This study evaluated the maximum grip strength in a position of elbow extension versus flexion as a diagnostic tool in the assessment of a patient with suspected lateral epicondylitis (LE).
From our database we identified 81 patients with grip strength measurements and the diagnosis of LE. From these patient records we collected grip strength measurements with the elbow in full extension and with the elbow in 90° of flexion for the affected and the healthy extremity. We then compared 2 values: the pretreatment grip strength in flexion and extension for the affected extremity and the pretreatment grip strengths of the nonaffected extremity compared with the affected extremity. Grip strengths were compared with paired and unpaired 2-tailed t tests.
Grip strength was no different in flexion and extension for the healthy extremity and 29% stronger in flexion than in extension for the affected extremity. The affected arm averaged 50% of the strength of the healthy arm in extension and 69% of the strength of the healthy arm in flexion. These differences were statistically significant. An 8% difference in grip strength between flexion and extension was found to be 83% accurate in distinguishing the affected from the unaffected extremities.
The measurement of extension grip strength is a useful objective tool to aid in the diagnosis of LE. In patients with LE, the grip strength decreases as one moves from a position of flexion to a position of extension.
Type of study/level of evidence
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Hand Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Provocation of epicondylalgia lateralis (tennis elbow) by power grip or pinching.Med Sci Sports Exerc. 1987; 19: 518-523
- Impact of elbow position on grip strength of elderly men.J Hand Ther. 1995; 8: 27-30
- The relationship between elbow position and grip strength.Am J Occup Ther. 1992; 46: 509-512
- Elbow positioning for maximum grip performance.J Hand Ther. 2000; 13: 33-36
- Grip strength in different positions of the elbow and shoulder.Arch Phys Med Rehabil. 1994; 75: 812-815
- Strength and pain measures associated with lateral epicondylitis bracing.Arch Phys Med Rehabil. 1998; 79: 832-837
- Grip strength as a measure of response to treatment for lateral epicondylitis.Br J Rheumatol. 1984; 23: 154-155
- Local corticosteroid injection versus Cyriax-type physiotherapy for tennis elbow.J Bone Joint Surg. 1996; 78B: 128-132
- Grip strength in patients with tennis elbow.Acta Orthop Belg. 1996; 62: 26-29
- Grip strength in tennis elbow: long-term results of operative treatment.Acta Orthop Belg. 1998; 64: 167-169
- Tennis elbow: its course, natural history, conservative and surgical management.J Bone Joint Surg. 1973; 55A: 1177-1182
- Elbow tendinopathy: tennis elbow.Clin Sports Med. 2003; 22: 813-836
- The McGraw Hill Companies, Inc, New York, NY2004: 543-544 Orthopaedic examination, evaluation and intervention.
- The radial tunnel syndrome.J Hand Surg. 1979; 4: 52-59
- Sarcomere length in wrist extensor muscles.Acta Orthop Scand. 1997; 68: 249-254
- Architecture of selected wrist flexor and extensor muscles.J Hand Surg. 1990; 15A: 244-250
Accepted: March 17, 2007
Received: March 16, 2007
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
Support was received from the Orthopaedic Research Education Foundation and the NIH/NIAMS (AR49407).
© 2007 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.