Mill’s Test is used for diagnosis of Lateral Epicondylitis in the elbow, also known as “Tennis Elbow”.
It was first described and published by Percival Mills, F.R.C.S (Jan 7th 1928), and updated on July 31. 1937 1 2
How do you perform a Mill’s test?
The patient is standing or seated.
The arm is slightly pronated with the wrist slightly dorsiflexed and the elbow flexed.
With one hand, the examiner grasps the patient’s elbow while the other rests on the lateral aspect of the distal forearm or grasps the forearm .
The patient is then requested to supinate the forearm against the resistance of the examiner’s hand.
What does a positive Mill’s Test mean?
Mill’s test is positive if pain over the lateral epicondyle and/or in the lateral extensors is elected.
This suggests Lateral Epicondylitis of the elbow (Tennis Elbow).
Sensitivity & Specificity
According to G Saroja Mill’s Test has good diagnostic accuracy. His study concludes that it has an excellent diagnostic value for ruling in Lateral Epicondylitis of the elbow (Tennis Elbow).3
Sensitivity: 53 %
Specificity: 100 %
LATERAL EPICONDYLOSIS (TENNIS ELBOW):
Lateral epicondylitis (LE) is also known as tennis elbow, shooter’s elbow, archer’s elbow or lateral elbow pain.
This is the most common tendinopathy, with pain arising mostly from the origin of extensor carpi radialis brevis (ECRB) at the lateral epicondyle and less frequently Extensor carpi radialis longus (ECRL) tendon.
The cyclic loading of stresses causes micro tears with formation of granulation tissue under the tendon and at the tenoperiosteal junction
While tennis players may be susceptible, most cases occur in those without a history of racquet use.
Sudden traumatic onset is suggestive of an acute tendon rupture that often requires surgical repair.
G Saroja , Antony Leo Aseer P , Venkata Sai P M. Diagnostic Accuracy Of Provocative Tests In Lateral Epicondylitis. International Journal of Physiotherapy and Research 2(6):815-823. December 2014. ResearchGate
Clinical Tests for the Musculoskeletal System, Third Edition.