The Elbow

Execution

• Patient supine, with the arm abducted and externally rotated, the elbow in almost full extension and in full supination.
• The therapist sits next to the patient and supports the elbow with the ipsilateral hand.
• The medial epicondyle is easily palpated. At its anterior aspect, the origin of the common flexor tendon can be found.
• The friction is performed with the index finger of the contralateral hand, reinforced with the middle finger.
• Counter pressure is given with the thumb at the lateral aspect of the elbow.
• Friction is produced by an adduction movement of the upper arm and an extension movement at the wrist that drags the fingertip in a lateral direction, transversely over the tendons.
  The thumb stabilizes the hand and serves as a pivot for the movement.
• During the passive phase the pressure is slightly released and the fingers are brought back to the starting position. Again fingers and skin move as a whole over the lesion.