The Mulligan concept: its application in the management of spinal conditions

The Mulligan concept encompasses a number of mobilising treatment techniques that can be applied to the spine, these include 'NAGs' (natural apophyseal glides), 'SNAGs' (sustained natural apophyseal glides), and 'SMWLMs' (spinal mobilisations with limb movements). These techniques are described and the general principles of examination and treatment are outlined. Clinical examples are used to illustrate the concept's application to the spine, how it has evolved and been integrated into constantly changing physiotherapy practice. New applications are considered which can assist in the correction of dysfunctional movement. The paper reflects on the possible role that this concept has to play within evidence-based practice. A future research direction is proposed in the light of presently available preliminary research results.