Key takeaways

  • Tennis elbow is characterized by pain and tenderness on the outside of the elbow, often accompanied by discomfort when gripping or carrying objects, and typically results from repetitive arm or wrist movements.
  • Several at-home tests, such as the coffee cup test, can help indicate the presence of tennis elbow, though some, like Mills’ and Cozen’s, require a doctor’s assistance for an accurate diagnosis.
  • Initial treatment for tennis elbow focuses on rest, avoiding aggravating activities, and pain management with NSAIDs, while more severe or persistent cases may require medical intervention, including injections, physical therapy, or even surgery.

Tennis elbow, or lateral epicondylitis, develops when the forearm muscles that connect to the outside of your elbow become irritated. This can cause pain and tenderness that’s usually located on the outside (lateral) part of the elbow. Oftentimes, there’s also pain when gripping and carrying objects.

The condition often occurs due to overuse or improper form during athletic activities. Using your arm or wrist for vigorous repetitive movements or heavy lifting can cause tennis elbow.

There are several simple tests you can do to determine if you have tennis elbow. You can do most of these tests on your own, but a few do require the assistance of a healthcare professional.

Read on to learn more about tests for tennis elbow, as well as treatment options.

The bony bump on the outside of your elbow is known as the lateral epicondyle. If you experience pain, tenderness, or discomfort in this area during any of these tests, you may have tennis elbow.

Use your affected arm to perform these tests. If you want to feel the difference between your arms, you can perform each test on both sides.

Mill’s test

Do this test with a doctor.

  1. While seated, straighten your affected arm.
  2. The doctor will extend your arm and fully flex your wrist to bend it forward.
  3. Then they’ll rotate your forearm inward while examining your lateral epicondyle.

Cozen’s test

Do this test with a doctor. Cozen’s test is sometimes referred to as the resisted wrist extension test or the resistive tennis elbow test.

  1. Extend your affected arm in front of you and make a fist.
  2. Rotate your forearm inward and bend your wrist toward your forearm.
  3. The doctor will examine your lateral epicondyle while resisting the movement of your hand.

Palpating

  1. Sit with your forearm extended out in front of you on a table.
  2. Apply gentle pressure to examine your lateral epicondyle and the area above it.
  3. Note any areas of pain, tenderness, or swelling.

The coffee cup test

  1. For this test, simply rate your level of pain while grasping a cup of coffee or a carton of milk.

Resistance

  1. Extend your affected arm straight out in front of you with your palm facing down.
  2. Place your opposite hand on the back of your extended hand.
  3. Press your top hand into your bottom hand and attempt to bend the bottom wrist backward.
  4. Create resistance by pressing the top hand against the bottom one.

Middle finger resistance

  1. Extend your affected arm straight out in front of you with your palm facing upward.
  2. Use your opposite hand to pull your middle finger back toward your forearm.
  3. At the same time, use your middle finger to resist this movement.
  4. Next, turn your palm to face downward.
  5. Press your middle finger down while at the same time resisting this movement.

Chair pickup test

  1. You’ll need a light chair with a high back for this test.
  2. Stand with a chair in front of you.
  3. Extend your affected arm straight out in front of you.
  4. Bend your wrist so your fingers face downward.
  5. Use your thumb, first finger, and middle finger to grasp the back of the chair and lift it.
  6. Keep your arm straight as you raise the chair.

If any of the preliminary tests indicate that you have tennis elbow, you may require further testing to see if there are additional causes for any of your symptoms.

A doctor may order an X-ray to rule out other potential sources of elbow pain such as arthritis. Sometimes a magnetic resonance imaging (MRI) scan is performed to examine the elbow’s anatomic structures in greater detail.

Electromyography (EMG) is a test that’s done if your doctor is concerned there’s a nerve problem responsible for your elbow pain.

Lateral epicondylitis affects athletes such as tennis and badminton players, golfers, and swimmers. It can also occur in people who use their hand, wrist, and elbow for repetitive motions during work or daily activities, such as painters, carpenters, and musicians.

In some cases, tennis elbow occurs without an obvious cause.

If you suspect you have a severe case of tennis elbow or there’s noticeable swelling in your elbow, you should seek medical attention. A doctor can then determine if there’s a more serious explanation for your symptoms.

An occupational or physical therapist can show you exercises, make sure you’re doing them correctly, and teach you correct movement patterns. They may also use ultrasound, ice massage, or muscle stimulation.

Surgery may be necessary if your condition doesn’t improve despite a trial of nonsurgical treatment. Surgery for tennis elbow can be performed either through an open incision or arthroscopically through several very small incisions. After surgery, you’ll do exercises to rebuild your strength, flexibility, and mobility.

You can do some of these tests for tennis elbow on your own. Usually, you can ease your symptoms and improve your condition on your own by sticking to a treatment plan that includes plenty of rest.

Change your form or technique if your daily or athletic movements are causing pain. Continue to do exercises to improve strength, flexibility, and mobility in your arms even if you’ve made a full recovery.

Talk with a doctor if your condition doesn’t improve, gets worse, or is coupled with other symptoms.