consistent test variation, wrist position, elbow angle, forearm position, resistance level, symptom criteria and comparison side.
Because diagnostic accuracy evidence is limited, the test’s validity is best understood as a symptom provocation tool rather than a diagnostic instrument.
Common errors include not recording the version used, applying inconsistent resistance, failing to ask whether pain is familiar, ignoring ulnar nerve symptoms, not comparing sides and treating the test as a diagnosis.
Limitations include overlap with ulnar nerve symptoms, UCL symptoms, medial joint irritation, pain sensitivity and load-dependent symptoms.
Use the Golfer’s Elbow Test to document medial elbow response to flexor-pronator loading or stretch. It can guide further grip, wrist flexion, pronation, ulnar nerve and valgus stress assessment.
Record test name, side tested, result as positive, negative, unclear or unable to test, version used, pain score, symptom location, symptom quality, elbow position, forearm position, wrist position, movement or force direction, resistance level, comparison side, irritability, confidence in result and reason for stopping.
Add related findings such as palpation, grip strength, wrist flexion strength, pronation strength, Tinel’s Test, elbow valgus stress, ulnar nerve symptoms and functional loading.
Elbow Valgus Stress Test
Tinel’s Test
Grip Strength Test
Wrist Flexion Test
Pronator Teres Syndrome Test
Upper Limb Tension Tests
Cozen’s Test
Polk’s Test
It assesses whether flexor-pronator loading or stretch reproduces familiar medial elbow pain.
A positive result is familiar pain around the medial elbow during the selected test variation.
No. It may increase suspicion of medial epicondylalgia but does not confirm it on its own.
Medial elbow pain can overlap with ulnar nerve symptoms, and ulnar neuritis may coexist with medial epicondylitis.
A negative result means the selected manoeuvre did not reproduce familiar symptoms. It does not fully exclude medial epicondylalgia.
Record the test version, side, pain score, symptom location, force direction, resistance level, comparison side and related findings.
The Golfer’s Elbow Test assesses medial elbow pain with flexor-pronator loading or stretch.
A positive result may increase suspicion when symptoms are familiar and localised.
Diagnostic accuracy evidence for the exact test appears limited.
Ulnar nerve and valgus-loading findings should be considered.
Measurz should capture the exact version, symptoms, position and related findings.
DeLuca, M. K., Cage, E., Stokey, P. J., & Ebraheim, N. A. (2023). Medial epicondylitis: Current diagnosis and treatment options. Journal of Orthopaedic Reports, 2(3), 100172. https://doi.org/10.1016/j.jorep.2023.100172
Zwerus, E. L., Somford, M. P., Maissan, F., Heisen, J., Eygendaal, D., & van den Bekerom, M. P. J. (2018). Physical examination of the elbow, what is the evidence? A systematic literature review. British Journal of Sports Medicine, 52(19), 1253–1260.
