The Elbow

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
- '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.

The pathological end-feels at the elbow are:

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 - haemartrosis.
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.