Arm Bar Test for Posteromedial Elbow Impingement

Published August 24, 2026 Read time 2 min read Readers 69
Arm Bar Test

The Arm Bar Test (also known as the Posteromedial Impingement Test) is a specialized orthopedic clinical examination used to evaluate posterior and posteromedial impingement of the elbow joint. It is particularly useful for assessing overhead throwing athletes (such as baseball pitchers or javelin throwers) who experience extension overload or valgus stress in the elbow.

What is the Purpose of the Arm Bar Test?

The primary purpose of the Arm Bar Test is to diagnose posterior or posteromedial elbow impingement syndrome. This condition occurs when the olecranon process repeatedly impacts or pinches against the olecranon fossa at terminal elbow extension.

Key Diagnostic Indications:

  • Evaluation of posterior elbow pain.
  • Screening for extension overload syndrome in throwing athletes.
  • Identifying osteophyte formation or impingement at the posteromedial olecranon.

How to Perform the Arm Bar Test

Follow these step-by-step clinical instructions to perform the test accurately:

  1. Patient Positioning:
    • The patient stands upright.
    • The hand of the affected arm rests on the examiner’s shoulder.
    • The test elbow is fully extended, and the shoulder is medially (internally) rotated so that the thumb points downwards.
  2. Examiner Action:
    • The examiner applies a downward force on the olecranon process or the distal humerus.
    • This motion simulates forced elbow extension and reproduces mechanical stress on the posterior joint structures.

Interpreting Test Results

Positive Result

A test is considered positive if it causes:

  • Pain Reproduction: Localized pain along the posterior or posteromedial aspect of the olecranon.
  • Loss of Extension: The patient exhibits an inability to achieve full passive extension (extension lag) due to mechanical block or pain.

Clinical Significance

Reproduction of posteromedial elbow pain during forced extension strongly indicates posteromedial impingement syndrome or valgus extension overload. Further diagnostic imaging (such as plain X-rays or MRI) may be recommended to rule out olecranon spurring, synovitis, or loose bodies within the olecranon fossa.

References

  1. Zwerus EL, Somford MP, Maissan F, et al. Physical examination of the elbow, what is the evidence? A systematic literature review. Br J Sports Med. 2017;51:1–9. PubMed
  2. Orthofixar – Arm Bar Test