Maitland's Grades of Oscillatory Mobilisations
- Grade I Small amplitude movement performed at the beginning of the range.
- Grade II Large-amplitude movement performed within the range but not reaching the limit of the range. It can occupy any part of the range that is free of any stiffness or muscle spasm.
- Grade III Large amplitude movement performed up to the limit of the range.
- Grade IV Small amplitude movement performed at the limit of the range.
Therapeutic Effects
- Activates the pain gate (grades 1/2)
- Stretches tissues (grades 3/4):- Collagen fibres have a slight wavy appearance under a microscope (crimping)
- 1st line of response to loading: fibres line up in the direction of the applied force during movement taking up the slack (uncrimping)
- 2nd line of response to loading: when force is applied the tissue can stretch, but when the force is removed the tissue returns to its resting length (elastic deformation)
- 3rd line of response to loading: the deformation of a tissue in response to a maintained or constant load. The excessive load causes the collagen fibres to 'give' (collagen cross-links begin to fail) and the tissue begins to tear (creep)
Process: stretching the connective tissue causes minor ruptures of the collagen fibres leaving free 'end points'. This initiates an inflammatory response, in which the fibroblasts deposit more collagen fibres. These reunite with the 'end points' to elongate the fibres increasing the length of the connective tissues.
- Activates trans-synovial pump
- Provides temporary muscle relaxation
- Improves neurodynamics
- Facilitates healing
Complete Contraindications:
Rhematoid collagen necrosis
Fracture - recent or unhealed
Joint ankylosis
Vertebrobasilar insufficiency
Active inflammatory or infective arthritis
Malignancy
Relative Contraindications:
Pregnancy
History of malignancy
Hypermobility
Osteoporosis
Neurological signs
Spondylolisthesis
Dizziness
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