Mill's Manipulation | Lateral Epicondyalgia

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This is not medical advice. The content is intended as educational content for health care professionals and students. If you are a patient, seek care of a health care professional.
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The Mill’s manipulation is not a classic manipulation in a sense that it targets a hypomobile joint or joint capsule, but is a soft tissue manipulation targeting the tendon insertion of the common extensor tendon in lateral epicondyalgia
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📚 ARTICLES: Nagrale et al. (2009): www.ncbi.nlm.n...
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[@lorrencarter8766]

Thank you for all of your helpful information. I’m a student going into the profession and it is helpful to see how it is demonstrated!

[@JB-cg1rn]

Excellent work. Thank you . I'm in NP school and your videos for tennis and Golfer's elbow are of great help with physical assessments.

[@user-xg4wy7vk4s]

Thanks for the explaining. Why is the thrust needed, if the purpose of the method is to stretch the tendon? Wouldnt a normal stretch in this posotion for some secs be enough? I mean, what's the story behind this manipulation, that brought the therapist to the conclusion that this is what the patient needs?

[@CoachNealF]

Was that "pop" necessary at 2:15? Regardless, that's outside my comfort zone. Thanks for sharing all these informative videos. A friend has epicondylitis (probably chronic) from years of paddling a whitewater canoe (he's really good at it) and we're going to talk about how to improve that issue so it does not distract from his activities.

[@Physiotutors]

Research shows us that a crack or pop is not necessary when the manipulation is performed correctly. Might help with the placebo effect though. Good luck with rehabbing your friend!

[@benjaminbaumgardner7620]

In the Cyriax study, they preceded the manip with xfm for 10mins then immediately followed with the manip.

[@yumekojabami4428]

Do you perform the manipulation only once at a time or is it necessary to repeat it let's say for 10 repetitions or so?

[@joranwa430]

If the patient have decreased range of motion. Is there an adjustment for the manipulation, or should Mill’s manipulation then be avoided until the patient can reach the full ROM?

[@Physiotutors]

No full extension in the elbow is a contra-indication for the Mill's manipulation. Then our first step would be to reach full extension with mobilization or manipulation techniques that tackle the joint rather than the extensor carpi radialis muscles.

[@archonoff]

Is this manipulacion effective against medial epicondylitis?

[@Physiotutors]

There is no manipulation for the medial epicondyle that we know of

[@AnaFisioRodrigues]

Muito bom

[@shadesofpoetry1361]

#Physiotutor I am from Pakistan. My elbow joint surgery done in 2019. After Dr. Suggested me physiotherapy, but now little movement in my elbow joint. Dr will remove the plate, screws and wire from elbow joint in the month of August and Please reply me... after this my arm move straight by physiotherapy or exercise????????

[@drzeeshanjafri1928]

I think it’s a first video on manipulation

[@Physiotutors]

Yes, it is

[@adtpgwgmgP]

Appear dangerous... Please please share your experiences if you have tried it.

[@Physiotutors]

It's not dangerous if done properly and followed the points that we describe before. Research and experience show that it can be effective in pain relief, but it makes sense to combine it with gradual loading (strength training) of the tendon.

[@user-tg7pn7my8h]

thank you ^~^

[@Physiotutors]

Ur welcome! Thx for subscribing to our channel!

[@LinkBuildingServicex]

Hi, Is there a way to make this by my own. I have no one to help me. Thanks

[@Physiotutors]

There is not and it should be done by a licensed practitioner after proper evaluation of your situation

[@LinkBuildingServicex]

@@Physiotutors Ok, then I will die from the pain because I have no money. Thanks

[@Physiotutors]

Best way to treat tennis elbow is to remove all aggravating activities and to start loading the tendon with exercise in a pain-free manner. We'll try to make an exercise/rehab series for tennis elbow, but you can start with 1kg weighted concentric and eccentric wrist extensions and increase weight and reps if pain allows.

[@NoNacK99]

The "finish move" seems a little bit violent ? No ?

[@Physiotutors]

Manipulations are always done under high velocity

[@amalel-zeiny5350]

How to perform this on patient right arm ? Cause I couldn't manipulate using my left hand

[@Physiotutors]

It's a skill that needs practice. Watching a video is not necessarily sufficient to learn a skill and you might need feedback by a teacher in person.

[@ridewithduke2502]

MWM is better oR Mills Manipulation !!

[@Physiotutors]

There are papers claiming that, for example from Nagrale et al. (2009) and Vicenzino but the evidence is not strong.

[@DottMarcoSegina]

in Italy it is forbidden (rightly) teach or divulgate rehabilitation techniques to persons that are not enabled at profession ... i find your videos very cool , but if disclosed even to civilians without any training are likely to alter the perception of competencies of physiotherapist and train for free abusive figures.

[@Physiotutors]

What do you suggest? A disclaimer? Glad to hear you like our videos, but it is impossible to provide information in a way that only people who are qualified as manual therapists consume and apply this information. It's common sense and that's the idea of the internet that information is available for everyone.

[@DottMarcoSegina]

Hello. I definitely suggest a discalmer and maybe even say a few words about it (if you show techniques that can have side effects if done in an inappropriate manner by non-expert people). as you can see I also have a channel with videos of exercises but I avoid giving precise and detailed explanations and above all I do not show techniques that could be used by people not qualified for the profession.

[@angelchercoles85]

Guys keep up the good work. I am a physiotherapist and I love the detail and work you put into it. When I was studying for my degree I used to watch your videos which helped me during my studies. Don't change a thing please.

[@Physiotutors]

Thanks a lot Angel, appreciate your kind words! We will do our utmost best to keep it up next year as well! Happy to hear our videos helped you and thanks a lot for following us!

[@Clement_Crta]

In the Netherlands we use the content of these video all the time as Physiotherapists in training. What a great knowledge you guys give ! Thank you very much. It would be such a pity not to have access to this treasure.