Mackenzie Method- Mechanical Diagnosis and Treatment

[jbizzle]

So I just made a new friend from my city league basketball team who is a DPT. He was inviting me to observe at his clinic which uses the Mackenzie method. Has anyone heard, observed, or even practice using this method.

I am looking on-line now and see literature on it but to be honest my experience with PT is only during observation. I don't wan to go in looking like I don't know crap because quite frankly I don't know much at this stage.

Anyone have any information to "dumb" down what the basics are because sometimes reading the research articles is like reading a passage for the GRE.

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[Dreamer131]

Hey JBizzle. I did some observation in a clinic that uses the McKenzie Method. It was really interesting to see. The PT had patients use the exercises to help alleviate back/neck pain and corresponding symptoms (numbness/tingling/pain radiating down leg/arm). The object of the program is first to centralize the symptoms. For an example if a person was having low back pain pain and symptoms such as tingling/pain down into the leg, the first step would be to decrease and eliminate that symptom to the lower back. The goal is to be get rid of these symptoms but also be able to use McKenzie's exercises to control the symptoms when they occur. The therapy is a lot of teaching the patient how to respond to their body and alleviate their pain/symptoms. Once the pain is localized to one area, the idea is that the person can better handle it and it can be treated. The PT guided the patients through stages of these exercises, watching and discussing with them how their pain/symptoms are before/during/after the exercise. They will not progress to the next level until the PT is confident that it is the right type of exercise for the patient and that they are ready for it. The PT also helps the patient fix poor posture, which is a great contributer to neck/back pain. The exercises use gravity to give it a good stretch.

Sorry if this is all jumbled. I'm about whipped and I thought I'd reply quick before passing out. The PT gave the patient a book that dumbs down the whats, whys, and hows.. It is pretty cheap, short, and may help.

-Treat your own back
-Treat your own neck
Both by Robin McKenzie

 

[adh28]

Wow that is interesting. So what kind of exercises are used in this method, since it seems like that is the big defining factor? Also, after the pain is localized and ready to treat, is that when the McKenzie method is complete? Thanks for the information Dreamer131 it is so cool to hear about different ways of treating patients!

 

[markelmarcel]

I shadowed a PT and he talked about something very similar to what Dreamer131 is talking about, although he didn't specifically say to me that it was the Mackenzie Method, but he did have a patient that was experiencing pain in her lower calf and through the exercises he had been leading her through (when I was observing) the pain had disappeared from the lower leg and was in her thigh/hip area and he was then trying to get it into the back.

I found it very interesting that the pain could be "moved" from one area to another as it got closer to the spinal cord.

 

[jesspt]

Here's the web site of the Institute that was founded by Robin McKenzie, a New Zeland Physiotherapist:

http://www.mckenziemdt.org/index_us.cfm

Essentially, The McKenzie Method, or Mechanical Diagnosis and Treament as it is also called, is an examination method that attempts to classify patients with low back pain into three categories. Placing patients into these sub-groups helps to determine what type of treatment might be most helpful for the patient. As noted previously, there is a big emphasis on identifying which movements centralize (move symptoms slose to the center of a patient's spine) or peripheralize (move symptoms away from teh cneter of a patient's spine) symptoms during the examination. Once these movements are identified, the patient's exercise regime employs the movements that centralize symptoms. These exercises are used to allow the patient to self-treat their pain when it occurs.

This is a very broad generalization, but it should give you a bit of an idea what the approach is about and may help you get involved with a discussion with the PT you'll be shadowing later.

 

[MinnDasota]

Most PT's use McKenzie as part of a larger bag of tools. Thus it is commonplace in many practices as the centralization of symptoms is an important concept in rehabilitation of low back pain with radicular symptoms. It works best with a specific subset of patients. The method is very specific and most PTs tend to only use the general concept as part of their overall treatment plan of care.

Just a tidbit: lower extremity radicular symptoms tend to follow a specific myotomal or dermatomal pattern originating from a certain level of the lumbar spine. This is why strength (myotomes) or numbness/tingling (dermatomes) affect certain muscles/areas in the leg and can "move" from one area to another within those patterns---hopefully moving proximally 🙂

 

[ClemsonGrad]

I observe with a PT who is McKenzie certified and all of what the above have stated is how she works. There are a few test exercises and she is able to discern which vertebrae is having the problem/decreased strength etc. She then will go through a series of exercises to see which improves the pain and centralizes it. These exercises can be used the whole time during treatment or can be changed from one exam to the next based on whether the exercise is still helping the pain centralize or if it is now obsolete and new exercise helps the pain centralize or go away.

She does stress a lot about posture at work, sleep, during chores etc and it's been very interesting to see how quickly the pain is centralized and eliminated. She only uses the McKenzie method to diagnose and treat.