A note on SNAGs
I am relating back to my first placement which was musculo at the curtin clinic. We did not spend much time on SNAGs during the spinal units but in this placement we were fortunate enough to have a clinical supervisor who had recently completed her masters in manipulative physio and had specialised in the mulligan's technique in the cervical spine as her thesis. One of the tutes that she gave was on SNAGs to assist restrictions into rotation. I found it very interesting as she recommended that a reasonable amount of force be provided through the contact and in an upward direction. It is important to warn the patient that the first 3-4 reps will be painful but then will improve dramatically. She recommended 8 reps with a brief hold at the end af rotation before returning to start position. We were fortunate enough to have cervical patients at the time and although the patients reported the technique to be painful is was very effective and provided immediate subjective and objective results. A further note to add is that those patients with very tight sub-occipitals would benefit from muscle release prior to applying the SNAGs. Just remember Ax determines Rx!
posted by Col @ 4:49 PM
4 Comments:
I also was fortunate enough to learn a couple of Mulligans techniques while on Musculo placement at SCGH-particularly a shoulder Mulligan with movement technique that had great results with a couple of patients. It is invaluable what you can learn from our supervisors who have the clinical experience and can guide us through helpful alternative techniques!
hey col, went through the same thing myself in my musculo placement. I just didn't realise how well Mulligans techniques, especially in the Cx spine actually work. Pure magic. It is also great to see an immediate effect and benefit to the patient.It dosn't always happen that we see a distinct difference betwen start and finish of treatment session and when it does happen, its gold.
I also agree that the use of SNAG's is great. When I did my 3 week placement at Graylands hospital the majority of the patients I saw had either neck and/or back problems due to very bad postures. I had a particular patient who came in with his head in a excessively felxed position which he could not bring into a neutral position. This had obviuos effects on his vision and balance. When i applied some SNAG's onto his neck, I was able to return his neck into a neutral position, it was like a mircale. It's such a simple technique and yet it gives instant results.
Hi Col,
popular post you got here! I too found some use for the "miracle" Mulligan techniques. But a word of caution for those who try to use it for multi-segmental hypomobility...it is not always appropriate. I encountered this on a pt. with a stiff upper Tx spine and found better objective improvements from grade 3 mobs for the restriction. Cheers!
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