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Maudsley's Test A Valuable Tool for Massage and Manual Therapists in Assessing Lateral Epicondylitis


As a massage or manual therapist, your ability to accurately assess and diagnose musculoskeletal conditions is crucial for providing effective treatment. One condition that frequently affects the elbow is lateral epicondylitis, commonly known as tennis elbow. In this blog post, we will explore the significance of Maudsley's test in the assessment of lateral epicondylitis, its practical application in a clinical setting, and its relevance for massage and manual therapists.

​This blog post is an excerpt from our professional development online course on Lateral Epicondylitis. To find out more and earn Professional development points please click the link

Understanding Lateral Epicondylitis: Lateral epicondylitis is a condition characterised by inflammation or degeneration of the extensor tendons at their attachment site on the lateral epicondyle of the humerus. It typically occurs due to repetitive activities involving wrist extension and forearm supination, such as sports (tennis, hence the name) or certain occupational tasks.

Maudsley's Test: The Middle Finger Extension Test:

Maudsley's test, also known as the middle finger extension test, is a clinical examination maneuver that can help assess for lateral epicondylitis. Here's how it is performed:

  1. Position the patient: Ask the patient to keep their wrist in a neutral position and flex their elbow to approximately 90 degrees.

  2. Apply resistance: With the patient's middle finger extended, oppose their attempt to extend it by applying resistance.

  3. Observe for pain or tenderness: Note any pain or tenderness experienced by the patient at the lateral epicondyle during the resisted middle finger extension.

Interpreting the Test Results: A positive finding during Maudsley's test, indicated by pain or tenderness at the lateral epicondyle, suggests the presence of lateral epicondylitis. However, it is essential to consider the patient's clinical history, symptoms, and other physical examination findings to arrive at an accurate diagnosis. In some cases, imaging studies may be necessary to rule out other conditions or assess the severity of the condition.

Applying Maudsley's Test in Massage and Manual Therapy: As a massage or manual therapist, incorporating Maudsley's test into your assessment protocol can enhance your ability to identify lateral epicondylitis. By performing this test, you can gather valuable information about the presence and severity of the condition, aiding in the development of an appropriate treatment plan.

When conducting the test, it is crucial to communicate effectively with your client, explaining the purpose and procedure clearly. Take note of any pain or tenderness they experience during the test and document your findings accurately for future reference and comparison.

Collaboration and Referral: While massage and manual therapy techniques can play a vital role in managing lateral epicondylitis, it is essential to recognize your scope of practice. If you suspect a severe or complicated case of lateral epicondylitis, it is recommended to collaborate with or refer your client to a healthcare professional, such as a physician or physical therapist, for further evaluation and treatment.

Conclusion: Maudsley's test provides a valuable tool for massage and manual therapists in assessing lateral epicondylitis, aiding in accurate diagnosis and treatment planning. By incorporating this simple yet effective examination maneuver into your assessment protocol, you can enhance your ability to identify this common condition and provide appropriate care for your clients.



  1. Watson J. The diagnosis and management of tennis elbow. Dtsch Arztebl Int. 2019;116(37


Disclaimer: This blog post is intended for educational purposes only and should not be used as a substitute for professional medical advice.

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