The Maitland-Australian method of manual therapy was developed by Geoff Maitland. This method focuses on patient symptoms and specifically how these symptoms change following specific manual therapy techniques, utilizing specific and graded joint mobilizations. These mobilizations are chosen for each individual patient based on their clinical presentation.
Upon evaluation, a thorough patient history is taken, focusing on exacerbating positions/activities and pain-relieving positions, then a movement assessment is completed. The clinician searches for the comparable sign – the movement that reproduces the patients pain most accurately. The therapist will then complete a treatment technique (often a joint mobilization of appropriate grade) and re-test the patient’s motion, looking for a reduction of their comparable sign.
If the patient’s motion is less painful and their comparable sign has been reduced, the clinician continues with this same technique. It’s that simple!
Typical bouts of hands-on techniques last 10-30 minutes based on the patient’s condition. Often, soft tissue mobilization, massage, muscle energy techniques, etc. are used in conjunction with joint mobilization in order to reduce pain and re-establish normal function.
Maitland is the father of graded joint mobilization
Grade I: small amplitude short of tissue resistance
Grade II: large amplitude short of tissue resistance
Grade III: small amplitude into 50% of tissue resistance
Grade IV: small amplitude into 50% of tissue resistance
Grade V: small amplitude, high velocity thrust and end of available range
Grades I and II are non-threatening mobilizations used to help with acute pain, reduce muscle spasms, and slightly improve range of motion, primarily used in pain-dominant patients. Grades III, IV, and V are mobilizations used to improve joint mobility, generally used in stiffness-dominant patients who have lower pain levels
The clinician will consistently re-test the patient’s motion, looking for reduction in pain levels and improved range of motion. Along with joint mobilization, modalities such as moist heat, electric stimulation, and ice (cryotherapy) are used to reduce the patient’s pain. When pain levels are controlled, a transition to non-threatening therapeutic exercise are used to build strength and stability surrounding the joint/joints that were once painful.
Many of Red Canyon therapists employ the Maitland concept and are actively pursuing a formal certification in this treatment technique. If you are interested and feel that the Maitland-Australian method will help relieve your pain, contact us today!