This self-help guide is designed to help the patient gain exercise independence by learning concepts and techniques including posture, self-snag, exercises and the pain release phenomenon.
A patient self-help guide designed to teach independence.
It has been suggested by many of my patients that I should write a small publication detailing treatment and management information we have found really helpful. Not to do so would be a shame because much of this information is not available to the public from other sources.
I have practiced Physiotherapy for over four decades but what makes this book pertinent is that over the last 15-20 years I have developed new treatment concepts and procedures. These have been professionally rewarding and exciting.
Self-treatments that have resulted from these concepts form the bulk of the material in this book.
Many professions, like my own, osteopathy and chiropractic to mention but a few, have been mobilizing and manipulating joints of the body for years. My main concept has been to combine mobilizations with active or passive movements. Apart from one exception, I have been unable to find literature evidence on this approach being used by anyone else. The one exception was for the restoration of ankle flexion.
When treating the joints of the arm and leg, I call them "Mobilization with Movement" abbreviated to "MWMS" and when dealing with spinal joints I call mobilization with movements "SNAGS". It is an acronym for "sustained natural apopheseal glides". The term "SNAGS" is less of a mouthful. The term "SELF SNAGS" is used when the patient is "SNAGGING" him/herself.
The two most satisfying things about this new "Mobilization with Movement" concept are: When it is used, the patient will experience no pain. (Over 90% of my patients seek therapy because of pain.) The patient should notice an immediate improvement in function.
Simply put if the technique causes any pain it should not be used. Try another approach. If there is no functional improvement at the time of delivery, you do not proceed further.
Example: A middle-aged patient is unable to bend his knee fully because it is painful. A trial "Mobilization with movement" ("MWM") is undertaken to establish if it enables him to bend his knee further and experience no pain when doing so. If it works, then repetitions are done.
Another point is that most of this improvement should be maintained between treatment sessions, and where possible the patient is taught to do his/her own "Mobilizations with Movement". Often, the sustained mobilization (or repositioning) can be maintained with a taping. As already mentioned, this self-treatment approach using "MWMS" is the main reason for writing this small book.
Postural advice, taping and other material will also be included in the text and at the end there are details of another new approach that I have developed called "PRPS" or "Pain Release Phenomenon Techniques".
I have already stated that over 90% of my patients have come to me because of pain and they also have some movement dysfunction. Some examples of dysfunctions would be that they may have restricted neck movement, be unable to flex up a hip sufficiently to climb stairs, unable to move and ankle freely after an ankle sprain or arising after sitting may be a problem. The list goes on and on.
Repetition can be tedious but please remember that with the exception of "PRPs", all the advice given in this book, when followed properly, should produce no pain. If the techniques produce any pain at all they should not be used.
All the treatment and management advice, when followed, should not only produce no pain, but when there is a loss of joint function this must also improve. If it doesn't, there would be no point in continuing. There should also be a lasting effect. If not, seek other advice.
If English is not your first language, or if you have any problems understanding clearly the text, then please seek professional advice.
Written by Brian Mulligan, FNZSP, Dip MT. Illustrated. Softcover, 120 pages.