At Sports & Orthopaedic Therapy Services, we are happy to provide the Mulligan’s Concept for relieving pain and improving joint mobilization for our patients. This form of manual therapy was named after New Zealand physical therapist Brian Mulligan. His concept of manual therapy coined the terms “mobilizations with movement” (MWMS) of the extremities, and “sustained natural apophyseal glides” (SNAGS) of the spine. These terms are crucial to the application of Mulligan’s Concept, using a combination of physical therapist-conducted services, as well as patient-generated physiologic movements.
Through the Mulligan’s Concept, our Silver Spring physical therapists are guided by the simple rule to avoid causing any pain to their patients. Instead, we apply MWMS and SNAGS to mobilize joints and the spine in a more tolerable way. By using this concept, we can reduce pain and stiffness, as well as help correct positional faults and diminish the presence of pain.
Clinical application of these techniques requires a passive motion applied to a joint and must be pain free. Once the corrective position is determined by the physical therapist the patient is requested to move into the restricted direction to check if the restriction has been improved (i.e. increased range of active motion, muscle contraction and free of the original pain). The goal is to have the movement performed without the presence of the original complaint. Once the physical therapist discovered the correct pain-free movement, the previously limited and/or painful movement is repeated by the patient while the physical therapist continues to maintain the appropriate hands on movement. Further gains are expected with repetition during a treatment session particularly when pain-free overpressure is applied. This technique is repeated for about 3-4 sets of ten repetitions. The patient is encouraged to ‘remember’ the position of the joint when it moves in its pain-free position. The physical therapist can then gradually reduce the assistance given as the patient is able to actively take over.
Mulligan’s Concept can be used to treat a large amount of acute and chronic conditions, from an ankle sprain to chronic joint pain. However, much like when considering the application of any other concept, a thorough evaluation of the patient must be completed first. Our Silver Spring physical therapy treatments are advanced and proven to be successful for those suffering from certain conditions. If you are suffering from pain and believe you may benefit from an application of the Mulligan Concept in your treatment plan, contact Sports & Orthopaedic Therapy Services in Silver Spring, MD today to schedule your consultation. We’ll get you back to moving normally again, without the fear of pain!