Spinal Mobilisation

Spinal Mobilisation Techniques: Maitland and Mulligan Approaches

What is Spinal Mobilisation? 

Spinal mobilisation is a fundamental technique in the field of manual therapy, aimed at restoring mobility, reducing pain, and improving function in the spine. Among the various methods, the Maitland and Mulligan approaches are two of the most renowned techniques used by sports and physiotherapists worldwide.

Maitland Approach

Overview

The Maitland approach, developed by Geoffrey Maitland, is a systematic method of assessing and treating musculoskeletal conditions. It emphasizes the importance of patient feedback and the therapist’s clinical reasoning.

Principles

The Maitland technique is based on the application of graded oscillatory movements to the spine. These movements are categorized into five grades:

• Grade I: Small amplitude, rhythmic oscillations at the beginning of the range of motion.
• Grade II: Larger amplitude oscillations within the range but not reaching the end range.
• Grade III: Large amplitude oscillations performed up to the limit of the range.
• Grade IV: Small amplitude oscillations at the very end range of motion.
• Grade V: Manipulative thrusts of small amplitude but high velocity at the end range of motion.

Applications

The Maitland approach is used to treat a variety of spinal conditions, including:

• Spinal stenosis
• Degenerative disc disease
• Facet joint dysfunction
• Mechanical low back pain

Mulligan Approach

Overview

The Mulligan concept, developed by Brian Mulligan, combines mobilization with movement (MWM). This technique involves the application of a sustained manual force to a joint while the patient performs a movement that was previously restricted or painful.

Principles

The Mulligan approach is characterized by the following principles:

• Mobilization with Movement (MWM): The therapist applies a sustained glide to the spine while the patient performs specific movements.
• Sustained Natural Apophyseal Glides (SNAGs): A combination of sustained glides with active or passive movements to improve spinal mobility.
• NAGS (Natural Apophyseal Glides): Passive oscillatory mobilizations at the end range of joint motion.

Applications

The Mulligan approach is effective in treating conditions such as:

• Cervical and lumbar radiculopathy
• Chronic neck and back pain
• Joint dysfunction
• Postural syndromes

only performed by Pippa Carrick