The McKenzie Method

Related Authors: Robin McKenzie PT

"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.

Assessment: 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.
1) Postural: End-range stress of normal structures
2) Dysfunction: End-range stress of shortened structures (scarring, fibrosis, n.root adherence)
3) Derangement: Anatomical disruption or displacement within the motion segment
(All three mechanical syndromes – postural, dysfunction, and derangement – occur in the cervical as well as thoracic and lumbar regions of the spine.)

Each distinct syndrome is addressed according to it 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, and those patients are then quickly referred for alternate care, thus avoiding unnecessary periods of inappropriate or expensive management.

Treatment: 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.

Preventive: 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."
Source

Mechanism of Action

Centralisation

Reviews/Trails/Studies

CORE LIST – Sponsored by the Mckenzie Institute.
(Containing only articles published in peer review journals directly relevant to MDT).
Lumbar: Systematic Reviews
Lumbar: Reviews
Lumbar: Trials
Lumbar: Surveys of Physical Therapy practice
Lumbar: Studies into assessment procedures, tests & techniques
Lumbar: Anatomical & physiological studies
Textbooks, Chapters and Overviews of MDT
Discussion Articles
Cervical: Systematic reviews
Cervical: Trials
Cervical: Studies into assessment procedures, tests & techniques
Cervical: Anatomical, physiological, and pain studies
Whiplash: Reviews
Whiplash: Trials
Extremities

The Spine Journal Jan-Feb 2008 - Interventional Review of the McKenzie Method Full Text + Links PDF (255 K)
Spine. 2007 Dec 15;32(26):2948-56.One-year follow-up comparison of the effectiveness of McKenzie treatment and strengthening training for patients with chronic low back pain: outcome and prognostic factors.
J Athl Train. 2006 Jan-Mar;41(1):117-9.Does McKenzie therapy improve outcomes for back pain

Guidelines

Guidelines

Sunday, February 15, 2009

Spring 2009

J Man Manip Ther. 2008;16(3):155-60.
Predictor Variables for a Positive Long-Term Functional Outcome in Patients with Acute and Chronic Neck and Back Pain Treated with a McKenzie Approach: A Secondary Analysis.
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Friday, May 2, 2008

May 2008

Spine J. 2008 Jan-Feb;8(1):134-41.
Evidence-informed management of chronic low back pain with the McKenzie method.
Man Ther. 2008 Feb;13(1):75-81. Epub 2006 Dec 22.
McKenzie classification of mechanical spinal pain: profile of syndromes and directions of preference.
J Manipulative Physiol Ther. 2006 Oct;29(8):637-42.
Classification by McKenzie mechanical syndromes: a survey of McKenzie-trained faculty.
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Monday, December 31, 2007

January 2008

Spine. 2007 Dec 15;32(26):2948-56.
One-year follow-up comparison of the effectiveness of McKenzie treatment and strengthening training for patients with chronic low back pain: outcome and prognostic factors.
J Athl Train. 2006 Jan-Mar;41(1):117-9.Does McKenzie therapy improve outcomes for back pain
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