Physical Therapy: The McKenzie Method®
The McKenzie Method® is not merely extension exercises. In its truest sense, McKenzie is a comprehensive approach to the spine based on sound principles and fundamentals that, when understood and followed accordingly, are very successful. In fact, most remarkable, but least appreciated, is the McKenzie assessment process.
Photos with permission from MIUSA provided courtesy of
Spinal Publications from the text The Human Extremities: Mechanical Diagnosis and Therapy.
Unique to the McKenzie Method® is a well-defined algorithm that leads to the simple classification of spinal-related disorders. It is based on a consistent "cause and effect" relationship between historical pain behavior as well as the pain response to repeated test movements, positions and activities during the assessment process.
A systematic progression of applied mechanical forces (the cause) utilizes pain response (the effect) to monitor changes in motion/function. The underlying disorder can then be quickly identified through objective findings for each individual patient. The McKenzie classification of spinal pain provides reproducible means of separating patients with apparently similar presentations into definable sub-groups (syndromes) to determine appropriate treatment.
McKenzie has named these three mechanical syndromes: Postural, Dysfunction, and Derangement.
- Postural: End-range stress of normal structures
- Dysfunction: End-range stress of shortened structures
- Derangement: Anatomical disruption or displacement within the motion segment (All three mechanical syndromes, postural, dysfunction, and derangement, occur in the cervical, thoracic, and lumbar regions of the spine.)
Each distinct syndrome is addressed according to its unique nature with mechanical procedures, utilizing movement, and positions. The Derangement syndrome where the phenomenon of "centralization" occurs is most common.
Well-trained McKenzie practitioners will be able to identify those more difficult cases where advanced McKenzie techniques might benefit the patient versus those patients whose diagnosis is non-mechanical in nature (those patients are then quickly referred for alternate care, thus avoiding unnecessary periods of inappropriate or expensive management).
McKenzie treatment uniquely emphasizes education and active patient involvement in the management of their treatment in order to decrease pain quickly, and restore function and independence, minimizing the number of visits to the clinic. And if a problem is more complex, self-treatment may not be possible right away. However, a certified McKenzie clinician will know when to provide additional advanced hands-on techniques until the patient can successfully manage the prescribed skills on their own.
Ultimately, most patients can successfully treat themselves when provided the necessary knowledge and tools. An individualized self-treatment program tailored to the lifestyle of the patient puts the patient in control safely and effectively.
Patients gain an experiential education learning to self-treat the present problem. The management of these skills and behaviors will minimize the risk of recurrence and allow patients to rapidly manage themselves when symptoms occur.