Athletic Training & Sports Medicine Center

 

Examination Links:

 

Milking Sign

Examination type Ligamentous integrity; joint stability
Patient & Body Segment Positioning Involved arm should be supported in 900 of shoulder abduction with external rotation of the glenohumeral joint, and 900 of elbow flexion with the forearm supinated.
Examiner Position Examiner stands behind the seated athlete and supports involved elbow with one hand while grasping thumb of involved side with other hand.
Tissues Being Tested Ulnar collateral ligament of the elbow
Performing the Test

From behind sitting patient, pull on thumb of involved arm moving the forearm backwards which causes a valgus stress on the elbow and stresses the ulnar collateral ligament.

Positive Test Excessive opening of the elbow with valgus stress or pain on medial aspect of elbow
Interpretation Pathology with the ulnar collateral ligament of the elbow (strain or tear)
Common errors in performing exam The examiner may be standing in the wrong position (for example too far to the side of the athlete rather than behind them).
Factors possibly resulting in misinterpretation Pain from an acute injury or inflammation of a bursa; passive pronation of the elbow at 90o
Related tests Valgus stress at 300 and at 0o
References Booher. Athletic Injury Assessment, 4th Edition. 2000.

Magee. Orthopedic Physical Assessment. 4th Ed. 2002.

Links:

http://nmathletictrainers.org/elboweval.pdf

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