PHYSIOTHERAPY CLINICIAN BECOMES FIRST NEW MULLIGAN TEACHER IN THE UK FOR 20 YEARS

Thomas Mitchell, a MSK clinician in the public and private sector, has become the newest teacher for the Mulligan Concept in the UK. The international Mulligan Concept Teachers Association is renowned globally, and provides training in full-body Mobilisation with Movement techniques, innovated by their founder Brian Mulligan.

Why did you choose to learn the Mulligan Concept?

To me, it was the form manual therapy which made most sense, as it was delivered in functional positions and encouraged self-management.

My first experience of using the Mulligan Concept was with the Great Britain Wheelchair Ruby team in 2005. The sport is restricted to players who have severe physical disabilities such as multiple-amputation, or quadriplegia from spinal cord injury. Using Mobilisations with Movement with these athletes whilst they were in their wheelchairs was ideal as transferring them to treatment beds was time consuming and they were always busy training. As I moved from Wheelchair Rugby to other Paralympic sports to GB Boxing, the appeal and utility of these treatments grew. I became convinced that immediate symptom modification was the perfect for the athletic environment, and I’d challenge anyone to find a more useful intervention to give for pain or stiffness in the immediacy of competition.

So, would you only recommend its use in the acute sports setting?

Ha, not at all. As my sporting career tapered off, my general MSK caseload exploded, and application of these pain-free methods to assess and treat are a core component of my clinical approach. I find their utility in my Advanced Practice role as First Contact Practitioner particularly useful, once the patient has been assessed for red flags and rheumatology within a systems thinking framework.  I aim to be a rounded MSK practitioner delivering the most efficacious interventions from evidenced clinical assessment; and I find attempting to change a person’s symptoms with functional activities an essential tool in my reasoning. Essentially, Mobilisations with Movement are dependent on good communication, and I feel they assist in forging the therapist-client alliance in finding the path toward recovery. Motion is lotion, and the combination of the clinical treatment, with the self-treatment empowers the patient and encourages self-reliance, exposure to fearful movements and helps to reduce fear avoidance with movement. To be clear, I treat from a multi-modal perspective, in which the Mulligan Concept often features.

How was the training path to becoming a Mulligan Teacher?

You’d probably expect me to tell you how hard it has been, however, although I’ve put in the hours, my main recollection is how much fun I’ve had! Jetting off around Europe and the UK assisting on courses has been brilliant, plus I’ve had excellent mentorship from the UK and EU teachers with special mention to Dr Toby Hall and Sarah Counsell. That said, I’m a lot poorer in my pocket, but a richer clinician from the endeavour.

And how was the exam?

It was undoubtedly the hardest academic and clinical assessment I’ve experienced. Prior to the exam there were critical reviews and case studies to write, in addition to assisting other teachers in all components of the Mulligan Concept. The exam itself was practical, where three international teachers took my clinical application to pieces, and really pushed to question my reasoning, rational, and understanding of the evidence base. At the end of it, I had to have an afternoon nap! The next day, Brian Mulligan broke the news to me that I’d made the grade, and I was presented to the teaching group. A very proud moment.

What do you plan do next?

My aim is to build on the success of the Mulligan Concept training programme in the UK. Sadly, the excellent Ed Wilson and Linda Exelby are retiring from teaching their Mulligan courses, which opened the door for me to take on the role of educator. I’m very excited about introducing a more advanced course over 6 days for the UK audience, and hope to bring the Mulligan Concept onto some of the MSK Masters programmes.

If you are interested in learning more about the Mulligan Concept, please view the website at www.b.mulligan.org. For information about upcoming courses, please visit www.mulligan-concept.co.uk