The final chapter of our “Why Manual Therapy” blog series has arrived! Thanks for following along throughout the year. If you missed any check them out (HERE).

The future of manual therapy (MT) has never been brighter (HERE & HERE) Thanks to brilliant researchers and thought leaders the evidence supporting MT as a pain modulation option is unquestionable. We live in exciting times for understanding and effectively applying MT.

As professionals, we have the responsibility to provide the most effective and evidence-informed care for our patients. We take great pride in our work. However, sustaining a high level of care throughout a professional career is a challenge we all experience. I believe this is particularly true regarding manual therapy skills.

How can clinicians keep their manual therapy skills sharp throughout their careers? 

While I can’t say what is best for everyone, in this blog I will present the top 5 methods I implement to keep my MT on point.

1. Develop a “Personal Model of Care” that helps guide your evaluation and treatment options.

If you are like me, the busyness of working full-time in the clinic can lead to treatment ruts. A treatment rut to me is too much reliance and focus on any one intervention. The complexity of clinical care creates mental fatigue and physical fatigue leading to treatment fidelity issues (HERE).

A perfect example of a clinical rut is taking an exercise-only approach with all of my patients.  While exercise is needed for every single patient I see, too much focus may lead to suboptimal care. This was highlighted in a previous blog (HERE) where taking an exercise-only approach led to worse outcomes in lower back pain.

The current evidence supports taking a multimodal approach as one of the best ways to practice at a high level. My multimodal model of care, represented in the below image, helps keep my evaluations and treatments focused.

Put to words, this model says to me.

• Let clinical reasoning guide all that I do; stay centered in clinical reasoning to promote function and strive toward person-centered goals. Always look at the whole person including pain mechanisms, personal factors, social determinants of health, and environmental variables.
• Taking an exercise approach is always vital. This approach is likely the best long-term way to keep function high and pain low.
• Use psychologically informed education topics to shift cognitions and maladaptive beliefs to move beyond stubborn yellow flags when needed
• Teach patients to listen to their bodies while setting boundaries for activity to keep pain flare-ups at a minimum.
• Use MT to modulate pain and drive afferent sensory input into the nervous system to facilitate neural plasticity if possible. Focus on symptom modification early and often to decrease pain and move towards focused movement strategies.

I imagine each patient has the potential to require some care from each quadrant.  However, each patient will have an individual “radar plot” that represents their best avenue to success. My challenge is to create an N=1 optimal “radar plot” for each person to ensure their best multi-modal approach.

(The below example would be a person with nociceptive pain classification who is a responder to MT that improves and meets clinical goals in 4-6 visits)

The best therapists I have ever worked with match the patient to the correct quadrant and “radar plot” early in care. Further, if they start in an ineffective category they realize it quickly and shift their strategy to a more effective one.

 

2. Set Continuing Education Goals and Execute Them.

What does your continuing education plan look like? If you don’t have one, make one now!

Set goals. Make a plan to work towards those goals. Find a MT class you love. Get good with your hands. Take all the courses. Get certified. But, please don’t do it for the letters after your name. Instead do it to create a deep foundation for clinical success. Take the long road and don’t try to master it all too quickly. Be like the slow-growing oak tree - grow deep roots and find joy in learning.

 

3. Find Honest and Reliable Sources for Research.

There is no way to keep up with all the research coming out. Social media is a great place to hear from thought leaders, but only going there for all your content can create narrow echo chambers of confirmation bias.  Go beyond social media. One website where I find consistently honest and credible content is (HERE). It blends research thought leader opinions and vetted research articles on MT.  Check it out.

 

4. Take Care of yourself.

It is hard to care for others if you do not mind your self-care and fitness you enjoy. Prioritize your sleep hygiene. Engage in movement that makes you feel good. Find things outside of work that brings you joy. Invest your time and money in things that care for your body and mind.

