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One-on-one physiotherapy in Kağıthane
Uzm. Fzt. Derya Boncuk KapısızKağıthane · İstanbul

Mulligan Concept in Kağıthane (Mobilisation with Movement)

A hands-on approach that applies a gentle, sustained, pain-free glide to the joint while you perform the painful or restricted movement, aiming to ease movement in neck, low-back, shoulder, elbow and knee complaints.

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The Mulligan Concept (also called the Mulligan technique) is a manual therapy approach developed by New Zealand physiotherapist Brian Mulligan and taught in many countries today. At its core is the idea of Mobilisation with Movement: while a gentle, sustained glide is applied to a joint, you actively perform the movement that is painful or restricted.

The core rule of the concept is that the application must be pain-free. If you feel pain during the glide, I change its direction, force or my hand position; if it still does not become pain-free, I stop. There is no quick thrust or “cracking”; you perform the movement under your own control.

At my clinic in Kağıthane I work one-on-one and, as a Certified Mulligan Therapist, use this approach in cases I find suitable after assessment. The Mulligan Concept is not a program on its own; it is applied together with manual therapy, soft-tissue mobilization and exercise, as part of a plan specific to you.

Who is it suitable for?

  • People who find it hard to turn their head because of neck pain or pain related to a neck herniation
  • People with low-back pain when bending forward, sitting down or getting up
  • People with pain and restricted movement when raising the arm due to shoulder impingement
  • People who struggle to grip and lift because of tennis elbow or wrist pain
  • People who struggle to squat or go up and down stairs because of knee pain
  • People whose movement is still restricted after an ankle sprain
  • People with headache originating from the neck (cervicogenic headache)

How is the Mulligan Concept applied?

The application begins by finding the movement that brings on your pain. A light, sustained glide, chosen according to the plane of the joint surfaces, is then applied to the joint, and the direction in which the movement can be done pain-free is found by trial. You perform that same movement while the glide is maintained, and the glide is held until the movement is complete and you are back in the starting position.

Applications are often done in the position where the complaint appears: sitting for the neck, standing with weight on the leg for the knee and ankle. If the movement becomes pain-free with the glide, a few repetitions follow, and the same movement is then re-tested without the glide. If there is pain, the application is changed or stopped; it is not continued through pain.

The most commonly used applications within the concept are:

  • MWM (Mobilisation with Movement): combining a sustained glide with active movement in joints such as the shoulder, elbow, wrist, knee and ankle
  • SNAG (Sustained Natural Apophyseal Glide): the application developed for the spine. A glide is applied to the small joints between the vertebrae (facet joints) along their own plane while you actively move your neck, mid-back or low back.
  • NAG (Natural Apophyseal Glide): gentle, rhythmic glides applied mostly to the neck and upper back while you sit. Unlike a SNAG, the glide is repeated rather than sustained, and you do not need to move during it.

Which complaints is it used for?

The Mulligan Concept is relevant when pain or restriction appears with a particular movement. Diagnosis belongs to the physician; the headings below are where Mulligan applications can be added to the program when the assessment findings are suitable:

  • Neck pain and pain related to a neck herniation
  • Headache originating from the neck (cervicogenic headache)
  • Low-back pain and restriction when bending forward or getting up from sitting
  • Shoulder impingement and restricted arm raising
  • Tennis elbow (lateral epicondylitis) and wrist pain
  • Knee pain and difficulty squatting or using stairs
  • Restricted movement that persists after an ankle sprain

Where does the Mulligan Concept fit in my program?

Every process starts with an assessment. I listen to the history of your pain, find the movement that brings it on and test range of motion and muscle strength. I add Mulligan applications to the program only when these findings are suitable; if they are not, I choose another approach.

In the session I usually combine Mulligan applications with manual therapy and soft-tissue mobilization, and we then support the eased movement with exercise. The aim is for the movement gained in the session to become usable in daily life as well.

Some applications in the Mulligan Concept have versions a person can be taught to do on their own. I do not hand these out as a general home protocol. When I find it suitable, I teach you a movement specific to you in the session, we check together that you are doing it correctly, and I review it in the following sessions. These movements are individual and may not be suitable for someone else.

Who is it not applied to, and when do I refer to a physician?

