Does Mobilisation with Movement Still Belong in Modern Physiotherapy?

Mobilisations With Movement (MWMs) have been a trusted technique in musculoskeletal physiotherapy for decades, as a tool that can be applied with immediate improvements in pain and mobility. But in an era where rehabilitation is increasingly evidence-based and exercise-focused, do MWMs still hold a place in modern-day physiotherapy?

In this blog, we’ll explore the role of MWMs in contemporary physio, their mechanisms, and how you can integrate them effectively into practice to optimise patient outcomes. We’ll also discuss when and why MWMs might be beneficial and how they complement active rehabilitation strategies.

For the full low-down on the role of MWMs in current practice, watch expert physio Thomas Mitchell’s full Masterclass HERE.

Change in perspective

Thomas Mitchell argues MWMs can still be a powerful tool for some patients, some of the time, and when used correctly. They blend passive joint mobilisation with active patient movement.

While manual therapy has lost favour in evidence-based physiotherapy, MWMs still have a place—if we reframe our understanding of why and how they should be used. Instead of relying on them as standalone treatments, integrating MWMs with active rehabilitation can enhance patient outcomes.

Some key benefits Thomas highlights include:

• Reducing fear of movement
• Enhancing patient-therapist rapport
• Adjunct to improve compliance
• Empowering patients through self-mobilisation

So no, MWMs aren’t about magically “realigning” a body part—but that doesn’t mean they don’t have a place in modern physiotherapy. When used with sound clinical reasoning, they can be a valuable tool for reducing pain, improving movement, and enhancing patient confidence in their recovery.

Watch as Thomas breaks down the mechanisms behind MWMs in this video from his Masterclass:

Principles for application

When applying MWMs, it’s important to follow structured principles to ensure safety, effectiveness, and lasting impact. Two key acronyms can help guide your approach:

1. CROCKS – key considerations for safe and effective use

C = Contraindications: Before applying an MWM, always screen for red flags such as fractures, ligamentous instability, or significant structural pathology. If contraindications exist, MWMs may not be appropriate.

R = Repetitions: Determine the minimum number needed for a therapeutic effect.

O = Overpressure: Apply overpressure to maximise benefits, but it must always be within the patient’s tolerance and remain pain-free!

C = Communication: Clear, ongoing communication is essential. Explain the technique to the patient, ensure they understand the process, and consistently ask for feedback on symptom response.

K = Knowledge: A thorough understanding of anatomy, biomechanics, and red flags is fundamental to applying MWMs safely and effectively, with clinical intent.

S = Skilled handling/sustained pressure: MWMs require precise handling and controlled, sustained pressure to be effective, and this may need to differ from patient to patient.

2 – PILL – process of application for MWM

P = Pain-Free: The technique must be pain-free.

I = Immediate: MWMs should produce an instant change in symptoms or movement quality. If there’s no immediate improvement, reassess and modify your technique or reassess whether MWMs are appropriate.

LL = Long-Lasting: The effects should persist beyond the session. If the improvements don’t last, consider adjusting the parameters or reinforcing the effects with self-mobilisation strategies.

MWMs in action

If you’ve identified a patient who may benefit from an MWM, there are plenty of options to choose from—but the ultimate goal should always be to eventually empower the patient with self-mobilisations. Encouraging self-management helps reinforce the benefits of treatment, promotes long-term improvements, and reduces reliance on hands-on therapy. By teaching patients how to apply MWMs on their own, you’re giving them the tools to take control of their recovery and maintain progress between sessions.

In his Masterclass, Thomas demonstrates a patient using a wrist self-mobilisation to take control of their recovery. Watch the snippet below:

Thomas explains that in non-traumatic wrist pain, pinpointing the exact structural cause can be challenging. Instead of chasing a diagnosis, focus on techniques that modify symptoms effectively—and always tailor your approach to the patient in front of you!

Wrapping up

Hands-on techniques have a place in physiotherapy—when backed by sound clinical reasoning.

If MWMs help your patient move with less pain and greater confidence, they’re a valuable tool in an individualised treatment plan. The key is to integrate them strategically, ensuring they serve as a bridge to active rehabilitation rather than a long-term crutch. When used effectively, MWMs can empower patients to regain function and take control of their recovery.

If you want to learn more from a musculoskeletal physiotherapy expert, then watch Thomas Mitchell’s full Masterclass HERE.