 

5. Don’t Let Any Brand of Manual Therapy Become Your Clinical Identity.

The Mulligan Concept is arguably the most evidence-based hands-on symptom modification approach available. I love it! I teach it! I can’t imagine practicing without it. However, instead of viewing myself as a “Mulligan Therapist”, I perceive myself as a physical therapist with many options to help an individual meet their goals.

Manual Therapy pioneer Freddy Katlenborn is credited as being one of Brian Mulligan’s most influential manual therapy mentors. Freddy passed away in 2019. One of my favorite Kaltenborn sayings from 2014 states:

“Perhaps the time has come for OMT practitioners to cease naming treatments according to a school of thought. The principles of treatment are far more important than the name of the practitioner who first developed the technique. It is not important that a technique, for example, was originally part of the “Kaltenborn”, “Cyriax”, “Maitland”, or any other method. Such compartmentalization of clinical practice hinders the development and growth of the OMT profession. The best OMT practitioners do not restrict their practice to a single approach or school of thought but rather develop expertise in many systems. Master clinicians utilize techniques derived from many sources, modifying, combining, and refining their repertoire of techniques into a unique application for each patient. As OMT practice so evolves, the principles of treatment which encompass all schools of thought will more clearly emerge.”  (HERE)

 

Conclusion:

Manual therapy techniques have been used since antiquity by caring individuals to help people in pain (HERE). Along this timeline, research focusing on the effectiveness of manual therapy is in its infancy.

The future of MT resides within you! Be open to change, follow the research, and don’t neglect your manual therapy skills!  Practice within the confidence that supports manual therapy as a pain modulation option.

The Mulligan Concept Teachers Association looks forward to seeing you at a live in-person course soon!

Stay tuned for our 2024 Newsletter content!

Have a blessed New Year!

Jarrod Brian

The biggest reason clinicians use manual therapy is to help restore pain-free functional movement faster.  Have you noticed the other benefits, particularly when using the Mulligan Concept and symptom-free Mobilization with Movement?

I certainly have! Here are my top 5.

1. Increased compliance with home exercise programs

If you can use a Mobilization With Movement to enable your patient to move without symptoms, especially when that particular movement means a lot to them, it opens up their ears to whatever else you have to say!  Especially if the follow-up exercise is a way they can produce the same effect as the MWM you just performed together, gaining compliance is easy!  Even when you may not have a perfect self-MWM as a follow-up exercise, being able to eliminate someone’s symptoms fosters confidence in everything else you recommend thereafter.  The patient will be all ears to other advice you give once you have demonstrated to them in a very real and practical way that you can help them turn off their symptoms.

2.  Improved rapport with your patients

As soon as you begin working with your patient and they realize that they are an important piece in their rehabilitation, your relationship strengthens.  When performing MWM’s, you are constantly asking your patient how it feels and what pressure or force feels better/worse, etc.  Patients soon appreciate more deeply the effect that the treatment is having on their function, and they start paying attention and tuning in more to their movement patterns and what feels good and what doesn’t.  They become more educated in their own condition!  Furthermore, when the movement you ask them to do is exactly the movement they have been complaining about, they understand that you have been paying attention to their story.  They also understand that how they react is an important part of what you decide to do next!  They are invested!

3. Improved self-perception of their problem

Many patients, especially those who have had a problem for any length of time, feel frustrated and lose hope in regaining their function.  Combining manual therapy with their exact functional movement they are struggling to achieve can have significant positive effects on their perception of their problem.  If patients learn that it is still possible for them to move without pain, the perception of their prognosis improves dramatically in a conscious way.  Subconsciously, every pain-free repetition they perform is extinguishing a learned pain response, changing that plastic nervous system right before your eyes.

4. Decreased dependence on healthcare

One of the biggest benefits of the Mulligan Concept is the ability to teach your patients ways of performing Mobilizations With Movement on their own.  If they can take away their own symptoms, then if these symptoms ever return, they have the tools to address them immediately.  Once taught, the use of Self MWM’s or the use of tape to facilitate a positive input and quicker return to symptom-free movement are not forgotten and can be reapplied again and again if necessary.  Furthermore, many patients pass these ideas on to their friends and family as well.