Diagnosis is the physician’s task. Although Mulligan applications are gentle, they are not suitable in every situation; if one of the following findings is present at assessment, I do not apply them and refer you to a physician:

  • Fracture or suspected fracture, or acute trauma after a recent fall or impact
  • Progressive loss of strength or spreading numbness in the arm or leg
  • Disturbance of bladder or bowel control
  • Unexplained weight loss, fever, or pain that does not ease with night rest
  • Known or suspected tumor, active infection, or advanced osteoporosis
  • Dizziness, double vision, or difficulty speaking or swallowing brought on by neck movements
Session Flow

What happens in a session?

  1. 01

    Assessment

    I listen to your complaint and test the movement that brings on your pain and the restriction; I review your MRI and physician’s report if available. We decide together whether the Mulligan Concept is suitable for you.

  2. 02

    Mobilisation with movement

    While I apply a gentle, sustained glide to the joint, you actively perform the painful movement. The application must be pain-free; if there is pain, it is changed or stopped.

  3. 03

    Re-test

    After the application we test the same movement again without the glide; we assess the change together and I plan the next step accordingly.

  4. 04

    Supporting program

    The program is completed with the manual therapy and exercise deemed necessary. If I find it suitable, I teach you a movement specific to you in the session and check that you do it correctly.

Frequently Asked Questions

Common questions about Mulligan Concept

What is the Mulligan Concept?
The Mulligan Concept is a manual therapy approach developed by New Zealand physiotherapist Brian Mulligan. While the physiotherapist applies a light, sustained glide to a joint, the person actively performs the painful or restricted movement. This is called Mobilisation with Movement (MWM); the versions used in the spine are called SNAGs and NAGs. Its core rule is that the application must be pain-free.
Does the Mulligan technique hurt?
It should not. The core rule of the concept is that the application is pain-free: if you feel pain during the glide, I change its direction, force or my hand position, and if it still does not become pain-free, I stop. You may feel slight pressure where my hand makes contact or a stretch at the end of the movement; we clarify how this differs from pain together in the first session.
How is it different from “cracking” (manipulation)?
In manipulation, popularly known as “cracking,” the joint is moved with a quick, short thrust and a sound is often heard. There is no such quick thrust in the Mulligan Concept: the glide is slow and sustained, you perform the movement at your own pace and you can stop whenever you want. Producing a sound is not the aim. This also sets it apart from the quick manipulation techniques used in chiropractic.
Can the Mulligan Concept be applied for a neck herniation?
It can, if the assessment finds it suitable. The aim is not to “put the disc back”; it is to ease neck movement without increasing pain and to prepare the ground for the exercise part of the program. Diagnosis belongs to your physician; bring your MRI or physician’s note to the first visit if you have one. If there are signs such as progressive loss of strength in the arm, loss of dexterity in the hand or unsteadiness when walking, it is not applied and physician assessment is needed.
How many sessions are needed?
There is no fixed number. The number of sessions depends on the assessment, how long the complaint has lasted and how you respond to the applications. At the first visit I explain an estimated plan, but it is not a promise; it is a plan we update together according to your response in the first sessions. I do not recommend unnecessary sessions.
Can I apply it to myself at home?
I do not recommend applying it to yourself based on online videos; the direction and location of the glide vary from person to person, and incorrect application can make the complaint worse. Some movements in the Mulligan Concept can be taught to the person, but I do this only after an assessment, as a movement specific to you that we check together in the session.
What is the difference between the Mulligan Concept and manual therapy?
The Mulligan Concept is one of the approaches within manual therapy. In classic joint mobilization the physiotherapist moves the joint while you rest; in the Mulligan Concept you actively perform the movement while the glide is maintained. In practice I do not use the two separately but together, according to the assessment findings.
Where can I find a physiotherapist who applies the Mulligan Concept in Istanbul?
At my practice in Kağıthane I work as a Certified Mulligan Therapist and apply the Mulligan Concept one-on-one after an assessment, as part of an individual program. I accept clients from every district of Istanbul, European and Asian side. I am close to Kağıthane station on the M7 and M11 metro lines and open 08:00-22:00 on weekdays and 08:00-18:00 on Saturdays.

The information on this page is for general information and is not a substitute for personalized medical advice or diagnosis. A diagnosis is made by a physician. For your complaint, please consult a healthcare provider.

Let’s take the first step together, Mulligan Concept

I listen to your complaint and carry out the necessary measurements and assessment; then we decide the right path for you together. You are under no obligation to continue with a program.

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