Resisted Wrist Extension Test
Also known as Cozen's test self-version, tennis elbow test.
Checks: The wrist and finger extensor tendons that attach on the outer elbow
What this checks
This checks whether the tendons that straighten the wrist and fingers, which share an attachment on the bony bump on the outside of the elbow, are irritable when you load them. Pain there when gripping or lifting is the classic tennis elbow pattern.
Do not do this test if
you have had a recent significant elbow or wrist injury, you cannot move the wrist at all, the elbow is very painful at rest, you have pins and needles or weakness spreading into the hand, or you feel unwell with the pain. See a doctor first if any of those apply.
How to do it
Step 1
Straighten the arm out in front of you
- Hold the arm out with the elbow straight and the palm facing down.
- Make a loose fist.
Step 2
Cock the wrist up towards the ceiling
- Bend the wrist back so the knuckles lift towards the ceiling.
- Keep the elbow straight.
Step 3
Press down on the back of the hand with your other hand
- Use your other hand to push the raised hand down while you resist.
- Use light to moderate effort only, held for about 5 seconds.
Step 4
Note where any pain appears
- Pain felt over the bony bump on the outside of the elbow is the response to look for.
- Compare with the other arm.
What your result means
Likely normal
A negative result usually looks like this.
- You can hold the wrist up against light pressure with no sharp pain.
- Any effort is felt evenly in the forearm, not pinpointed at the elbow.
- Both arms feel similar.
Possible problem
A positive result usually looks like this.
- Pain over the bony bump on the outside of the elbow when you resist.
- The same spot is tender if you press on it.
- Gripping or lifting a kettle reproduces the same pain.
Tips for a clearer result
Small things that make the test easier to read.
- Keep the elbow fully straight - a bent elbow makes the test less clear.
- Compare with the other side.
- Stop if the pain is sharp rather than a mild pull.
How to read this
A positive result may point towards tennis elbow, an irritation of the wrist extensor tendons where they attach at the outer elbow, but it cannot confirm it - neck and nerve problems can refer similar pain, and only a hands-on assessment can tell you for sure.
This is a guide, not a diagnosis. It cannot rule a problem in or out - a physiotherapist can. If your symptoms are severe, spreading, or you feel unwell, see a doctor. Please do not start exercises based on these tests without guidance from a physiotherapist who has assessed you; doing so is at your own risk.
Points towards
If your result points to a problem, these condition guides are a good place to start reading.
Reproduced your pain?
A positive result is worth getting looked at. Book a £40 online assessment with an HCPC-registered physiotherapist, wherever you are in the UK.
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