Mulligan Concept
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Description
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Mobilizations with movement were first coined by Brian R. Mulligan, a highly recognized manual therapist. What makes Mulligan based intervention interesting is the lack of a systematic evaluation process unique to his treatment methods. Instead Mulligan has pulled various evaluation techniques, adjectives, and processes from other notable manual therapists (Maitland and Kaltenborn in particular). Following the physical assessment of a joint, the therapist utilizes descriptors stemmed from Maitland such as: loss of joint motion, pain associated with movement, and/or pain associated with functional activates. Joint assessment is applied via the teachings and methods of Kaltenborn with special attention in identifying pain free accessory motions.
A key component of Mulligan mobilizations are the absence of pain with motion. While performing the technique it is crucial for the therapist to continually monitor the patient via verbal and non-verbal feedback to ensure there is no pain with movement. The therapist must utilize their clinical understanding of tissue extensibility, anatomy, and joint motion in order to mobilize the joint in it's biomechanical accessory motion. While holding an accessory motion the patient is asked to move the extremity in the painful/limiting direction. A success would be absence of pain and this accessory glide is than reinforced with graded sets and frequent intersession re-assessment. If pain is not eliminated than either the point of contact is incorrect or the technique is not indicated. In the situation where pain is reduced, the therapist reinforces the motion with accessory glides via sets and reps with the goal being full range and pain free. Again to emphasize, this process should be pain free.
Indication
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Clinical Presentation[edit | edit source]
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