Moving Valgus Stress Test

Original Editor - Tyler Shultz

Top Contributors - Rachael Lowe, Tyler Shultz, Sweta Christian, Kai A. Sigel and Evan Thomas

Purpose

The purpose of the moving valgus stress test is to assess the integrity of the medial collateral ligament, or the ulnar collateral ligament of the elbow.

Technique[1]

This test can be performed with the patient sitting or standing. The therapist abducts the patient's shoulder to 90 degrees.  The therapist grasps the distal forearm with one hand and stabilizes the elbow with the other.  The examiner then maximally flexes the elbow and places a valgus stress to the elbow while externally rotating the shoulder.  When the shoulder reaches the end range of external rotation, the examiner quickly and smoothly extends the elbow to approximately 30 degrees.

For this test to be considered positive, 1) the patient must experience pain at the medial elbow, and, 2) the maximal amount of pain must be experienced between 120 and 70 degrees of elbow flexion.

[2]

Evidence

Diagnostic Accuracy of the Moving Valgus Stress Test[3]
Sensitivity  1.00
Specificity  0.75
Negative Likelihood Ratio  0.00
Positive Likelihood Ratio  4.00    


See test diagnostics page for explanation of statistics.

References

  1. Flynn, T.W., Cleland, J.A., Whitman, J.M. (2008). User's guide to the musculoskeletal examination: Fundamentals for the evidence-based clinician. Buckner, Kentucky: Evidence in Motion
  2. Physiotutors. The Moving Valgus Stress Test for MCL Tears of the Elbow. Available from: https://www.youtube.com/watch?v=JIU_kv5VoQk
  3. O'Driscoll, S.W., Lawton, R.L., Smith, A.M. (2005). The "moving valgus stress test" for medial collateral ligament tears of the elbow. Am J Sports Med, 33(2):231-239.