5. Improved clinician understanding of your patient’s problem

If you can make a significant within treatment change with your patient, and this carries over into the next treatment, your understanding of your patient’s problem improves.  Their prognosis improves.  These are the patients you want to treat, and the ones you can have the biggest effect on.  In some settings, this can be extremely valuable for triage.  Furthermore, many Mobilizations With Movement help with differential diagnosis and can help you discover and emphasize the most effective treatment faster when considering multiple possible sources.

Conclusion

While manual therapy is rarely the only treatment you use within a session, and the Mulligan Concept may only be one piece of that, its value cannot be overstated.   Mobilization With Movement is a fantastic manual therapy procedure to restore pain-free function.   The Mulligan Concept can be the gateway to you and your patient understanding their problem, and the most efficient means to remedy it.

Mark

From Drama to Empowerment

Traditional manual therapy has been biomechanically based with only a recent sprinkling of neurophysiology and pain science. The beliefs and expectations of the patient have often been ignored. The biopsychosocial-spiritual nature of care is what ultimately drives change. N=1. The patient’s unique functional impairment will never follow a recipe of care.

Traditional manual therapy places the ultimate story in the hands of the therapist. The therapist feels impaired movement and attempts to correct it for the patient before typically reinforcing “the fix” with education and home exercises. We unknowingly have become a rescuer as a clinician and have unknowingly placed the patient into the role of a victim.

The Dreaded Drama Triangle

The way we look at things is the most powerful force in shaping our lives. Our stories matter!

The Dreaded Drama Triangle (DDT) is the toxic interplay of three distinct roles; Persecutor, Victim and Rescuer, which was first articulated by American psychiatrist Dr. Stephen Karpman in the 1960’s. Healthcare often follows this narrative. The patient plays the role of the Victim with situations such as health acting upon them often beyond their control. This situation or condition may be seen as a Persecutor. The clinician plays the part of the Rescuer, the one who intervenes on behalf of the Victim, to deliver the Victim from harm by the Persecutor. While the Rescuer may have the best of intentions, their actions remove the Victim from responsibility, thereby reinforcing their Victim mindset.

David Emerald wrote about The Empowerment Dynamic (TED) in 2005. TED shifts the story in the DDT. I feel that this is the perfect analogy to the power of narratives. The TED flips the DDT 180 degrees. The Victim becomes a Creator. The Persecutor becomes a Challenger. The Rescuer becomes a Coach. Patients tell us they want autonomy and to be a part of a team, relatedness. The TED lens places patients in the role of the hero in their own journey. This shifts and transforms their story from reacting to creating. A Creator has choices that lead to growth and resiliency. Possibilities. Creators take responsibility and action toward desired outcomes. A Challenge is something that can be overcome and can be seen as an opportunity to grow. We as clinicians take on the role of a Coach. We walk beside the Creator. We do not need to carry them. We focus on the need to understand versus the need to fix. We provide therapy with a coaching edge. Guiding empowerment, finding, and creating meaning. Coaching embraces whole-person care. We are a co-creator. Confluence.

The Mulligan Concept Creates Confluence

In The Mulligan Concept, the patient has the locus of control, not the therapist. We do therapy with our patients as opposed to them or on them. Our patients are doing the impaired activity while we are providing an accessory movement/glide. We are in constant communication with the patient as they decide what is working not us. We alter the treatment direction/force/location accordingly. The patient can see and feel if treatment is successful, and we adapt as guided by them. The outcome is created together as a team. This fuels patient self-efficacy and motivation that change is possible and shows them that they have an autonomous role. The new story moving forward is created together as a team. It is a confluence.

Intrinsic motivation is the key to any change and opens the door to adherence. Behaviour change strategies such as cognitive behavioural theory, self-determination theory, social cognitive theory, and motivational interviewing all intersect at the themes of autonomy support, a sense of team (relatedness), and self-efficacy (competence). All of these themes are born out of empathy, connection, and trust. The Mulligan Concept is a living example of how this works in practice. Fixing somebody does little for their intrinsic motivation.

