Milking Maneuver Test: Purpose, Technique, and Interpretation

Published July 24, 2026 Read time 1 min read Readers 45
Milking Maneuver

What Is the Milking Maneuver Used For?

The Milking Maneuver is an orthopedic special test that helps clinicians assess the medial (ulnar) collateral ligament (UCL/MCL) of the elbow. It is used to identify valgus instability and UCL injury, which is especially common in overhead athletes such as baseball pitchers, javelin throwers, and tennis players.

How to Perform the Milking Maneuver

  1. Position the patient with the elbow flexed to 90 degrees and the forearm supinated.
  2. Reach under the patient’s arm and grasp the thumb of the affected side.
  3. Pull the thumb to apply a valgus stress to the elbow, loading the medial collateral ligament.

What Is a Positive Milking Maneuver Result?

The test is positive if the patient experiences:

  • Apprehension
  • Instability of the elbow
  • Pain at the origin of the MCL on the medial elbow

A positive result suggests a medial ulnar collateral ligament injury and warrants further evaluation, such as imaging or comparison with other valgus stress tests.

References