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Mulligan Therapy

Brian Mulligan developed the Mulligan therapy concepts on the basis of his clinical findings with patients. He was able to develop a number of techniques starting from simple finger techniques through to more elaborate techniques. His basic concept for treatment is that the joints are slightly out of alignment. Pushing the joint further out of alignment will create pain but pushing the joint back into correct alignment will reduce pain and allow pain free movements, thus it is very important when using these techniques that the patient understands that they have to inform the therapist if the technique is hurting. A simple explanation of the first technique he developed might explain this. He had a patient with a sore finger that wasn’t responding to normal established physiotherapy techniques. The patient couldn’t bend her finger. He thought he should try something different. He found the sore joint and pushed on the bones either side of the joint. This made the patient sore. He then pushed the joint in the opposite direction and the patient reported that it felt better. He then asked the patient to bend their finger and was amazed to see the finger bend fully without any pain. Since then he has developed techniques for just about every joint in the body. The results from these techniques are amazing to see at times but the critical thing is that they need to be done pain free. The less pain the better the techniques work. They often work really well with other techniques to achieve great results for patients.

Fascia

The deep front line fascial train passes through and surrounds the pelvic floor. This fascia extends from tibialis posterior in the lower leg up to diaphragm and into scalenes in the neck. The fascial network is continuous and very little in known about its functional relationship to muscle tension and less is known about changes that may occur during pelvic floor rehabilitation, (exercises) and surgery. Meyers a well known fascail train expert and myofascial therapist believes that fascia is a highly adaptive structure that can change in response to forces placed through the body. We do know that fascia is made mostly of elastic tissue and has no contractile elements like muscle. We can also demonstrate fascia is able to lengthen or tighten, depending on loads applied. Lets argue that a weak pelvic floor, which is essentially bowl shaped, deepens. This deepening potentially stretches the fascia over time, maybe 1-2 years. Which then leads to less support through the pelvic floor for the pelvic organs. Strengthening the pelvic floor leads to reduced stretch of the pelvic fascia. Therefore we could assume that those that get some relief from their pelvic pain by lying down, especially if the pelvis is higher than the shoulders, may get relief from long term pelvic floor strengthening routines. We could also assume that some of the pelvic pain may be due to altered tension of the pelvic fascia.