Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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ISOMETRIC CONTRACTIONS

Resisted flexion

Positioning

The subject stands with the arm hanging, the elbow flexed to a right angle and
the forearm supinated. The examiner stands level with the elbow. One hand is on the distal part of the forearm and the other hand on top of the shoulder.

Procedure.

Resist the subject’s attempt to flex the elbow.

Common mistakes:

• In strong subjects flexion cannot sufficiently be resisted if the resistance is not given perpendicular to the subject’s forearm.
• Movement is allowed at the elbow.
• The subject performs shoulder elevation.

Anatomical structures tested:

Muscle function:

• Important flexors:
– Brachialis
– Biceps brachii
• Less important flexors:
– Brachioradialis
Extensor carpi radialis longus
– Pronator teres.

Common pathological situations:

• Pain indicates a lesion of either the biceps brachii or the brachialis muscle.
• Painless weakness occurs in either a CS or a C6 nerve root lesion.
• Painful weakness is suggestive of an avulsion fracture of the radial tuberosity.

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