Execution
- 1Position the patient sitting.
- 2Flex the elbow to 90° or more and supinate the forearm.
- 3Grasp the patient’s thumb from under the forearm.
- 4Pull on the thumb to impart a valgus stress at the elbow.
- 5Abduct and externally rotate the shoulder with the elbow near 70° while applying valgus stress with the examiner’s thumb.
Positive outcome
Reproduction of symptoms is positive, including apprehension, medial joint pain, gapping, or perceived instability. Magee describes the finding as suggestive of a partial tear of the medial collateral ligament.
Studies
| Study | Reliability | Sn | Sp | LR+ | LR− |
|---|---|---|---|---|---|
| Zwerus et al. (2018) — systematic review | NA | NA | NA | NA | NA |
CommentMagee presents the milking maneuver as a valgus-stress provocation for MCL symptoms, but does not provide strong test-specific Sn / Sp data. The modified shoulder-abducted version may better simulate throwing stress. Use the moving valgus stress test when diagnostic accuracy is needed.
Low Clinical Value