How the Mulligan Concept Helps with Sprained Ankles

The Mulligan Concept is a technique in physical therapy that was developed by Brian Mulligan, a physical therapist in New Zealand, and uses the concept of mobilizations with movement (MWM) as a specific therapeutic intervention, designed to couple accessory mobilization with physiological motion. Mulligan theorized that injuries and sprains were caused by minor positional faults in the joints, which can limit a person’s movement (Woodman, 2013). Positional faults can either be a misalignment of the joint or a dislocation that is unnoticeable and too subtle to feel or see on a radiograph. The techniques developed in the Mulligan Concept have been designed to correct these positional faults and help a person become pain free and regain movement (Mau, 2014).

The Mulligan Concept is especially helpful in treating inversion ankle sprains painlessly. To treat the inversion ankle sprain with the MWM technique, the patient is positioned supine with their heel at the end of the treatment table. The therapist will then place their hand on the anterior and distal portion of the lateral malleolus and the other hand to support the leg. Then, the MWM is done by gliding the fibula posteriorly and the tibia obliquely (Woodman, 2013). While the glide is being done, the patient is asked to do a plantar flexion and inversion movement. After that, the therapist puts force on the foot using his abdomen in order to further displace it beyond the limit of active movement. Once the MWM technique is applied, tape can be used to help keep the fibula reposition in place.

Many clinicians and therapists that use the Mulligan and MWM technique have reported decreases in self-reported pain and improved function in their patients after one treatment. Other MWM techniques have also been used to other types of ankle sprains. Therapists using MWM said their patients had increased pain free motion and improved gait. One doctor used these techniques on a college soccer player who had suffered from a lateral ankle sprain. After MWM treatment, the player became symptom free and was able to return to competition without reinjury for the rest of the year. The Mulligan treatment is pain free and can be used on any patient no matter what stage their injury is in (Mau, 2014). Especially for ankles, the Mulligan Concept has become an effective and proven way to treat sprains and injuries. The above mentioned technique is used at Enhanced Physical Therapy with a 90-100% success rate.