Modified Milch Method (back)

modified milch

You can also view a video demonstration of this technique.

Method

This technique uses a combination of scapular fixation and positioning the humerus in the Zero Position. It is useful for patients who are in  abduction already, as is the Scapular Manipulation Method.
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Step 1 – Positioning

The starting point for this is with the patients arm in abduction and is useful if your patient cannot adduct (see Analgesic Position 2).

Sit your patient in a hard backed chair and stand behind the affected limb. Place your left hand over the trapezius and spine of scapula. This fixes the scapula and informs you of any scapular movement during the procedure.

Aim to get your patient comfortable by finding Analgesic Position 2.

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Step 2 – Abduction and External Rotation

Hold the right arm by the wrist.

Slowly and gently abduct to 100°.

Gradually externally rotate as the arm is lifted.

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Step 3 – Push The Humeral Head

The humeral head may be gently pushed anteriorly (by your thumb or an assistant) if the relocation does not occur.

You also have the option of utilising the modified Milch method from the front.

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