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What is the McKenzie Method?

What is the McKenzie Method? Who is Robin McKenzie? The McKenzie Method was discovered by accident while a physiotherapist (Robin McKenzie) was treating a back pain patient in the late 1960's in New Zealand. The common treatment for low back pain at the time was Williams flexion exercises. Therefore, when McKenzie found his client lying face down on a treatment table elevated into full extension, he curiously asked the client, "How are you feeling?" When the client replied, "The best that I have felt in weeks," Mckenzie was puzzled but started to explore movement testing of pain conditions. Since then his movement testing has become a systematic process called The McKenzie Method and is used by clinicians trained in evaluation and treatment of musculo-skeletal conditions worldwide.

The conditions that can be evaluated using the McKenzie Method include any joint or spine pain including disk problems and referred pain. Conditions can be treated successfully regardless of duration of symptoms.

When evaluating using the McKenzie Method, there are four primary categories that pain conditions fall into. These are posture syndrome, derangement syndrome, dysfunction and inconclusive also called non-mechanical pain.

Posture syndrome is the easiest to treat of all the conditions. Pain is intermittent and only comes on when in static positions for a prolonged period of time or when performing repeated movements in the same range of motion for greater than 20-30 minutes. Changing position or posture is the treatment for postural syndrome and patients rarely if ever have symptoms when arriving at the office for evaluation.

Derangement syndrome is the most common of the McKenzie classifications. Derangements are further identified as reducible or irreducible. The usual conditions that are thought to be the cause of joint derangement include strained disc, cartilage tear or joint tracking problems. Pain can be intermittent or constant, new onset or old injury and can include referral symptoms. Reducible derangements generally have a direction of preference for stretching that will improve the condition rapidly. If irreducible the client may benefit from return to primary care provider to do further testing.

Dysfunction syndrome is the easiest condition to identify. Joint or muscle tightness is consistent and produces pain every time stretched to end range and soreness lasts no more than a few minutes afterward. Dysfunction can be the most difficult of conditions to treat for the patient since it takes dedication to frequent stretching to end range 6 times per day. Examples of dysfunction include adhesive capsulitis/capsulosis or old ankle sprain that never completely stretched to pre-existing ROM.

We call conditions that cannot be classified into one of the three categories mentioned non-mechanical pain. This can include inflammation, neurogenic pain and other conditions that are produced from stress or psychosocial factors. In case of non-mechanical pain conditions the patient is referred back to the primary care or referring practitioner.

If you would like to discuss these concepts or to schedule an appointment, call Ted at (503) 445-4936.