Milking Maneuver: Difference between revisions

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<div class="editorbox"> '''Original Editor '''- [[User:Anas Mohamed|Anas Mohamed]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
<div class="editorbox"> '''Original Editor '''- [[User:Anas Mohamed|Anas Mohamed]] '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}</div>
=== Purpose ===
=== Purpose ===
'''Milking Maneuver''' is a [https://www.physio-pedia.com/Elbow_Ligamentous_Injuries?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal#share elbow ligamentous injury] test which evaluates the anterior and posterior bundle of the ulnar collateral ligament (UCL).<ref name=":0">Karbach LE, Elfar J. Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing. J Hand Surg Am. 2017 Feb;42(2):118-126. doi: 10.1016/j.jhsa.2016.11.025. PMID: 28160902; PMCID: PMC5821063.</ref><ref name=":1">Erickson, Brandon & Harris, Joshua & Chalmers, Peter & Bach, Bernard & Verma, Nikhil & Bush-Joseph, Charles & Romeo, Anthony. (2015). Ulnar Collateral Ligament Reconstruction: Anatomy, Indications, Techniques, and Outcomes. Sports health. 7. 511-517. 10.1177/1941738115607208. </ref><ref name=":2">Patel, Ronak & Lynch, T. Sean & Amin, Nirav & Calabrese, Gary & Gryzlo, Stephen & Schickendantz, Mark. (2014). The Thrower's Elbow. The Orthopedic clinics of North America. 45. 355-376. 10.1016/j.ocl.2014.03.007. </ref><ref name=":3">Freehill, Michael T. MD; Safran, Marc R. MD, FACSM Diagnosis and Management of Ulnar Collateral Ligament Injuries in Throwers, Current Sports Medicine Reports: September 2011 - Volume 10 - Issue 5 - p 271-278
'''Milking Maneuver''' is a [https://www.physio-pedia.com/Elbow_Ligamentous_Injuries?utm_source=physiopedia&utm_medium=search&utm_campaign=ongoing_internal#share elbow ligamentous injury] test which evaluates the anterior and posterior bundle of the ulnar collateral ligament (Valgus instability).<ref name=":0">Karbach LE, Elfar J. Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing. J Hand Surg Am. 2017 Feb;42(2):118-126. doi: 10.1016/j.jhsa.2016.11.025. PMID: 28160902; PMCID: PMC5821063.</ref><ref name=":1">Erickson, Brandon & Harris, Joshua & Chalmers, Peter & Bach, Bernard & Verma, Nikhil & Bush-Joseph, Charles & Romeo, Anthony. (2015). Ulnar Collateral Ligament Reconstruction: Anatomy, Indications, Techniques, and Outcomes. Sports health. 7. 511-517. 10.1177/1941738115607208. </ref><ref name=":2">Patel, Ronak & Lynch, T. Sean & Amin, Nirav & Calabrese, Gary & Gryzlo, Stephen & Schickendantz, Mark. (2014). The Thrower's Elbow. The Orthopedic clinics of North America. 45. 355-376. 10.1016/j.ocl.2014.03.007. </ref><ref name=":3">Freehill, Michael T. MD; Safran, Marc R. MD, FACSM Diagnosis and Management of Ulnar Collateral Ligament Injuries in Throwers, Current Sports Medicine Reports: September 2011 - Volume 10 - Issue 5 - p 271-278


doi: 10.1249/JSR.0b013e31822d4000 </ref>
doi: 10.1249/JSR.0b013e31822d4000 </ref>
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=== Technique ===
=== Technique ===


==== Milking Maneuver<ref name=":1" /><ref name=":2" /> ====
==== Milking Maneuver ====
'''Step 1.''' Patient position in standing or sitting.
'''Step 1.''' Patient position in standing or sitting.


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'''Step 4.''' Pain, instability and apprehension shows positive sign.
'''Step 4.''' Pain, instability and apprehension shows positive sign.


'''Step 5.''' Comparison can be done with the contralateral elbow.
'''Step 5.''' Comparison can be done with the contralateral elbow.<ref name=":1" /><ref name=":2" />


==== Modified Milking Maneuver<ref name=":0" /><ref name=":3" /> ====
==== Modified Milking Maneuver ====
'''Step 1.''' Patient position in standing or sitting.
'''Step 1.''' Patient position in standing or sitting.


