McKenzie, Manual, Gary Gray, etc

[kmendes]

Entering the workforce, there are several pathways to channel MOST of your diagnostic thinking. I say most because only an ignorant practitioner would utilize one method, especially since some of them don't agree with each other (think NAIOMT and McKenzie).

I've heard great things about McKenzie for the peripheries from colleagues (I've only done back stuff with that method). I've been exposed to manual and like some of it and think other parts are crap. I like functional methods like Sahrmann, Gary Gray, etc.

I intend to be educated in several methods, but which would you recommend first? My program had a decent manual basis, some McKenzie, and some functional.

Every method works, that's obvious. McKenzie haters can't say anything about his method being globally popular where as manual is only really big here in the USA. I'm into higher level therapy, so gary gray and functional screens are sort of my cup of tea.

Any input?

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[Sheldon]

NAIOMT and McKenzie don't agree with one another? How so? From who?

 

[kmendes]

could be particular to the practitioners, but some manuals I know say McKenzie full of (bleep) and it's bogus, while McKenzie people have said "You can't feel true movement here or there" which to a point I agree for SOME joints.

MTs think McKenzie PTs are lazy bc they don't touch patients (although for their defense, isn't MDT all about self-treatment to reduce visits to the PT?)

McKenzies think MT are too hands on and patients can't carry on the therapy at home.

like I said, it could be the source, not the training

 

[jesspt]

Entering the workforce, there are several pathways to channel MOST of your diagnostic thinking. I say most because only an ignorant practitioner would utilize one method, especially since some of them don't agree with each other (think NAIOMT and McKenzie).

I've heard great things about McKenzie for the peripheries from colleagues (I've only done back stuff with that method). I've been exposed to manual and like some of it and think other parts are crap. I like functional methods like Sahrmann, Gary Gray, etc.

I intend to be educated in several methods, but which would you recommend first? My program had a decent manual basis, some McKenzie, and some functional.

Every method works, that's obvious. McKenzie haters can't say anything about his method being globally popular where as manual is only really big here in the USA. I'm into higher level therapy, so gary gray and functional screens are sort of my cup of tea.

Any input?

I have no idea what that means.

 

[kmendes]

I have no idea what that means.

Sorry. Basically no walkers or canes. Higher level ambulatory challenging orthopedic intervention.

Think "sports therapy"

 

[jesspt]

Sorry. Basically no walkers or canes. Higher level ambulatory challenging orthopedic intervention.

Think "sports therapy"

The primary issues with Gary Gray, Sahrman or FMS/Grey Cook in my opinion is their lack of sound foundational theory. The prevalence of many of these asymetries that these methods are designed to find is very high in the asymptomatic population.

Look into the reliability and validity of these assessment that is espoused by these methods. You'll find that many of them are quite poor.

Your first resource in attempting to focus your "diagnostic thinking" should be those methods with sound theory, hopefully with some supporting data to back that up.

 

[kmendes]

you're absolutely correct on forming sound theories first. I've worked with PTs trained via sahrmann and the intervention is stuff I do anyways with my patients, but I've yet to learn the theoretical side of it.

McKenzie seems like something that would be good to have because it's the quick n dirty screening and if patients don't improve on their own, then switch to manual/functional intervention.

 

[NewDPT31]

McKenzie seems like something that would be good to have because it's the quick n dirty screening and if patients don't improve on their own, then switch to manual/functional intervention.

I tend to use a little bit of everything and mix it together. For example with LBP where I need to regain extension, I don't solely do extension. I do HS stretch, piriformis stretch, etc...AND THEN do the extension stuff, because they still have super tight hip mm and I think it's beneficial. This is assuming they can tolerate it and of course moderated by me.

 

[gray0620]

I have experience with both Shirleys and Gary Gray's methodologies. From my point of view, I agree more with Gary Gray's systems of approach of tri planar movement and facilitating the "Chain Reaction". Meanwhile, I think Sharmans work is very isolative and non-functional because the patient has to consciously think about turning muscles on. Similarly, that is my view of the FMS system. Correct me if I am wrong, I just think the FMS system is artificial and doesn't consider the proprioceptive input and tri planar motion of the chain reaction. For example, the screen testes Anti-Rotation stability but doesn't actually test you in the transverse and frontal planes. Movement is tri-planar. In a practical case, the FMS system looks at a lunge with a patient pronating at the foot as weak hip stabilizers and as poor movement. Meanwhile, the Gary Gray system looks at this as good (in moderation). Calcaneal eversion is the key that turns on the system.

That is my take on the systems. However, I would like to see what others opinions are.