Mulligan's Upper Quadrant

Mulligans upper2

Along with Mulligan's Lower Quadrant course, this course forms one of the two 'core' units of the Mulligan Concept Program and the use of mobilisation with movement. Mobilisation with movement is one of the most popular approaches physiotherapists use to treat neuromusculoskeletal conditions. Mark has presented Mulligan courses for over 30 years and assisted Brian worldwide on numerous occasions. The approach is easy to learn and integrate into existing examination and treatment models. There is a large body of research validating the concept.

Presented by Mr. Mark Oliver (certified Mulligan concepts teacher), this 2-day practical workshop provides participants with new examinations and easy-to-apply treatment skills. Participants must be registered as a physiotherapist, chiropractors, osteopaths or medical practitioners with AHPRA.

The Upper Quadrant course includes:

  • MWM techniques for the shoulder girdle, shoulder, elbow, wrist, and hand
  • SNAGS (a form of MWM for the spinal column) for the cervical and thoracic (including ribs) region
  • NAGs and SNAGs for the cervical and thoracic regions
  • Techniques for cervicogenic headaches and dizziness 
  • Techniques for treatment of upper limb neural elements. 

Mark has had the privilege of Brian’s mentoring since 1981 which continues to this day. He is Australia's most experienced Mulligan Concept teacher having taught the approach intensively since 1988.

Learning Outcomes

  1. At the completion of this course, participants should have a good understanding of the Scandinavian concept of joint mobilisation.
  2. At the completion of this course, participants should have a basic understanding of the Mulligan concept of mobilisation with movement and the clinical reasoning process it is based on.
  3. At the completion of this course, participants should have a basic understanding of the “Pain Release Phenomenon” (PRP) concept and be able to perform PRP techniques on structures of the upper limbs and cervical spine.
  4. the completion of this course, participants should be able to perform basic mobilisation with movement and self – mobilisation with movement treatment techniques to joints of the upper limb, cervical spine, thoracic spine and ribs.
  5. At the completion of this course, participants should be able to perform NAGs and SNAGs to the cervical spine.
  6. At the completion of this course, participants will be expected to be aware of the current research and publications related to the Mulligan concept.
  7. At the completion of this course, participants should be able to perform spinal mobilisation with arm movement techniques.
  8. At the completion of this course, the participant should be able to apply appropriate Mulligan Concept techniques to the upper cervical spine for headaches and autonomic phenomena associated with upper cervical dysfunction.

Participants are required to; Mull upp2

  1. Have a sound knowledge of human anatomy and biomechanics
  2. Be fully aware of the contraindications to manual therapy and adhere to appropriate examination and treatment guidelines
  3. Comply with the most important Mulligan Concept guideline: When applying a Mobilization with Movement (MWM) technique, if you take up the slack and it is painful, DO NOT PROCEED
  4. Possess competent handling and communication skills, to facilitate patient compliance with instructions
  5. To treat other participants with the same care and respect accorded to patients
  6. Take personal responsibility for any conditions you may have that might be exacerbated by practising manual therapy skills: INFORM YOUR FELLOW PARTICIPANTS

Mobilisation With Movement made simple!

  • Identify symptomatic or dysfunctional movement or activity
  • Apply and sustain pain-free mobilization forces
  • With the mobilization forces applied and sustained, repeat the symptomatic movement or activity
  • If the movement is then PAIN-FREE, repeat the activity three times and at the end of each movement, apply end-of-range overpressure.
  • When the symptomatic movement is re-tested, there should be a significant lessening of pain and improvement in movement
  • Depending on the presentation and response to treatment, the MWM can be repeated, modified, and progressed/integrated into self-treatment techniques and functional exercise.

Mobilisation With Movement

  • Combines passive mobilization with active movement
  • Performed in weight-bearing positions if possible and if indicated
  • A "no pain" guideline is used as a basis for sound clinical reasoning in examination and treatment
  • Clinically facilitates normal muscle function and eliminates maladaptive movement patterns and movement "fear avoidance".

A simple theoretical model for the effectiveness of MWM

  • The pain-free normal movement is achieved by applying specific forces relative to the joint plane so that neural afferent activity from innervated joint structures, surrounding ligaments, fascia, tendons, and muscles are normalized - reassertion of an appropriate response from the CNS
  • Re-establish normal mechanoreceptor and nociceptor activity responses during movement aided by: 
    • Performing the MWM in weight-bearing positions  
    • Combining with cognitive goal-directed functional movement
    • Guiding and supporting the patient as they move to INSTANTANEOUSLY eliminate fearful responses, bracing patterns, and other maladaptive compensatory movement strategies

Rural & Remote Professional Development Support

See Rural Workforce Support Agencies for details in your state or territory.