Understanding the Milking Maneuver Assessment
To assess the integrity of the **Posterior Bundle of the Medial Collateral Ligament (MCL/UCL)**, commonly injured in overhead athletes.
Watch How It's Done
How do I start?
Patient is sitting. Shoulder is flexed and abducted. Elbow is flexed to 90°.
What happens?
The examiner grasps the patient's thumb and applies a forceful, sustained **valgus stress** to the elbow, as if 'milking' the forearm.
In Plain English
What Does a Positive Result Mean?
Reproduction of **medial elbow pain** or a feeling of **instability** in the medial joint.
Helpful Tip:
This maneuver is very specific to the MCL, especially the posterior bundle, by producing a high-intensity valgus load in a loaded position.
Safety First
This guide is to help you understand what happens in a clinic. Do not try to diagnose yourself. If you have severe pain, swelling, or cannot put weight on your leg, please visit an urgent care center or your doctor immediately.
Other elbow Tests
Wartenberg's Sign
To test for **Ulnar Nerve palsy/weakness**, specifically of the Palmar Interossei, which leads to unopposed abduction of the little finger.
Beighton Score
To quantify **generalized joint hypermobility** (laxity) across the body, which can be a predisposing factor for elbow instability or other injuries.
Elbow Extension Sign
A screening test used to rule out an **intra-articular fracture** (e.g., radial head or olecranon) in an acutely injured elbow.
Elbow Flexion Test
To provoke symptoms associated with **Cubital Tunnel Syndrome** (ulnar nerve entrapment at the elbow).