THE MCKENZIE METHOD

MECHANICAL DIAGNOSIS AND THERAPYBy: Lindsay Tuhacek

OUTLINE

History of Manual Therapy The Prevalence of Spinal Pain The Causes of Pain The McKenzie Approach The Lumbar Spine Classification and Diagnosis Research Conclusion

THE HISTORY OF MANUAL THERAPY

The idea of Manual Therapy was first introduced by Hippocrates(460-370 B.C.)

He practiced medicine on the basis of inductive reasoning.

McKenzie Method was developed by Robin McKenzie, a practicing physiotherapist.

1956-Accidental hyperextension gives new meaning to directional preference.

20 years of trial and error to develop the McKenzie Method.

• (McKenzie 2009)

THE HISTORY OF MANUAL THERAPY

1977-The first workshop for Mechanical Diagnosis and Therapy(MDT).

1982-The McKenzie Institute was formed. Currently there are 26 separate branches

throughout the world and growing. Institute offers a Program of Certification

which includes a 4 part credentialing examination.

The final stage is a Diploma in MDT. Eligibility to take the exam include: Bachelors

degree in health care field and current licensure.(MD, DO, DC, PT)

• (McKenzie 2009)

THE PREVALENCE OF SPINAL PAIN

Activity-related disorders of the spine are experienced by approximately 50-80% of the adult population at some point(s) in life.

The peak prevalence of this pain is between ages 40-50 years.

Disability due to back/neck pain has dramatically increased in the last 10 years.

Many individuals are treated with medications when the nature of most disorders are not inflammatory.

Most spinal disorders develop insidiously upon the repetitive movements we do on a daily basis.

• (McKenzie 2009)

THE CAUSES OF PAIN

Most tissues in the body possess a system of nociceptive receptors(nerve endings).

These receptors are the body’s warning system. Ex: Telling us when a joint has moved past its

normal range of motion(ROM). Pain is produced either by a chemical or

mechanical stimulation. The McKenzie Method is a way to treat

mechanical pain only. The Bent Finger Syndrome. Directional Preference.

• (McKenzie1990)

THE MCKENZIE APPROACH

Lifestyle plays a major role in the development of these conditions.

MDT attacks the lifestyle factors that contribute to the onset, recurrence and progression of these disorders.

Modification of behavior and patient awareness of their habits will decrease the incidence of pain.

Patients are given directional preference exercises to use when pain arises.

Patient control will decrease doctor visit, health care costs, visits to the E.R., and decrease disability rates.

RESEARCH

Journal of Athletic Training A study was done with individuals with low back

pain and the effects of different therapies such as: pain meds, massage, educational booklet and spinal mobilization.

Conclusion: The results showed that trends favored the

McKenzie Method at intermediate term follow-up for pain and disability as well as work absences.

The McKenzie treatment group also tended to have fewer health care contacts in the 12 months after the study compared to all other groups.

• (Basanich,B.M., Verscheure, S.D.Journal of Athletic Training, 2006)

THE LUMBAR SPINE

Lumbar extension

Lumbar flexion

(McKenzie 2009)

CLASSIFICATION AND DIAGNOSIS

(McKenzie 2009)

RESEARCH

Journal of Rehabilitation Medicine Gathered data on the effects of the McKenzie

Method vs. advice only in working adults.

Conclusion After 6 months low back pain and leg pain were

better in the McKenzie group than the advice only group.

After 12 months the McKenzie Group had a better disability index.

(Markuu, Paatelma et al, Journal of Rehabilitation Medicine, 2008)

RESEARCH

Journal of Manipulative and Physiological Therapy 50 patients with spinal pain Assessed by 14 PT’s trained in the McKenzie

Method Conclusion: reliability was .84 for syndrome

classification McKenzie assessments performed by persons

trained in the McKenzie Method allow for reliable classification of patients with spinal pain.

• (CLARE, H.A, ADAMS, R, MAHER, C.G, JOURNAL OF MANIPULATIVE AND PHYSIOLOGICAL THERAPEUTICS, 2005).

CONCLUSION

The McKenzie Method is an effective form of manual therapy.

Studies have proven its effectiveness The medical profession should pay more

attention to manual therapies such as the McKenzie method to manage back pain.

More information on the McKenzie Method can be found at www.mckenziemdt.org.