Milking Maneuver

 Milking Maneuver

  • Milking Maneuver is used for  medial ulnar collateral ligament injury (Valgus Instability) of the elbow joint.

  • Create a valgus stress by pulling on the patient’s thumb with the forearm supinated and elbow flexed at 90 degrees.

  • Positive Milking Maneuver if there is apprehension, instability, or pain at the MCL origin of the elbow.

  • Medial or ulnar collateral ligament (MCL or UCL) has three bundles: anterior, posterior, and transverse bundles.
  • It arises from the anteroinferior portion of the medial humeral epicondyle and is the primary static stabilizer to valgus stress.
  • Anterior bundle is the most important in helping resist valgus forces and attaches 18 mm distal to the coronoid tip at the sublime tubercle.
  • Valgus stability with the arm in pronation suggests that the anterior bundle of the UCL is intact.
  • Posterior bundle: greatest change in length from flexion to extension.
ulnar collateral ligament of the elbow

Ulnar collateral ligament of the elbow

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