McKenzie’s Method For Exercise Therapy: Introduction, Steps ,Goals , Exercises for Lower Back Pain and Neck Pain

Introduction :

The McKenzie method of exercise is a overall program of assessment, diagnosis, treatment and preventive methods for spinal and limb related disorders.

• It is also known as Mechanical Diagnosis and Therapy (MDT).
• The McKenzie method of spinal therapy is the progression of mechanical forces applied to the patient to utilise a therapeutic effect in the present disease or condition.
• This method was developed by ” Robin Anthony McKenzie ”
• He was the physical therapist in New Zealand.
• Also He was the Founder and President of International Institute of McKenzie.
• Robin McKenzie always believe in Movement based examination as well as treatment protocols.

Goals of McKenzie’s Exercises :

• To understand the patient’s presentation and behavior of symptoms.
• To Determine the appropriate and effective treatment plan for the patient.
• To Eliminate present symptoms and restore full function.
• To encourage the patient to self treat and prevent recurrences.
• To give proper information to the patients , if other medical advice or testing is needed.

Steps of McKenzie Method :

• McKenzie Method has 4 steps :
• Assessment
• Classification
• Treatment
• Prevention

This four steps are described below

Assessment :

• it is used to understand the nature of problem, which the patient is suffering from.
• it is done by asking following questions to the patient :
• History of symptoms
• Checking of Movement performance
• By giving certain positions
• By this step the therapist or examiner can know the problem or condition the patient is suffering from.

Classification :

• McKenzie has classified the conditions or syndromes into three groups :
• Postural Syndrome
• Dysfunction Syndrome
• Derangement Syndrome

They are described as below :

Postural Syndrome :

• Most commonly Postural pain occurs from capsule and supportive ligaments around joint which is involved.
• it happens because of the continuous long duration end position of the joint.
• to relieve the pain you need to move your joint from that position.

Dysfunction Syndrome :

• it occurs when you stretch your prolonged shortened soft tissues.
• pain is cured when you stop end range stress.
• so because of tightness you will not be able to perform movement.
• this abnormality might be possible because of inflammatory or degenerative or traumatic causes.
• so because of this there will be formation of contracture, scarring, and adaptive shortening in soft tissues.

Derangement Syndrome :

• most commonly seen in patients.
• pain is generally felt when there will be displacement of inter vertebral segments.
• so because of unequal loading on spine , there will be possibility of disc protrusion in any direction.
• centralization of symptoms will cure or relieve your pain .

Treatment :

• following are the aims of this step :
• to reduce pain
• centralization of symptoms
• recovery of pain as soon as possible.

Prevention :

• educate the patient regarding their problem and how to prevent it from further damage.
• teach the patient self care techniques.
• encourage the patient to do exercise regularly.

McKenzie’s Exercises for Lower back pain :

Here are some examples of Mckenzie Back Extension Exercises :

Prone Lying :

• lie on your stomach with your both hands by your side.
• turn your head towards one side.
• now maintain the position for 5 to 10 mints.

Prone lying on elbow :

• lie on your stomach and put your body weight on your elbows and forearms.
• your hips should be relaxed on floor or ground.
• now relax your lower back.
• hold this position for 5 to 7 minutes.

Prone press-up exercise :

• take prone lying position or lie on your stomach with palms near your shoulder.
• now slowly push your shoulders in upward direction.
• keep your hips on the couch or met.
• let your lower back sag slowly .
• then come back to starting position.
• repeat the exercise for 5 to 7 times.

Progressive back extension exercise :

• you need pillows for progression.
• lie on your stomach and place one pillow under your chest.
• after some time add second pillow .
• stay in this position for 7 to 10 minutes.
• remove pillow one at single time.

Standing extension exercise :

• while standing place your both hands over low back.
• now lean backward.
• hold the position for 10 to 15 seconds.
• and repeat this exercise for 4 to 5 times.
• you can use this exercise after doing activities like lifting , forward bending or prolonged sitting.

Side gliding exercise :

• you can only perform this exercise if you have problem in your one side of lower back.
• it is used to correct lateral shift .
• you can use only if you have unilateral injury.
• procedure :
• take standing position with affected side facing towards wall.
• your painful side faces away from the wall.
• put your elbow between your rib cage and wall.
• keep your lower back straight.
• use your hand to push your hip towards wall.
• if you feel movement restriction, slide your feet further from wall.
• when you reach at end range you will feel big stretch in side near the wall.
• do not separate elbow from your rib cage.
• you may feel pain during the movement so perform it slowly.
• perform 7 to 10 repetitions.

Self Treatment exercises:

• Use resting position when you are not doing any kind of activity.
• Try to use “Sphinx pose ” or “Gentle Back bend Pose “
• Perform Standing back extension exercise after bending activities.

McKenzie’s Exercises for Neck pain :

Neck extension exercise :

• move your head in backward direction .
• your face should look upward as if you are looking at sky.
• return to the starting position.
• repeat the exercise for 5 to 10 times.

Neck side bending exercise :

• bend your head in a side way, so that your ear touches your shoulders.
• hold the position for few seconds then repeat it over opposite side.
• perform the exercise for 5 to 10 times.

Neck rotation exercise :

• Turn your head towards one side .
• feel the stretch and hold the position for 2 to 3 seconds.
• perform this exercise another side also.
• perform the exercise 5 to 10 times in one session.

Shoulder Shrug exercise :

• slowly lift your shoulders close to your ears as much as you can.
• hold the position for 5 to 7 seconds.
• then return to the starting position.
• perform the exercise for 5 to 7 times.