Therapy with a coaching edge is built on these same foundations of empathy, connection, and trust. Change is not imposed on the patient. Options are considered, readiness to change is assessed and the narrative speaks to possibilities. Once autonomy support and relatedness are truly present, then self-efficacy, competence, and confidence emerge in the arms of enhanced intrinsic motivation. Physical therapy is an agent of change. Therapy with a coaching edge shifts the story for us as clinicians to that of partner and co-creator. Narratives are healing and transformative for the patient and the clinician.

Stories matter. Are we creating sanctuaries or are we creating prisons by the words we use? Are we creating challenges for our patients or introducing them to persecutors? Do we invite them to be the creators of their own hero’s journey, or do we unknowingly place them in the role of victim?

Stories matter. Do we tell them the story we want for them or are we creating a shared story together? Finding and creating meaning collaboratively is a skill. It is a practice. It is the confluence of being a clinician.

The Mulligan Concept lives at the intersection of manual therapy and pain science but it also is an effective example of the confluence of care. It is a therapeutic alliance fueled by autonomy support and gives the patient the role of the creator. The Mulligan Concept allows the patient to be the hero of their own journey!

Creative writing and poetry have played a big part in my own self-reflection process. The writing and study of stories and poetry build empathy and narrative competence to not only get to know ourselves but to meet others where they truly are. Poetry has assisted me in navigating the uncertainty of being a clinician as it embraces the mystery of just being alive. We can never trade mystery for mastery. I shared this journey as a poetic odyssey in my book, Cuoreosity: The heArt of Being. Please reach out to me if you are interested in where coaching and therapy connect to help create a more fulfilling practice or how poetry/creative writing can transform the resilience of ‘being” a physiotherapist.

jim@mulligancanada.com

@jim_millard Instagram

Substack https://substack.com/@jamiemillard1

www.cuoreosity.com

Thank You,

Jim Millard

Confluence

Two lives colliding at the altar of care
A communion of collaboration
Weaving a tapestry of meaning
Converging into a new story
Woven in possibility
Inviting change
A confluence
Two stories
Transforming
Two-One

J.Millard

 

 

We are ultimately in the people business serving rehab, not in the rehab business serving people. We are in the people business! We serve people. People who are unique individuals with unique challenges. There will never be a recipe for treatment. No two people are the same, and no two problems are ever the same. The clinical “problem” may be found in a textbook, ie. Mechanical hip pain, but the patient’s context never will be in a textbook.

“If Content is king then Context is queen. Conversation is the kingdom, and the Currency is Human Connection.” Jim Millard

We believe that we tell stories but often our stories tell us. This goes for our patients but also for us as clinicians. Stories matter. Stories are both our sanctuaries and our prisons. John Launer, one of the key figures in Narrative Medicine, states that a consultation is really a conversation and our quest is to find and to create meaning. In clinical care two stories come together as one. That new story is built in the kingdom of communication and comes to life in the currency of connection.

Connection

Our clients and patients desire empathy and effective communication. At this intersection lies connection. Connection is the bridge to a strong therapeutic alliance. Connection and communicating may often be used synonymously. The truth is that we all communicate, however, it doesn’t mean that we are successfully connecting. As practicing clinicians, we need to communicate and connect with 100% of the patients we encounter, 100% of the time. We lead patients every day. We rely on sound communication skill to inspire and to positively influence others. Most of us assume that we do this well already. Communication is defined by what has been understood, not by what we have conveyed. Communication skills are rarely reflected on, practiced, or specifically trained in our clinical healthcare professions. Connection multiplies communication. Through connection we can find the path to meaning.

The work of Dr. Maxi Miciak shows that effective clinicians initiate connection with their patients. They create a sense of team on a deeper emotional level beyond just an interaction. Miciak also identified four conditions necessary to create a therapeutic relationship; being present, receptive, genuine, and committed. All speak to connection. Connection is the gate to effective communication.

