Physical Exam

Hand Strength

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Video coming September 2026

How to Perform

Test hand and finger strength against resistance, comparing sides: grip strength (squeezing your fingers or a dynamometer), finger abduction and adduction, thumb opposition and abduction, and the pinch between thumb and fingers. Grade the strength and note any pain or give-way weakness.

How to Interpret

Carpal Tunnel Syndrome

Weakness of thumb abduction (and opposition) — testing the abductor pollicis brevis by resisting the thumb as it lifts straight up away from the palm

Rule in

Minimally helpful

Rule out

Somewhat helpful

Evidence:Strong

References

D'Arcy CA, McGee S. The rational clinical examination. Does this patient have carpal tunnel syndrome? JAMA. 2000 Jun 21;283(23):3110-3117. doi:10.1001/jama.283.23.3110. PMID 10865306. (Erratum JAMA. 2000;284(11):1384.)
Andrews K, Rowland A, Pranjal A, Ebraheim N. Cubital tunnel syndrome: anatomy, clinical presentation, and management. J Orthop. 2018 Aug 16;15(3):832-836. doi:10.1016/j.jor.2018.08.010. PMID 30140129. (Erratum J Orthop. 2020;23:275.)
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.