AN ALTERNATIVE APPROACH TO THE TREATMENT OF MENISCAL PATHOLOGIES: A CASE SERIES ANALYSIS OF THE MULLIGAN CONCEPT “SQUEEZE” TECHNIQUE
Author: Robinetta Hudson, MAT, ATC, CHES1 Amy Richmond, MS, ATC, CSCS, CES1 Belinda Sanchez, MS, ATC1 Valerie Stevenson, MS, ATC, CSCS1 Russell T. Baker, DAT, ATC1 James May, DAT, ATC1 Alan Nasypany, EdD, ATC1 Don Reordan, PT, MS, OCS, CMP, MCTA2
Reference: 11: 4
Background: Partial meniscectomy does not consistently produce the desired positive outcomes intended for meniscal tears lesions; therefore, a need exists for research into alternatives for treating symptoms of meniscal tears. The purpose of this case series was to examine the effect of the Mulligan Concept (MC) “Squeeze” technique in physically active participants who presented with clinical symptoms of meniscal tears.
Description of Cases: The MC “Squeeze” technique was applied in five cases of clinically diagnosed meniscal tears in a physically active population. The Numeric Pain Rating Scale (NRS), the Patient Specific Functional Scale (PSFS), the Disability in the Physically Active (DPA) Scale, and the Knee injury and Osteoarthritis Outcomes Score (KOOS) were administered to assess participant pain level and function.
Outcomes: Statistically significant improvements were found on cumulative NRS (p ≤ 0.001), current NRS (p ≤ 0.002),
PSFS (p ≤ 0.003), DPA (p ≤ 0.019), and KOOS (p ≤ 0.002) scores across all five participants. All participants exceeded the minimal clinically important difference (MCID) on the first treatment and reported an NRS score and current pain score of one point or less at discharge. The MC “Squeeze” technique produced statistically and clinically significant changes across all outcome measures in all five participants.
Discussion: The use of the MC “Squeeze” technique in this case series indicated positive outcomes in five participants who presented with meniscal tear symptoms. Of importance to the athletic population, each of the participants continued to engage in sport activity as tolerated unless otherwise required during the treatment period. The outcomes reported in this case series exceed those reported when using traditional conservative therapy and the return to play timelines for meniscal tears treated with partial meniscectomies.