What is a Clinician?

Everything intersects at the story we co-create. All of the evidence, our skill, our compassionate care and meaning intersect at the story. Confluence. Confluence precedes influence. Confluence is the heart of Being a clinician! A clinician, not a technician.

Being a clinician as opposed to a technician exists at the confluence of evidence, clinical skill, care, and communication. The confluence of art and science. The confluence of two experiences. The confluence of me and we. The confluence of two stories merging into one as I shared in the poem that I wrote above. We as clinicians are guided by evidence, our training, and the compassionate empathic communication of care. However, all of this is only as effective as how we create meaning for and with the patient. I believe that The Mulligan Concept beautifully demonstrates this confluence.

In The Mulligan Concept, we focus on the patient’s unique movement/function impairment. The context drives the treatment not the content per se. The patient’s unique impairment and how it affects their function becomes the treatment in itself.  The patient helps define meaning. Treatment is guided by communication lived together as a team. We truly form a therapeutic alliance in every sense of patient/relationship-centered care. We both perform the treatment together as a new story fueled by the foundation of connection.

Creating Meaning

John Launer calls finding and creating meaning, hermeneutics. The term hermeneutics is derived from the Greek word hermeneuo which means ‘translate’ or ‘interpret’. This originally pertained to the interpretation of classical texts. Launer and associates use the term hermeneutics to signify an approach that seeks to help clinician and patient find and create meaning in a context-specific manner. The perspectives and experiences of both are brought together during a therapeutic encounter to generate a new understanding. Far from just storytelling. It is creating a shared understanding that becomes a new story. Agreed-upon truths and solutions are established by the process of dialogue itself. A confluence.

Treatment encounters are always a meeting of interpretation and translation. Our patients ultimately define if communication actually took place. Launer refers to “listening in order to speak” and “speaking in order to listen.” In the former, we only scan the words that patients are saying, looking for opportunities to jump in, to give advice and to rescue them. In the latter, we do the opposite: speaking only in order to give them more opportunities to explain their own views and how they make sense of their world. We collaborate on a shared understanding at the intersection of empathy, connection, and trust. To the clinician this understanding is a much closer approximation of the patient’s contextual reality. To the patient it is the deeper understanding of what matters to them with regards to their situation and what they need to do. It is far beyond the understanding of what is the matter with them. It’s about what matters to them! It is a conversation versus a consultation. Without this level of communication, adherence cannot be assured, with it, adherence is enhanced. Confluence leads to influence.

Conclusion

Creative writing and poetry have played a big part of my own self-reflection process. The writing and study of stories and poetry build empathy and narrative competence to not only get to know ourselves but to meet others where they truly are. Poetry has assisted me in navigating the uncertainty of being a clinician as it embraces the mystery of just being alive. We can never trade mystery for mastery. I shared this journey as a poetic odyssey in my book, Cuoreosity: The heArt of Being. Please reach out to me if you are interested in where coaching and therapy connect to help to create a more fulfilling practice or how poetry/creative writing can transform the resilience of ‘being” a physiotherapist.

jim@mulligancanada.com

@jim_millard Instagram

Substack https://substack.com/@jamiemillard1

www.cuoreosity.com

Thank You,

Jim Millard

Manual therapy has been an essential part of healthcare for centuries, offering a hands-on approach to treating musculoskeletal conditions, reducing pain, and restoring optimal function. Among the various manual therapy techniques, the Mulligan Concept stands out as a quick, safe, and effective method, when indicated, and is currently used by manual therapists worldwide. It is distinctly different from some traditional forms of passive manual therapy that have been shown to be unreliable.

Understanding the Mulligan Concept

Developed by New Zealand physiotherapist Brian R. Mulligan, the Mulligan Concept is a manual therapy approach that includes mobilization with movement (MWM) and sustained natural apophyseal glides (SNAGs). Unlike many traditional manual therapy techniques, the Mulligan Concept involves active patient participation that is central to the treatment process. It aims to decrease or eliminate pain, increase functional mobility, and improve maladaptive movement patterns.

