• Lian Yun-Perng, Physiotherapist

A Personal Review: Mulligan Concept


I first saw the acronym NAGS, SNAGS and MWM in 2010 and I didn’t pay much attention to it as my PT school only taught me PA and so forth by Maitland. Then, I went abroad to continue my PT undergrad and was taught about the Mulligan Concept. And soon after I fell in love with the concept as it was “functional” and it could be used in a weight bearing positions.

Fast forward a few years and here I am attending my first manual therapy course. To be honest, I did not expect much from this course but I was wrong. I signed up for both Part A: Cx, Tx and ULs and Part B: Lx, SIJ and LLs. It was two days for each part. I must say that this course was intense; there were so many things to learn and to unlearn. For example, my force, my glide directions, my grip and my positioning. I must also admit that everything I read and watched about NAGS, SNAGs and MWM were wrong, wrong, wrong!!! Even my undergrad lecturers taught me wrongly but I don’t blame them.

Mulligan’s mobilization is so gentle that it almost feels useless. I have never used a technique this soft before. Conventionally, I would use 80-100% of my force and BW to mobilize a joint but this concept suggested a force of around 10-40% and each glide has to be Pain free and should lead to Instant results and Long Lasting (PILL). This concept is about trial and error and I do not have any issues with that since the human body is so complex.

My main reason for liking this concept more than any other manual therapy is its requirement for active participation and its HEP. The client has to actively move together with the therapist during MWM or SNAGS and the client can be taught to self-mobilize!

Now let’s talk a bit of science……

Mulligan concept associates improvements to:

  1. Correcting positional faults

  2. Modulating motor neurone pool

  3. Therapeutic alliance

  4. Expectations

The only thing that could be improved during the course was the notes given. One would not be able to learn or replicate the mobilization by just reading the notes. I think it’s a great way to protect the Mulligan concept from infringement but not so much to revise afterwards. Maybe that’s why they advised us to get the book if we want to take the certification exam. One more thing; I won’t recommend doing Part A + B consecutively. It is too strenuous to the mind and body. There are so many things to learn and apply so it is best to take them separately.

Jillian McDowell is a great teacher; she knows her stuff well and she is just brilliant! Although she was still suffering from jet lag + flight delays, Jillian did not show any signs of tiredness. The flow of the theory and practical sessions were smooth, she gave us enough time to practise under her supervision. She also shared some of her clinical experience with us and told us that she was not a purist in her treatment as she would use DN, McKenzie or Mulligan to help her clients. She also played a prank on my friend when she tore his certificate during the presentation time. Fortunately, that was a spare certificate! She gave all of us a shock!!

I am looking forward to Part C and also the exam. I know my skills are not there yet and I am still working on it. I have tried some of the NADS, SNAGS and MWM and there were positive results. I will need to test them out more before I comment further.

Thanks for reading!

#Opinions #Reflection #Concept

Editor

Lian Yun-Perng  

UK Qualified Physiotherapist
Bachelor of Physiotherapy

Keele University, United Kingdom
Diploma in Physiotherapy

AIMST University, Malaysia

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