I personally believe that in the field of orthopaedic physical therapy, Brian Mulligan is the second most influential PT in the world (just my opinion).

He introduced mobilizations with movement (MWMs) which focused on empowering the patient and having them actively move their own body part synchronous with the specific manual therapy.

Although it seems logical now, prior to Mulligan, mobs were pretty much always passive where the patient just laid there and did nothing!

What I greatly respect about McKenzie & Mulligan is that they both promoted manual therapy based on directional preference of the patient. They empowered patients to determine what manual therapy and home exercise they received. They both rejected performing manual therapy based on motion palpation skills, looking for tiny motion restrictions.

With the greatest of respect to Brian Mulligan, I believe the term MWM should be changed to FWM (Facilitation With Movement). The terms MWM or SNAGs emphasize the assumption that specifically “joints” are being mobilized, when in fact the techniques have an inevitable neurophysiological effect on the skin, fascia, muscles, joint capsules and the nervous system.

We need to focus less on the assumption that only a specific joint deep inside is being mobilized, as realistically, it is far more complex than that.

I am in no way questioning the potential efficacy of the treatments, I am simply suggesting we move forward and acknowledge that whenever we touch a patient, more than just joints are involved.

 

We facilitate movement… that is the essence of manual therapy!

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