PT Classroom - A Brief Review of Maitland Joint Mobilization Grades  ׀ by Chai Rasavong, MPT, COMT, MBA


Joint mobilizations are one of many tools utilized by physical therapists to treat various conditions at various joints. According to Maitland, patient’s can be categorized into two categories – pain dominant and stiffness dominant. This categorization can assist with determining which grade of mobilizations should be performed on the affected area of the patient. Through the subjective and physical examination, a therapist can usually determine which type of patient they may be dealing with:



Once a determination is made on whether a patient is pain or stiffness dominant through both the subjective and physical exams a treatment plan can be developed (see chart below).



Maitland categorizes grades of movement by the following (1, 2):
• Grade I small amplitude, short of resistance
• Grade II Large amplitude, short of resistance
• Grade III Large amplitude to 50% of R1 – R2
• Grade IV Small amplitude to 50% of R1 - R2
• Grade V Small amplitude, high velocity thrust at end of available range
* R1 = Defined as the first perceptible onset of resistance which varies from area to area
* R2 = Limit of Resistance

Maitland further refines the grades of movements above with pluses and minuses (1, 2):
• III- - or IV- - are taken to the first onset of R1
• III- or IV- are taken to 25% of R1-R2
• III+ or IV+ are taken to 75% of R1-R2
• III++ or IV++ are taken to max R or end of range

Despite which grade of mobilization is utilized in the treatment, the Maitland method emphasizes “assessment” when working with the patient. The assessment should be conducted throughout the entire process ie. at the initial evaluation, after the initial evaluation, during the performance of a technique, after the application of a technique, at the end of the treatment session, at the beginning of the next treatment session, retrospectively and continuously (1, 2).

For additional information on manual therapy, joint mobilization and the Maitland approach please visit


Last revised: October 30, 2015
by Chai Rasavong, MPT, COMT, MBA

1) Maitland Australian Physiotherapy Seminars MT – 1 Basic Peripheral
2) Maitland Australian Physiotherapy Seminars MT – 2 Basic Spinal

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Please review our terms and conditions carefully before utilization of the Site. The information on this Site is for informational purposes only and should in no way replace a conventional visit to an actual live physical therapist or other healthcare professional. It is recommended that you seek professional and medical advise from your physical therapist or physician prior to any form of self treatment.