Developed by New Zealand physical therapist Brian Mulligan, the concept of mobilizations with movement has become a popular treatment for musculoskeletal injuries. The concept of mobilizations in movement in the extremities and sustained natural apophyseal glides (SNAGS) in the spine has advanced physical therapist-applied passive physiological movements and accessory techniques.
When are the Mulligan Techniques Used?
The Mulligan concept can be used to help treat a variety of injuries and pain including neck pain, back pain and upper and lower extremity injuries. Designed to reduce pain and improve the patient’s range of motion the Mulligan technique involves Natural Apophyseal Glides (NAGS), Sustained Natural Apophyseal Glides (SNAGS) and Mobilization with Movement (MWM) for the treatment of musculoskeletal injuries.
When applying manual therapy techniques a Physical Therapist will identify one or more comparable signs that may include loss of joint movement, pain associated with movement or pain associated with specific functional activities. Then a passive accessory joint mobilization is applied either parallel or perpendicular to the joint plane and the accessory glide is to be pain free. Using various combinations of parallel or perpendicular glides the therapist will try to find the correct treatment plane and grade of movement. When done the comparable sign should be significantly improved by either an increase in the range of motion or absence of pain. If this is not achieved the therapist has not found the correct contact point, treatment plane, grade or direction of mobilization.
The Mulligan concept can be practiced with home exercises to improve range of motion and help reduce pain that has been caused by injury. The mobilizations with movement concept were discovered in 1985 and Mulligan’s first textbook on his technique was published in 1999. Today manual therapy is used to treat musculoskeletal pain and disability and commonly includes kneading and manipulation of muscles, joint mobilization and joint manipulation. The technique can also be used to reduce soft tissue inflammation, induce relaxation and improve function. In Motion Physical Therapy has therapists trained in the Mulligan treatments techniques and if you are interested in trying this form of manual therapy contact our office today.
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