by Manual Concepts (www.manualconcepts.com)

 

The following information provides a brief introduction to the Mulligan concept. The basic principles outlined will be covered in detail during Mulligan Concept courses. The majority of programme time during each course will be devoted to the clinical application of techniques aimed at addressing spinal and peripheral musculoskeletal dysfunction, as outlined below under the specific course details. Seminar participants can expect a syllabus high on practical application with a clear understanding of the rationale for use of Mulligan Concept techniques in both the spine and extremities. Following this course, therapists should be able to effectively apply the techniques in their own practices and expect an immediate positive impact on their clinical outcomes.

 

Introduction to the Mulligan Concept

Brian Mulligan’s concept of mobilisations with movement (MWMs) in the extremities and natural appophyseal glides (NAGS & SNAGs) in the spine are the logical continuance of the evolution of manual therapy with the concurrent application of both therapist applied accessory and patient generated active physiological movements.

Principles of Treatment

In the application of manual therapy techniques, Physiotherapists acknowledge that contraindications to treatment exist and should be respected at all times. In the Mulligan Concept the basic rule is to never cause pain. However therapist choosing to make use of Nags or SNAGS in the spine and MWMs in the extremities must still know and abide by the basic rules of application of manual therapy techniques.

Specific to the application of MWM and SNAGs in clinical practice, the following basic principles have been developed and are taught on Mulligan Concept courses.

  1. During assessment the therapist will identify one or more comparable signs. These signs may be a loss of joint movement, pain associated with movement, or pain associated with specific functional activities (i.e., lateral elbow pain with resisted wrist extension).
  2. A passive accessory joint mobilisation is applied following the principles of Kaltenborn (i.e., parallel or perpendicular to the joint plane). This accessory glide must itself be pain free.
  3. The therapist must continuously monitor the patient’s reaction to ensure no pain is recreated. Utilising knowledge of joint arthrology and clinical reasoning, the therapist investigates various combinations of parallel or perpendicular glides to find the correct treatment plane and grade of movement.
  4. While sustaining the accessory glide, the patient is requested to perform the comparable sign. The comparable sign should now be significantly improved (i.e., increased range of motion, and a significantly decreased or better yet, absence of the original pain).
  5. Failure to improve the comparable sign would indicate that the therapist has not found the correct contact point, treatment plane, grade or direction of mobilisation, spinal segment or that the technique is not indicated.
  6. The previously restricted and/or painful motion or activity is repeated by the patient while the therapist continues to maintain the appropriate accessory glide. Further gains are expected with repetition during a treatment session typically involving three sets of ten repetitions.
  7. Further gains may be realised through the application of passive overpressure at the end of available range. It is expected that this overpressure is again, pain-free.

Self-treatment is often possible using MWM principles with adhesive tape and/or the patient providing the glide component of the MWM and the patient’s own efforts to produce the active movement. Pain is always the guide. Successful MWM and Snags techniques should render the comparable sign painless while significantly improving function during the application of the technique. Sustained improvements are necessary to justify ongoing intervention.

The Mulligan Concept – The Lower Quarter Snags, MWM’s and PRP’s – Examination & Treatment Techniques for the Lumbar Spine, Thoracic Spine, Pelvis and Lower Extremity

Content: This exciting two day clinical workshop will present in depth the unique concept developed and refined by New Zealand physiotherapist Brian Mulligan who is no longer teaching. This concept will provide clinical practice with a stimulating new dimension, giving an extensive array of treatment options to manage a client list. All the latest techniques, including Snags, PRP’s and MWM’s, for the Lumbar spine, pelvis and lower extremity will be covered in this fully comprehensive programme. No previous experience of the Mulligan Concept is required to attend. Participants are given very close practical supervision to ensure high levels of competency and an understanding of technique application through clinical reasoning and patient demonstration.

About the Presenter

Kim Robinson and Toby Hall are founding members of the international Mulligan Concept Teachers Association and have been teaching this Concept for more than 10 years in Australia as well as all over the worldwide. Kim and Toby have worked closely with Brian Mulligan and are heavily involved in research to develop the evidence base for the concept and so are very well qualified to teach this programme.

Course Date and Venue


Course title:Mulligan Concept - Lower Quarter
Date: 10-11 June 2017 (Sat-Sun)
Time: 9:00am-5:00pm
Venue: 10, Arumugam Road, 409957
Fees: S$900 per person
Closing date for registration: 10 June 2017
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