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Mobilisation with movement (MWM) for the elbow using a doorframe is a self-treatment technique based on Mulligan’s principles. It is commonly used to manage lateral epicondylalgia (tennis elbow) by improving joint mechanics and reducing pain. This technique involves applying a sustained lateral glide to the elbow joint while performing a functional movement, such as gripping. By altering joint positioning, the movement can be completed with reduced pain, helping to restore normal function.

Instructions

  • Stand side-on to a sturdy doorframe with your affected arm straight. Place the outside of your arm against the doorframe, the frame should be pressing against the upper arm, just before the elbow joint.
  • You may want to place a soft towel between your arm and the doorframe for comfort.
  • With your opposite hand, place the webspace of your thumb and index finger on the inside of your elbow, just after the joint.
  • Apply a lateral glide by gently pushing your forearm towards the doorframe using your opposite hand. Maintain this pressure throughout the exercise.
  • While holding the glide, grip a small towel in your affected hand and squeeze firmly.
  • Release the grip slowly and repeat the movement while maintaining the glide.
  • Complete repetitions as prescribed by your physiotherapist.

This exercise should be completely pain-free. If you experiencing pain, attempt to slightly change the angle of the pressure.

Common Errors

  • Applying excessive force, causing discomfort or increased pain.
  • Letting the glide release before completing the grip movement.
  • Incorrect hand positioning, leading to ineffective mobilisation.
  • Moving too quickly without maintaining control.

Progressions

To make the exercise more challenging, you can:

  • Increase the intensity of the grip by using a thicker towel or resistance object.
  • Apply a firmer lateral glide while still ensuring it remains pain-free.
  • Hold the grip contraction for a longer duration before releasing.

Regressions

To make the exercise easier, you can:

  • Reduce the pressure of the lateral glide.
  • Use a softer towel or sponge to make gripping easier.
  • Decrease the duration of the grip contraction or reduce the repetitions.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.