Elbow Ligamentous Instability (Medial) Evidence: confirmed

Modified Milking Maneuver Special Test

Orthopedic Physical Examination & Clinical Assessment Guide

Modified Milking Maneuver Orthopedic Special Test

What is it used for?

  • Detecting Ulnar Collateral Ligament (UCL) insufficiency (specifically the posterior bundle).

How to Perform

  • Position: Patient sits with the arm adducted, elbow flexed to 70°, and the thumb pointing backward (shoulder external rotation).
  • Action: Examiner pulls the thumb outward/backward to apply valgus stress.

Interpretation of Results

  • Positive Test: Pain, apprehension, or medial joint opening. This position isolates the UCL more specifically than the standard maneuver.

Diagnostic Accuracy

  • Sensitivity: High for partial tears.

References

  • Magee, D. J. (2021). Orthopedic Physical Assessment.