Potential Benefits of Including the Mulligan Concept in a Multi-Modal Treatment Plan

Modern views of manual therapy suggest that a multi-modal approach is key to success knowing that different individuals respond uniquely to various treatment interventions. Integrating a multi-modal approach that includes manual therapy, therapeutic exercise, patient education, and other techniques or modalities can provide a comprehensive and tailored treatment plan.

The Mulligan Concept fully embraces a multi-modal approach in the following ways:

• Immediate Pain Relief: Mulligan Concept manual therapy techniques such as MWMs can often provide immediate pain relief, even – when indicated - in chronic conditions. Often by applying minimal external forces, the therapist may change a painful movement into one without pain. This allows patients to experience reduced discomfort providing a pathway to uninhibited therapeutic exercise.
• Improved Functional Range of Motion: Restricted mobility is a common issue in musculoskeletal conditions presenting in the clinic. The Mulligan Concept's MWM approach promotes functional improvement by sustaining external forces similar to those applied in joint or soft tissue mobilization throughout the full ROM, with over-pressure applied at the end of the range, if pain-free.
• Enhanced Patient Participation: Reduction of fear-avoidance behaviors due to pain relief can lead to greater compliance and adherence to the treatment plan.
• Customization: The Mulligan Concept allows manual therapists to tailor treatment to each patient's specific needs and goals by directly addressing the client-specific impairment measure (CSIM). This personalized approach enhances patient outcomes and satisfaction with the treatment process.

The Science Behind Manual Therapy

Critics often question the efficacy of manual therapy due to the lack of concrete scientific evidence. This lack was present in the mid-1980s during the development of the concept. However, in the last 40-odd years numerous high-quality studies have confirmed the positive effects of the manual therapy techniques of the Mulligan Concept. Research published in peer-reviewed journals has consistently shown increases in range of motion, reduction of pain (and other symptoms), and improved functional outcomes in patients with various musculoskeletal conditions.

Interestingly, Mobilization with Movement is consistent with modern neuroscience theory. In their 2016 article in Physiotherapy Theory and Practice, Combining Manual Therapy with Pain Neuroscience Education in the Treatment of Chronic LBP: a narrative review of the literature. Puentedura and Flynn note: A narrative review of pain education suggests more benefit when manual therapy is coupled with exercise/activity.

While evidence-informed practice forms the foundation of modern medicine, it is crucial to balance it with patient beliefs and individual experiences. David Sackett, a pioneer in evidence-based medicine, emphasized integrating clinical experience with the best available external clinical evidence.

A Common Question Asked about the Mulligan Concept!

Must I accept Mulligan’s original hypothesis of positional faults to practice this form of manual therapy? 

No! In line with a significant volume of modern research, MWM examination procedures and treatment techniques do not:

• Require palpation of the relative position of bony landmarks or relative movement of bones
• Rely on findings of pain provocation tests
• Require belief in any biomechanical theory, including the "positional fault" hypothesis
• Depend on establishing a diagnosis, a classification, or identification of a specific pathology or a “pain generator”
  (Verbiage credit to Mark Oliver)

Mulligan Concept References

The 2022 edition of the reference list on www.bmulligan.com, the concept’s International website, currently contains 388 references pertaining to the Mulligan Concept. This number continues to grow year by year as more and more research about the concept is performed and published.

Mobilization with Movement: Validated – an example

As referenced in a previous post in this year’s blog, the APTA Clinical Practice Guideline (CPG) published in the December 2022 issue of the Journal of Orthopedic and Sports Physical Therapy (JOSPT) offers compelling evidence in favor of its efficacy. This CPG identifies Level I evidence and assigns a Grade B rating, indicating moderate evidence, for the use of manual therapy techniques and specifically the Mulligan Concept Mobilization with Movement in the treatment of lateral elbow tendinopathy.

