The Elbow & Forearm: MMT

Question 0

Elbow FLEXION

Grades 2, 1, 0

Answer 0

Patient Position:
Short sitting
Arm ABD 90* supported by therapist
Forearm supinated/pronated/mid position

Therapist Position:
In front of patient supporting forearm

Palpation:

• Biceps: tendon in antecubital space
• Brachialis: medial to biceps tendon
• Brachioradialis: proximal volar surface of forearm

Test:
Patient attempts to flex elbow

Question 1

Elbow FLEXION

Grades 5, 4, 3

Answer 1

(Biceps, Brachials, Brachioradialis)

Patient Position:
Short sitting arms at sides
-Biceps: forearm supinated
-Brachials: forearm pronated
-Brachioradialis: forearm mid position 

Therapist Position:
In front of patient toward test side
Resistance over forearm, proximal to wrist

Stabilization:
Opposite hand over anterior shoulder

Test:
Patient flexes elbow

Instructions:
“Bend your elbow. Hold it. Don’t let me pull it down.”

Question 2

Elbow EXTENSION

Grades 5, 4, 3

Answer 2

(Triceps)

Patient Position:
Prone
Arm ABD 90*
Elbow flex 90*

Therapist Position:
Support test arm above elbow
Resistance to dorsal forearm

Test:
Patient extends elbow

Instructions:
“Straighten your elbow. Hold it. Don’t let me push you down.”

Question 3

Elbow EXTENSION

Grades 2, 1, 0

Answer 3

Patient Position:
Short sitting
Arm ABD 90*
Shoulder in neutral rotation
Elbow flex 45*
Entire limb is parallel to floor

Therapist Position:
Stand at test side
-2/5: support limb at elbow
-1/5-0/5: support under forearm

Palpation:
Triceps just proximal to Olecranon process

Test:
Patient attempts to extend elbow

Instructions:
“Try to straighten your elbow.”

Question 4

Forearm SUPINATION

Grades 5, 4, 3

Answer 4

(Supinator)

Patient Position:
Short sitting 
Arm at sides
Elbow flex 90*
Forearm in pronation

Therapist Positions:
Stand/Sit in front of patient
One hand supporting elbow
Other hand “shaking hand” position

Test:
Patient supinates from full pronation to full supination

Instructions:
“Turn your palm up. Hold it. Don’t let me turn it down.”

Question 5

Forearm SUPINATION

Grade 2

Answer 5

Patient Position:
Short sitting
Shoulder flexed btw 45-90
Forearm is neutral

Therapist Position:
Support under elbow

Test:
Patient supinates through partial ROM

Instructions:
“Turn your palm toward your face.”

Question 6

Forearm SUPINATION

Grades1, 0

Answer 6

Patient Position:
Short sitting 
Arm at sides
Elbow flex 90*
Forearm in pronation

Therapist Position:
Support forearm distal to elbow

Palpation:
Supinator distal to radial head on dorsal forearm

Question 7

Forearm PRONATION

Grades 5, 4, 3

Answer 7

(Pronator Teres)

Patient Position:
Short sitting 
Arm at side,
Elbow flex to 90*
Forearm supinated

Therapist Position:
Stand in front of patient
Support elbow
Resistance over dorsal wrist

Test:
Patient Pronated forearm until Palm faces downward

Instructions:
“Turn your palm down. Hold it. Don’t let me turn it up.”

Question 8

Forearm PRONATION

Grade 2

Answer 8

Patient Position:
Short sitting
Shoulder flex 45*-90*
Elbow flex 90*
Forearm in neutral

Therapist Position:
Support test arm under elbow

Test:
Patient attempts to pronate forearm

Instructions:
“Turn your palm facing away from your face.”

Question 9

Forearm PRONATION

Grades 1, 0

Answer 9

Patient Position:
Short sitting 
Arm at side,
Elbow flex to 90*
Forearm supinated

Therapist Position:
Support forearm just distal to elbow

Palpation:
Pronator Teres over volar surface of forearm from medial condyle to lateral radius

Test:
Patient attempts to pronate