Mulligan's MWM's with ankle sprains (Full Version)

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SPT 06 -> Mulligan's MWM's with ankle sprains (March 4, 2004 1:14:00 PM)

Does anyone have a lot of experiance with his MWM's with lateral ankle sprains. e.g. posterior mobilization of the fibula at the lateral malleolus. I have heard people say that they have amazing results with this. How does everyone else feel?




eam -> Re: Mulligan's MWM's with ankle sprains (March 4, 2004 3:08:00 PM)

MWM's work very well in my experience with ankle sprains. What I find also useful is an anterior glide of the fibula at the proximal tib-fib joint. I have tried this on occasion and have had good results. The Mulligan taping for ankle sprains is also helpful.
Good luck!
Erica




mcap56 -> Re: Mulligan's MWM's with ankle sprains (March 4, 2004 4:43:00 PM)

I have also had good results with both the mob and the taping. I do think however, that we are looking at very short term benefits only. Mark Laslett, who worked/teached with Mulligan, was himself very skeptical of this mobilization.

Furthermore, the mob rests on the theory that the fibula is anteriorly displaced after ATF sprain. This is highly questionnable. A recent article in the AM J Sports Med found that the fibula was more likely to be posteriorly displaced after sprain.

So......this may be a case where we need to look beyond the hype!!!!

mcap




PTupdate.com -> Re: Mulligan's MWM's with ankle sprains (March 6, 2004 9:07:00 AM)

JOSPT did an article back in April 2002 regarding posterior glidiing with an ankle sprain. Mcap, which recent article are you referring to? Sometimes I miss something in the index of that journal.

Duffy [URL=http://www.PTupdate.com]www.PTupdate.com[/URL]




FLOrthoPT -> Re: Mulligan's MWM's with ankle sprains (March 6, 2004 3:59:00 PM)

I too use this mob and taping often. I am not so sure it works for the reason mulligan would like to think it works, but it may have something to do with stabilizing the calcaneus from excessive pronation which would take stress off of the concentric and eccentric stabilizers and reduc pain. I do use it thou, I had one high school athlete come in on crutches, mobs hime, tape him, and he walked out without any help...something is going on there, just don't think it is for the reasons mulligan says so.

By the way, which other mulligan techiques do you have success with? I have lots of success with carpal glide and taping, and thoracic spine mobilizations, much less success with the inferior glide during active humeral abduction that mulligan instructors all praise...just wondering-




eam -> Re: Mulligan's MWM's with ankle sprains (March 7, 2004 9:09:00 PM)

Other MWM's I find useful are elbow joint mobs with the belt, particularly with lateral epicondylitis as well as loss of elbow range of motion esp. flexion. Sometimes I find that the belt gets in my way with these. Does anybody have any helpful ideas with that? I also find that the GH abduction technique less successful. The SNAGS for the c-spine are wonderful and I have had instant success with this (roation and lateral flexion). But what I do find sometimes with these and his peripheral mobs is that the carryover to the next visit is lacking. However, with the following visits there certainly is gain.
Erica




goodlooks58 -> Re: Mulligan's MWM's with ankle sprains (March 8, 2004 3:31:00 AM)

Would reading the book by Brian Mulligan and following the techniques beneficial as compared to taking a seminar?




Alex Brenner PT MPT OCS -> Re: Mulligan's MWM's with ankle sprains (March 9, 2004 4:33:00 AM)

Goodlooks,
I bought the book and have tried using some of the techniques with the help of another therapist who attended the course. I have some success but could not imagine trying to do the techniques without attending the course or having another therapist teach me. Goodluck,

Army




mcap56 -> Re: Mulligan's MWM's with ankle sprains (March 9, 2004 10:17:00 AM)

Duffy:

Here you go......You probably have this one in the library.......

Eren OT, Kucukkaya M, Kabukcuoglu Y, Kuzgun U.

Am J Sports Med. 2003 Nov-Dec;31(6):995-8.

The role of a posteriorly positioned fibula in ankle sprain.

BACKGROUND: Specific anatomic variations of the ankle mortise may predispose people to ankle sprains. HYPOTHESIS: There is a correlation between a higher malleolar index (posteriorly positioned fibula) and incidence of ankle sprain. STUDY DESIGN: Prospective case control study. METHODS: We compared the malleolar index (transverse plane of the talus) on computerized axial tomographic images of 61 patients with ankle sprain with that of 101 normal controls. A positive number for the malleolar index meant that the lateral malleolus was posterior to the plane of the medial malleolus. A negative number meant that the lateral malleolus was actually anterior to the plane of the medial malleolus. RESULTS: The average malleolar index of the patients with ankle sprain was +11.5 degrees with a standard deviation of 7 degrees. Malleolar relationships varied from -6 degrees to +39 degrees, a range of 45 degrees. The average malleolar index in the control group was +5.85 degrees with a standard deviation of 4.9 degrees, which varied from -8 degrees to +16 degrees. However, there was no correlation between recurrence of sprains and malleolar index values. CONCLUSION: Patients with an ankle sprain were more likely to have a posteriorly positioned fibula, possibly predisposing them to ankle sprain.




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