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'''Step 4.''' Pain, instability and apprehension shows positive sign.
'''Step 4.''' Pain, instability and apprehension shows positive sign.


'''Step 5.''' Comparison can be done with the contralateral elbow.
'''Step 5.''' Comparison can be done with the contralateral elbow.<ref name=":0" /><ref name=":3" />{{#ev:youtube|ezmqCnjQCbg|300}}<ref>Modified Milking Maneuver. Ccedseminars. Available from: https://youtube|ezmqCnjQCbg</ref><div class="row">{{#ev:youtube|KhG6svSw3Ec|300}}<div class="col-md-6">
<div class="row">
<ref> Milking Maneuver. Check.physio. Available from: https://youtube|KhG6svSw3Ec </ref>
<div class="col-md-6"> {{#ev:youtube|ezmqCnjQCbg|300}} <div class="text-right"><ref>Modified Milking Maneuver. Ccedseminars. Available from: https://youtube|ezmqCnjQCbg</ref></div></div>
 
<div class="col-md-6"> {{#ev:youtube|KhG6svSw3Ec|300}} <div class="text-right"><ref> Milking Maneuver. Check.physio. Available from: https://youtube|KhG6svSw3Ec </ref></div></div>
== References ==
== References ==
</div>
<references />
<references />
[[Category:Elbow]]
[[Category:Elbow]]

Revision as of 12:46, 20 June 2022

Original Editor - Anas Mohamed Top Contributors - Anas Mohamed and Chelsea Mclene

Purpose[edit | edit source]

Milking Maneuver is a elbow ligamentous injury test which evaluates the anterior and posterior bundle of the ulnar collateral ligament (Valgus instability).[1][2][3][4]

Technique[edit | edit source]

Milking Maneuver[edit | edit source]

Step 1. Patient position in standing or sitting.

Step 2. Patient forearm is supinated and elbow is flexed 90 degree.

Step 3. Then patients contralateral extremity or examiner pulls patient thump laterally which gives elbow valgus stress.

Step 4. Pain, instability and apprehension shows positive sign.

Step 5. Comparison can be done with the contralateral elbow.[2][3]

Modified Milking Maneuver[edit | edit source]

Step 1. Patient position in standing or sitting.

Step 2. Patient forearm is supinated and elbow is flexed 70 degree with shoulder adduction and externally rotated.

Step 3. Then examiner pulls patient thump laterally which gives elbow valgus stress.

Step 4. Pain, instability and apprehension shows positive sign.

Step 5. Comparison can be done with the contralateral elbow.[1][4]

[5]

[6]

References[edit | edit source]

  1. 1.0 1.1 Karbach LE, Elfar J. Elbow Instability: Anatomy, Biomechanics, Diagnostic Maneuvers, and Testing. J Hand Surg Am. 2017 Feb;42(2):118-126. doi: 10.1016/j.jhsa.2016.11.025. PMID: 28160902; PMCID: PMC5821063.
  2. 2.0 2.1 Erickson, Brandon & Harris, Joshua & Chalmers, Peter & Bach, Bernard & Verma, Nikhil & Bush-Joseph, Charles & Romeo, Anthony. (2015). Ulnar Collateral Ligament Reconstruction: Anatomy, Indications, Techniques, and Outcomes. Sports health. 7. 511-517. 10.1177/1941738115607208.
  3. 3.0 3.1 Patel, Ronak & Lynch, T. Sean & Amin, Nirav & Calabrese, Gary & Gryzlo, Stephen & Schickendantz, Mark. (2014). The Thrower's Elbow. The Orthopedic clinics of North America. 45. 355-376. 10.1016/j.ocl.2014.03.007.
  4. 4.0 4.1 Freehill, Michael T. MD; Safran, Marc R. MD, FACSM Diagnosis and Management of Ulnar Collateral Ligament Injuries in Throwers, Current Sports Medicine Reports: September 2011 - Volume 10 - Issue 5 - p 271-278 doi: 10.1249/JSR.0b013e31822d4000
  5. Modified Milking Maneuver. Ccedseminars. Available from: https://youtube%7CezmqCnjQCbg
  6. Milking Maneuver. Check.physio. Available from: https://youtube%7CKhG6svSw3Ec