McKenzie Method and Physical therapy
The McKenzie Method® for Pain Relief
Have You Heard of the McKenzie Method®?
If you have ever worked with a physical therapist for spine or extremity problems you may have noticed that they use several different approaches to treat your condition.
In the physical therapy world, practitioners and researchers have developed many different treatment methods to address musculoskeletal conditions. Physical therapists take courses to become proficient and sometimes certified in these approaches. One such approach for addressing symptoms in the spine and extremities is the The McKenzie Method® of Mechanical Diagnosis and Therapy® .
The McKenzie Method teaches therapists to categorize their patients into subgroups which then directs their treatment. Many therapists today use the McKenzie Method and this article will introduce the method, describe how it works and why it is popular among therapists today.
HISTORY OF THE MCKENZIE METHOD®
The McKenzie Method® of Mechanical Diagnosis and Therapy® was developed by world-renowned expert physiotherapist, Robin McKenzie. McKenzie developed this method in the 1950s after a patient with radiating right-sided low back pain, which worsened when he extended his spine or bent it backward, experienced an unexpected change and then resolution in his symptoms after he spent several minutes lying on a table that inadvertently held his spine in that extended position. While McKenzie may have inadvertently left one end of the table raised at an angle, it was a happy accident to suddenly discover the patient’s symptoms had improved whereas nothing the week before had given the patient relief. The observation of this change in symptoms, a phenomenon that became known as centralization, led McKenzie to experiment with and observe how other simple movements and positions caused a change in his patients’ symptoms. He continued to help many people with their back pain as he developed the theories and practices that would later become the The McKenzie Method® of Mechanical Diagnosis and Therapy® and then went on to develop the McKenzie Institute in 1982 which has trained many therapists in the McKenzie Method.
The McKenzie Method is somewhat unique in that it aims to provide physical therapists with a method of treating spine and extremity symptoms while also providing patients a method to self-treat. Through therapist and patient-led treatments, the McKenzie Method aims to eliminate the patient’s symptoms, restore full function and prevent symptoms recurrence in the future. While the The McKenzie Method® may have been based on theory and experimentation initially, it has since been backed by quite a bit of evidence. Therapists who use this method use an algorithm to assess the nature of their client’s conditions but are also trained to recognize when referring to another healthcare provider for more assessment or medical treatment is needed.
According to the McKenzie Institute, this technique of assessment and treatment can be applied to nearly all musculoskeletal problems including back, neck and extremity pain, sciatica, sacroiliac (SI) joint pain, arthritis, degenerative disc disease, muscle spasms, intermittent numbness in the extremities and more.
HOW DOES IT WORK?
Like all physical therapists, a Mckenzie Method trained PT will begin with a subjective and objective examination to gain an understanding of what your symptoms are, discover any patterns of symptoms and look out for any signs that would indicate the need for referral to another provider like a physician. During the physical examination, your therapist will ask you about how various movements and positions affect your symptoms. In other words, what makes your symptoms worse and what makes them better. After gathering this information, you will perform movements and motions in different directions and report any changes in symptoms to your therapist. Knowing how your symptoms change and what makes them better or worse allows your therapist to place your condition in one of four subgroups or syndromes that later will direct your treatment.
These four subgroups are derangement syndrome, dysfunction syndrome, postural syndrome and “other.” Patients classified under derangement syndrome typically have a directional preference to their symptoms in which sustaining a certain posture or repeating a movement in a certain direction causes a relevant improvement in their symptoms. Those classified under dysfunction syndrome often have been experiencing symptoms for at least 8-12 weeks and their pain is more likely the result of the deformation of structurally impaired tissues like scar tissue or those that have adaptively shortened. Postural syndrome includes those who experience pain when they sustain a certain posture but their pain improves when they move out of that posture or do a different activity. Finally, those categorized under “other” do not fit as neatly into the other mechanical subgroups.
Each subgroup is treated in its own way which is why it is helpful to categorize patients in the first place. Once the subgroup has been established, your therapist will use the McKenzie treatment method for that subgroup and will teach you how to treat yourself through a series of carefully-prescribed motions and exercises or what the McKenzie Method calls, patient-generated forces. McKenzie found this method of treatment to be superior because it teaches patients how they can treat themselves in the future should their symptoms recur. This makes them less reliant on the physical therapist. In cases where the patient-generated forces are not quite enough to fully resolve symptoms, the therapist can supplement the treatment with a clinician-generated force like a passive mobilization.
LOOKING FOR SOLUTIONS TO YOUR PAIN?
As you can see, the McKenzie Method is an effective treatment approach for spine and extremity pain but it is not the only successful approach used by our team of therapists. Our therapists often have a variety of approaches in their treatment toolbox to help improve your symptoms. If you are experiencing spine or extremity pain and haven’t had success with managing it on your own, working with our therapists can make all the difference. Call Evolve Physical Therapy today to schedule an initial evaluation and take the first steps to pain relief.
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