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Pain can be a highly debilitating condition. Whether it’s acute pain with a sudden onset or chronic pain which persists for weeks or months and is associated with an underlying condition.
Pain is often both elusive to diagnose and complex to treat effectively. However, a physiotherapy-based approach called the Mulligan concept offers promising new results in treating pain-related conditions in some patients.
What Is The Mulligan Concept?
The Mulligan concept is a comparatively new method of treatment. It looks to correct changed arthrokinematics (how the surfaces of our joints move) by mobilizing the joint while it is being activated.
Healthy joints ensure the shape of the joint surfaces enable friction-free movement while dampening potential issues caused by the physical forces triggered by repetitive movement.
Anything that alters the interior joint faces or the joint’s ability to freely track during movement, triggers pain symptoms, weakness or stiffness. The techniques embodied in the Mulligan concept simply look to re-align the joint surfaces.
Mulligan Concept Techniques
The Mobilizations With Movement (MWM) of the joints and Sustained Natural Apophyseal Glides (SNAG) of the spine were concepts created by Brian R. Mulligan.
The Mulligan concept can be defined as, “Mobilization with movement (MWM) is the concurrent application of sustained accessory mobilization applied by a trained therapist and an active physiological movement applied by the patient. Passive end-of-range overpressure, or stretching, is then delivered without pain posing a barrier to treatment.”
Spinal Consultants here at The Brisbane Spine Clinic have undergone advanced training in the Mulligan technique. When patients present to our spinal consultants, he/she assesses the extent of movement loss in the joint and the level of movement-related pain. They then identify the pain by activities conducted during the assessments.
Indications For Using The Mulligan Concept
After an appointment with The Brisbane Spine Clinic, many pain sufferers find they benefit from applying the Mulligan technique at home. The desired outcome can be instant and produce long-lasting results.
Common Indications for the Mulligan Concept approach include:
- Non-inflammatory related pain
- Acute pain caused by an injury
- Arthritic related motion loss
- Post-surgical conditions resulting in painful movement
- Neck-related headaches and dizziness
- TMJ and jaw pain conditions or restricted movement
- Ankle sprains ranging from chronic to acute
- “Tennis elbow” pain
How Is The Mulligan Treatment Performed?
During your assessment, our spinal consultant will apply a passive joint mobilization. You will be asked to move your problem extremities or spine in the restricted direction. This establishes if the restriction has been improved through an increased range of motion, muscle contraction and decreased pain.
Once your consultant has identified the correct pain-free arthrokinematic adjustment glide, the patient repeats the painful movement, while the spinal consultant maintains the correcting accessory glide.This technique is repeated for approximately 3 to 4 sets of 10 repetitions.
The SNAG treatment model can be applied to the sacroiliac joint, ribcage issues and spinal joints. During an assessment, the required accessory zygapophyseal glide is applied while the patient replicates the movement. This triggers the symptoms. SNAGs are not a preferred choice for conditions made worse by movements that irritate the joint.
Consult A Qualified Physiotherapist
To speak with one of our professional spinal consultants about the benefits the Mulligan’s technique may bring to your condition book an appointment by phoning 07 3841 3070.
*Please note, content within this article is for educational purposes only and treatment and advice mentioned may not be suited for everyone. Please consult a team member at the Brisbane Spine Clinic or your General Practitioner for specific advice.
