Introduction
The treatment of musculoskeletal injuries has progressed from its foundation in remedial gymnastics and active exercise to therapist-applied passive physiological movements and on to therapist-applied accessory techniques.
Brian Mulligan's concept of mobilisations with movement (MWMS) in the extremities and sustained natural apophyseal glides (SNAGS) in the spine are the logical continuance of this evolution with the concurrent application of both therapist applied accessory and patient generated active physiological movements.
Principles of Treatment
In the application of manual therapy techniques, therapists acknowledge that contraindications to treatment exist and should be respected at all times. Although always guided by the basic rule of never causing pain, therapist choosing to make use of SNAGS in the spine and MWMs in the extremities must still know and abide by the basic rules of application of manual therapy techniques.
Self-treatment is often possible using MWM principles with adhesive tape and/or the patient providing the glide component of the MWM and the patient's own efforts to produce the active movement.
Pain is always the guide. Successful MWM and Snags techniques should render the comparable sign painless while significantly improving function during the application of the technique. Sustained improvements are necessary to justify ongoing intervention.
