Milking Maneuver

Original Editor - Anas Mohamed Top Contributors - Anas Mohamed

Purpose[edit | edit source]

Milking Maneuver is a elbow ligamentous injury test which evaluates the anterior and posterior bundle of the ulnar collateral ligament (UCL).[1][2][3][4]

Technique[edit | edit source]

Milking Maneuver[2][3][edit | edit source]

Step 1. Patient position in standing or sitting.

Step 2. Patient forearm is supinated and elbow is flexed 90 degree.

Step 3. Then patients contralateral extremity or examiner pulls patient thump laterally which gives elbow valgus stress.

Step 4. Pain, instability and apprehension shows positive sign.

Step 5. Comparison can be done with the contralateral elbow.

Modified Milking Maneuver[1][4][edit | edit source]

Step 1. Patient position in standing or sitting.

Step 2. Patient forearm is supinated and elbow is flexed 70 degree with shoulder adduction and externally rotated.

Step 3. Then examiner pulls patient thump laterally which gives elbow valgus stress.

Step 4. Pain, instability and apprehension shows positive sign.

Step 5. Comparison can be done with the contralateral elbow.

References[edit | edit source]

  1. 1.0 1.1 Karbach LE, Elfar J. Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing. J Hand Surg Am. 2017 Feb;42(2):118-126. doi: 10.1016/j.jhsa.2016.11.025. PMID: 28160902; PMCID: PMC5821063.
  2. 2.0 2.1 Erickson, Brandon & Harris, Joshua & Chalmers, Peter & Bach, Bernard & Verma, Nikhil & Bush-Joseph, Charles & Romeo, Anthony. (2015). Ulnar Collateral Ligament Reconstruction: Anatomy, Indications, Techniques, and Outcomes. Sports health. 7. 511-517. 10.1177/1941738115607208.
  3. 3.0 3.1 Patel, Ronak & Lynch, T. Sean & Amin, Nirav & Calabrese, Gary & Gryzlo, Stephen & Schickendantz, Mark. (2014). The Thrower's Elbow. The Orthopedic clinics of North America. 45. 355-376. 10.1016/j.ocl.2014.03.007.
  4. 4.0 4.1 Freehill, Michael T. MD; Safran, Marc R. MD, FACSM Diagnosis and Management of Ulnar Collateral Ligament Injuries in Throwers, Current Sports Medicine Reports: September 2011 - Volume 10 - Issue 5 - p 271-278 doi: 10.1249/JSR.0b013e31822d4000
  5. Modified Milking Maneuver. Ccedseminars. Available from: https://youtube%7CezmqCnjQCbg
  6. Milking Maneuver. Check.physio. Available from: https://youtube%7CKhG6svSw3Ec