Test library › Elbow & forearm
Milking manoeuvre
For: UCL injury
An injury to the ulnar collateral ligament on the inside of the elbow, which stops the forearm being forced outwards away from the body. Common in throwers.
Best used to rule inFigures from the full paper (Table 3): sensitivity 77%, specificity 85%, LR+ 5.10, LR− 0.28 (84 consecutive patients, surgical findings as the reference).
What the numbers mean
- Positive result: a moderate rule-in: a positive result makes the diagnosis clearly more likely.
- Negative result: a small shift: a negative result nudges the diagnosis down, but does not exclude it.
Source
Sciascia AD, Bowman EN, Camp C, et al. Clinical Utility of the Moving Valgus Stress Test and Milking Maneuver for Medial Ulnar Collateral Ligament Injuries of the Elbow. Am J Sports Med. 2026;54(8):1993–2002. Journal article (DOI) · single study
Figures as they will appear in Rule It In, Rule It Out (Trokos, forthcoming). If a newer or better study changes them, this page changes with the book. Figures last updated from the book on 2 October 2026.
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This page gives the published figures. Rule It In, Rule It Out adds how to do this test, what counts as positive, how to read the result, and, where studied, whether combining it with other tests helps.
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One study, one test, once a month
Rule It In is a free evidence letter for musculoskeletal clinicians: one recent study explained, one examination test with its real numbers. From Trokos, publisher of Rule It In, Rule It Out.