Order here your CD-rom ' The Elbow'
"The Elbow" Demo
This term describes the sensation that the examiner experiences at the end of the passive
movement. It gives him information about the structure or condition that stops the
movement and has therefore a high diagnostic value.
In addition it has therapeutic and prognostic consequences; see capsular pattern.
In the elbow, three normal endfeels can be felt
The pathological end-feels at the elbow are:
- 'Ligamentous' or 'Elastic' endfeel :
The feeling of a thick piece of leather being stretched via a lever.
This is the normal endfeel for the rotations (pronation and supination)
- 'Tissue approximation' : this is the typical normal endfeel in flexion of the elbow:
The examiner feels the soft biceps and brachialis muscles being squeezed between forearm and humerus.
- 'Bone to Bone' endfeel: typical for the extension:
The olecranon is brought in contact with the fossa olecranii.
- too hard a flexion in combination with a ligamentous extension: arthrosis, osteophytic outcrops or capsular contracture
- muscle spasm: an involuntary muscular contraction protects the inflamed tissues against further
overstretching. It is present in severe and acute conditions - arthritis in the acute stage
- empty endfeel: The examiner does not feel any organic resistance but stops the
movement because the perceived pain is too intense and further forcing would result in active and voluntary muscular contraction.
- springy endfeel: The joint 'recoils' at the moment the endrange is almost reached.
This is a typical endfeel for internal derangement and in the elbow it indicates a loose body.