Cozen’s Test

Original Editor - Tyler Shultz

Top Contributors - Evan Thomas, Tony Lowe, Rachael Lowe, Sheik Abdul Khadir and Tyler Shultz  

Purpose

The purpose of Cozen's test (also known as the "resisted wrist extension test" or "resistive tennis elbow test") is to check for lateral epicondylalgia or "tennis elbow".

Patient Position

The patient should be seated, with the elbow extended forearm maximal pronation, wrist radially abducted, and hand in a fist.

Examiner Position

The therapist should stabilise elbow while palpating lateral epicondyle, other hand placed on the dorsum of the hand.

Technique

The patient is asked to move the wrist to dorsal flexion and the therapist provides resistance to this movement, in the position described above.[1] The test is positive if pain on the lateral epicondyle is elicited.
 

Cozen's test video provided by Clinically Relevant

Helpful Tips

To reduce the likelihood of finding pathology at the origin of extensor digitorum, keep the patient’s fingers flexed during resisted wrist extension. During isometric wrist extension, the counter-force should be applied on the dorsoradial aspect of the fist to reduce involving extensor carpi ulnaris and thus obtaining a false-positive finding if there is pathology within this muscle/tendon.[2]

Evidence

Sensitivity and specificity has not yet been determined.

References

  1. Zwerus EL, Somford MP, Maissan F, Heisen J, Eygendaal D, van den Bekerom MP. Physical examination of the elbow, what is the evidence? A systematic literature review. Br J Sports Med. 2018 Oct 1;52(19):1253-60.
  2. Kochar M, Dogra A. Effectiveness of a specific physiotherapy regimen on patients with tennis elbow: clinical study. Physiotherapy, 2002; 88: 333–341.