Enhanced Milking Maneuver for UCL Injuries
The milking maneuver is a common test for UCL (Ulnar Collateral Ligament) injuries, especially in overhead athletes like baseball players. This test is typically performed with the athlete in a supine position, passively brought into external rotation to check for medial elbow pain. However, sometimes the pain is subtle and hard to detect.
To enhance the sensitivity of the milking maneuver, try performing it with the patient in a pronated position. This adjustment increases the torque on the medial side of the elbow by altering the radius of the ulnar position, which can help reveal subtle UCL injuries.
Key Takeaways
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Perform the standard milking maneuver in a supine position with external rotation.
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If pain is not obvious, repeat the test with the forearm in a pronated position.
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Pronation increases torque on the UCL, making the test more sensitive.
By incorporating the pronated position into your assessment, you can more effectively diagnose UCL injuries and provide appropriate care for your athletes. This simple adjustment can make a significant difference in detecting subtle changes in symptoms and ensuring accurate diagnosis.
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