Conclusion

So, back to the questions:

1. Can manual therapy be beneficial?
2. Should it be part of a comprehensive treatment plan?

There is definite evidence in favor of including manual therapy in a treatment plan, particularly the Mulligan Concept. By incorporating this efficient and effective technique into a multi-modal plan its numerous benefits can be harnessed to provide quality care and maximize patient outcomes.

So…manual therapy…

Should you use it? YES!  (…says the evidence base, and many therapists and patients.)

Could you use it? YES!  ( If you have been trained in manual therapy techniques such as the Mulligan Concept, and especially if you are a Certified Mulligan Practitioner (CMP)

Would you use it? OF COURSE!!

 

Don Reordan, PT, MS, OCS, MCTA, CIDN

Michael Møller Nielsen
 B.PT. Post. grad cert. sports phys., Dip. MPT. CMP, MCTA. Msc.Med PainMgt.

Looking Back

My first meeting with The Mulligan Concept was in 2010 when Josef Andersen introduced me to the concept. My background in manual therapy was rooted in the "classic" manual therapy - Maitland, Mckenzie, and structural osteopathy. At first, I was a bit provoked by the claimed efficacy of the Mulligan Concept and techniques which were conflicting with the education and knowledge I had gained from education in the “traditional manual therapy” courses.

By nature, I’m curious and I tried to implement the Mobilization with Movement techniques in my treatment protocols. I was amazed at the efficacy of the techniques when I included them in my multimodal treatments!

The same year I passed the Certified Mulligan Practicioner (CMP) exam. A year after that I felt lucky that Brian Mulligan came to Denmark to give a workshop about "the art in manual therapy". Brian traveled with his wife Dawn and Mark Oliver who also held a lecture about his approach to the SIJ and TMJ.

On the last evening of these courses, a group of CMPs were invited to have dinner with the teachers. During the dinner, I was fortunate to sit at the table with Brian, Mark, Josef, and their spouses. It was at this time I experienced the warmth and cordiality of these wonderful teachers – just like a big family – which is something I highly valued.

Looking at the Present

Now 13 years later I passed the Mulligan Concept teacher accreditation exam in Orlando. I have become part of the Mulligan Concept Teacher Association (MCTA). The joy of passing the exam was naturally a fantastic sensation, but what made me even more happy was the warm welcome of all the teachers in the group. It was just like being adopted by a family.

I believe the energy in the group is something special that is hard to describe in words only. Perhaps it is best described by Brian Mulligans DNA – great humor and excellent professional skills – has merged into the values of the group. It was fantastic to experience my first professional meeting with other highly skilled and experienced teachers in the MCTA. I discovered there is room for disagreements without losing friendships. A sign of great leadership and integrity from all members of the MCTA. An organization that put its values on top of all the decisions is an organization that can withstand all challenges!

My personal values are loyalty, honesty, and credibility. I treasure people who are like-minded. I reached my goals through hard work, being humble and honest with myself, and life values. In my private life, I’m married to Lene, with whom I have two children, Thor who is 15 years and Freya who is 12 years.

Before I became a physiotherapist, I was a sergeant in the Danish army and a sub-elite soccer player. My leisure time is spent with my children where I’m a soccer coach for my daughter’s team. When I have the time, I love the feel of adrenaline when riding my Ducati motorcycle on racetracks in Europe.

Looking Forward

I love to learn and evolve as a therapist and believe in knowledge sharing for greater mutual output. Becoming a teacher in the MCTA and being a part of a group of extraordinary people is a big shoe to fill – especially comparing myself to my mentors through the years – Josef, Peter, and Mark.

The transition from focusing on my own career to focusing on teaching other colleagues and helping them to evolve in their professional life is a responsibility I will take very seriously. I will strive to become a welcoming and appreciated teacher. I think teaching makes you an even better therapist and entering the MCTA will not be an end station for me, rather it will be a new starting point from which I can educate, research, and practice.

Thanks for the warm and friendly reception in the group. It means a lot to me and I will with humility and diligence try to repay the fine reception.

Cheers

Michael Møller Nielsen, (Denmark)