Tribute to Geoffrey Maitland (19242010) by the manipulation association of

chartered physiotherapists (UK)

If I have seen further, it is by standing on the shoulders of
giants Sir Isaac Newtons quote could aptly be applied to the
progression of the physiotherapy profession, and its debt of grati-
tude to one of its own giants and pioneers, Geoffrey Maitland MBE.
Maitland was instrumental and inspirational in developing the
eld of musculoskeletal physiotherapy. He introduced careful and
precise examination of patients, and emphasised the need for
continual assessment of patients that was to be used to guide
management. These aspects were clearly the forerunners of what
we now refer to as clinical reasoning and patient-centred care. He
was passionate about postgraduate education for qualied physio-
therapists and this helped to pave the way for our current position
as autonomous practitioners, and a modern musculoskeletal
specialist profession.
Born in South Australia in 1924, he joined the RAAF in 1942 and
was drafted to Britain to y Sunderland bombers, and to take part in
the Battle of Britain. Whilst in the UK, he met his wife and life
partner Anne, marrying in 1945, and sharing 60 years together until
her death in 2009. After leaving the RAAF, Maitland trained at the
University of Adelaide, graduating in 1949, and later went on to
lecture at the South Australian Physiotherapy School. It was here
that he developed his special interest in the use of passive joint
mobilisation techniques, and the assessment and treatment of
patients with spinal problems.
His integrated approach to assessment and treatment of the
patient, demanding precise communication and questioning, care-
ful assessment and, vitally, re-assessment after treatment, and the
integration of scientic knowledge with the clinical decision-
making process still underpins the practice of high quality manual
therapy. Whilst common place today, these approaches were revo-
lutionary in their time, for a profession that had been so medically
directed previously.
Maitlands permeable brick wall concept encapsulates the
integration of science and clinical practice, encouraging the thera-
pist to balance information from questioning and from physical
testing, with research evidence and past experience, to come up
with an individualised and specic programme of treatment for
each patient. It offers the therapist the chance to break free and
be innovative. His suggestion that Technique is the brainchild of
ingenuity is borne out in an incident from a course Maitland
was running, where he was treating a patient in front of students.
When asked what technique he was doing, he replied, I dont
know, Ive never done it before the technique was specic to
that individual patient and based on his examination ndings
only, not on textbook techniques.
Maitland was one of the rst to explore the use of manipulative
treatments, building on the examination approaches of Cyriax and
the gentler treatment techniques of Mennel. His use of manipula-
tion to treat pain and not just stiffness, and work with colleagues
to dene grades of movement, and methods of annotating this,
was ahead of its time. This precision in recording of treatment is
a legal requirement today, but at the time was revolutionary, and
helped develop clinical decision-making and communication.
He was also instrumental in developing exam-based postgrad-
uate qualications for Physiotherapists in Australia in 1966, and
worked with Greg Grieve to develop a similar course in the UK,
which led to the formation of the Manipulative Association of Chartered
Physiotherapists, a highly qualied group of expert physiotherapists
still promoting postgraduate training for musculoskeletal physio-
therapists today.
Maitland travelled extensively to share his work and ideas,
working with Greg Grieve in the UK, Freddy Kaltenborn in Norway,
and Stanley Paris in the USA. With these other pioneers, he was
instrumental, in 1974, in setting up the International Federation
of Orthopaedic Manipulative Therapists, the rst Special Interest
Group of the World Congress of Physical Therapy.
In 1981 Geoff Maitland was awarded an MBE for his services to
the physiotherapy profession. Other honours have included the
World Congress of Physical Therapy Mildred Elson Award for Inter-
national Leadership in 1995, an Honorary Fellowship of the Char-
tered Society of Physiotherapists, Honorary Life Membership of
the South African Society of Physiotherapy, Honoured Membership
of the Australian Physiotherapy Association and Life Membership of
the Australian Musculoskeletal Physiotherapy Association.
Maitland published extensively and his seminal texts Vertebral
Manipulation, and Peripheral Manipulation are into their 7th and
5th editions respectively, a sign of the ongoing currency of his
approach.
Despite his numerous achievements and accolades, Maitland
was known for his humility and graciousness, and his willingness
to share and learn with others. He was opposed to the use of the
term Maitland techniques and very much against guru led
approaches, favouring the development of the individual physio-
therapist and their own clinical reasoning. These qualities are borne
out in the many personal reections given by those who worked
with him, and were taught by him, over his long career.
Geoff Maitlands contribution to the physiotherapy profession,
and in particular to musculoskeletal physiotherapy cannot be
underestimated. His inspiration and collaboration with our own
UK pioneers led to the development of the MACP and really set
Contents lists available at ScienceDirect
Manual Therapy
j ournal homepage: www. el sevi er. com/ mat h
1356-689X/$ see front matter
doi:10.1016/j.math.2010.02.005
Manual Therapy 15 (2010) 298299
the foundations for all the extended scope roles and postgraduate
physiotherapy education that we enjoy today. We acknowledge
his sad passing and pay tribute to his contribution.
Personal reection fromDr. Nikki Petty a member of the MACP
After completing my Postgraduate Manipulative Therapy course
in Melbourne in 1986, I went to observe Geoff for a few days in his
private practice in Adelaide. I felt both excited and nervous at the
prospect. What was most amazing to me was his incredible
humility; he was known to physiotherapists from all around the
world, yet had time for me. I remember watching him examine
a patient with foot pain and he spent ages hunting around to try
and reproduce this guys pain; I cant quite remember whether he
ever did manage to, what struck me was the enormous effort and
dedication in trying to help him. After this visit I returned to the
UK and kept in contact by phone and at various conferences here
and in Australia. At an IFOMTconference in Cambridge he publically
requested that therapists stop using the term Maitland mobilisa-
tions, saying that mobilisations are mobilisations and are not
related to a person. After writing the foreword to a book on exam-
ination and assessment, he said that the sooner he died and let
things move on, the better. He felt he was somehow holding things
back. Again his humility astonished me. While our paths crossed
infrequently, Geoff left a lasting impression on me that I will always
treasure. God bless you Geoff.
Tribute to Geoffrey Maitland / Manual Therapy 15 (2010) 298299 299