According to Maitland's five grades of joint motion, which grade would be most appropriate when joint movement is limited by pain and spasm?

According to Maitland's five grades of joint motion, which grade would be most appropriate when joint movement is limited by pain and spasm?

• A. Grade I
• B. Grade II
• C. Grade III
• D. Grade IV

Answer: (A)

In Maitland’s system, when movement is limited by pain and muscle guarding, you start with very gentle, early mobilization. The best fit is a small-amplitude movement performed at the beginning of the available range. This approach aims to soothe pain and reduce spasm by providing gentle proprioceptive input without pushing tissue into end range, which could aggravate symptoms. This initial grade helps desensitize the joint, supports pain modulation, and gradually re-educates motion without provoking the irritated tissues. As pain and guarding settle, progression can be considered—but starting with this small, early arc keeps the response favorable. Other grades require moving more into the range or toward end range, which can increase pain or guarding in a painful, spasm-limited joint. A thrust-grade technique (beyond usual mobilizations) is reserved for different contexts and would not be appropriate when pain and spasm dominate.

In Maitland’s system, when movement is limited by pain and muscle guarding, you start with very gentle, early mobilization. The best fit is a small-amplitude movement performed at the beginning of the available range. This approach aims to soothe pain and reduce spasm by providing gentle proprioceptive input without pushing tissue into end range, which could aggravate symptoms.

This initial grade helps desensitize the joint, supports pain modulation, and gradually re-educates motion without provoking the irritated tissues. As pain and guarding settle, progression can be considered—but starting with this small, early arc keeps the response favorable.

Other grades require moving more into the range or toward end range, which can increase pain or guarding in a painful, spasm-limited joint. A thrust-grade technique (beyond usual mobilizations) is reserved for different contexts and would not be appropriate when pain and spasm dominate.