Question: If a client feels anterior elbow pain on passive pronation of the forearm, what does this indicate?

Answer: The distal attachment of the biceps tendon is injured.

The biceps muscle-tendon unit might be injured in five different places - in the muscle belly, at the musculotendinous junction, in the body of the upper tendon or the lower tendon, or at the tenoperiosteal attachment (where the tendon attaches to the radial tuberosity). An injury in the lower tendon body or the tenoperiosteal attachment will cause anterior elbow pain on two separate assessment tests: resisted flexion of the elbow and resisted supination of the forearm. Passive pronation (medial rotation) of the forearm tests specifically for an injury to the tenoperiosteal attachment of the biceps tendon. If this movement causes anterior elbow pain, it's likely the tendon attachment is getting pinched between the radius and the ulna. This pinching action is not painful if the tendon is healthy. When the tendon is injured, it becomes slightly swollen and irritated, which makes the pinching painful.