Hip Joint

Maitland Techniques
• Various sources and/ or contributing factors which need to be taken into
consideration in the analysis of movement disorders of the hip.

Possible symptom areas associated with movement

disorders of the hip.
According to Sahrmann (2002),
faulty posture and
dysfunctional movement
patterns are not only the result
of pain and pathology but may
also cause these lesions.

If the symptomatic structure

alone is treated (with passive
movement, for example) and
the dysfunction or “cause of the
cause” (Maitland 1991) is
disregarded, symptoms could
well reoccur.
 It is emphasized that every technique and position of treatment may be adapted
to the needs of the patient and the specific constitution of the therapist

• Both physiological and accessory movements may be suitable for treatment,

depending on the clinical indications and their effects.
• In many cases flexion/adduction techniques or accessory movements performed in
end-of-range flexion/adduction positions may be particularly suitable in treatment.
• 'The technique is the brainchild of ingenuity' is a core principle of this concept.
Accessory movements may be adapted to the patient's limitations of activity and
may be carried out in various physiological and func­tional positions. For example,
the techniques may be performed in mid- or end-of-range positions of flex­ion/
adduction, extension, flexion/ abduction, etc.
• In some cases the techniques may be performed in functional positions (e.g. sitting
with crossed legs or in half-standing positions).
• Required range of motions for some activities
Maitland
• Choice of technique
There are many factors that influence the choice of technique such as:
o Accessory and physiological movements or combinations of these
o Minimal distraction or compression
o Sagittal, coronal, horizontal planes or longitudinal direction (in any of the
planes just mentioned)
o Combining techniques in varying sequences
o Pathology and other factors such as recent injury or chronicity
o The therapist's experience and skill
o The nature and frame of reference of the patient
o The desired effect.
Maitland
• Grades of movements in various conditions
ACCESSORY MOVEMENTS
LATERAL MOVEMENT
USES

• Recovery of range following fracture of the femur or acetabular

region.

• Capsular tightness or a medially migrated OA hip.

• Painful hip conditions or stiff ranges of movement.

Longitudinal movement caudad
USES

• Very soothing for painful hip disorders.

• Superior migrating OA and capsular tightness.

Posteroanterior and anteroposterior movements
USES
• Very little PA and AP movement of the head of the femur takes
place in the acetabulum. However, these movements may be
useful as a treatment for very painful hip disorders (grades I and
IT).
• Can be used as an accessory movement at the limit of stiff
physiological range (grades III and IV).
• May be a technique to consider in disorders such as
subtrochanteric bursitis or piriformis syndrome.
TREATM ENT TECHNIQUES
UNDER COMPRESSION
Maitland
USES
• Mild aching in hip with weight bearing
• To reproduce and treat joint surface pain
USES
• Chronic pain symptoms which makes it uncomfortable for patient
to lie on affected side
• OA Hip which is painful when patient lie on affected side
 •TREATMENT TECHNIQUES
ENCAMPASSING PHYSIOLOGICAL
MOVEMENTS