What is the McKenzie Method?

Also known as Mechanical Diagnosis and Therapy (MDT), the McKenzie Method is a scientifically proven assessment process. Proper assessment and examination is a critical first step with back and neck problems. Pain is a symptom, not a diagnosis! To successfully treat back and neck problems a clinician must first effectively evaluate the patient.

The MDT assessment process includes active patient involvement and education that is trusted and used by practitioners and patients all over the world for the back, neck and extremity problems. This approach continues to be one of the most researched physical therapy methods available. The key distinction is its initial assessment component, a safe and reliable means to accurately reach a diagnosis and only then develop the appropriate treatment plan. Rarely is time or money wasted to perform expensive test. Certified McKenzie clinicians have a valid indicator to know right away whether the method will work for each patient.

Three Steps to Success

Step 1: Assessment

Unique to the MDT assessment, the process begins with a thorough history and testing of spinal movements to identify distinct patterns of movement restrictions and pain responses that are: reproducible, objective and reliable. Often times patients may report very similar symptoms and problems but with a thorough MDT evaluation we are able to determine very different characteristics of the underlying pain generator. These various characteristics might require significantly different methods of treatment.

There is no “one size fits all” treatment for back and neck problems. The McKenzie Method allows us to determine the right treatment for the right patient at the right time.

The most common and meaningful pattern of pain response is Centralization, which is well documented in the scientific literature as both a diagnostic tool and a prognostic indicator. Centralization is defined as a patient’s referred or radiating pain (whether just slightly off the center, into the buttock, or all the way to the toes) promptly reversing, returning to the center of the back and then usually abolishing.

Whether the patient’s pain is acute or chronic, if Centralization occurs through this logical step-by-step assessment process, good outcomes are highly likely. Numerous scientific studies have proven this fact. If Centralization occurs it provides a benefit to the patient and practitioner by eliminating the need for expensive or invasive procedures.

Ultimately Centralization provides a rational guide to the most optimal treatment strategy for a specific patient. Here is the really bad news, most physical therapists and doctors are not trained to assess for Centralization. In the scientific studies mentioned earlier, one thing was very clear, Centralization can only be detected accurately and consistently if the clinician is well trained. All of the physical therapists at RehabAuthority are required to undergo this training.

Step 2: Treatment

The most basic, faulty assumption made about the McKenzie Method is that it is simply a series of exercises. It is so much more.

When appropriate, the basis of McKenzie treatment takes advantage of the patient’s own movements and forces to abolish the pain and restore function. A series of individualized exercises subsequent to the patient’s responses during the assessment are prescribed and – most critically – are based on the Directional Preference that will Centralize or abolish pain. Directional Preference is defined as specific movements, postures or exercises that will cause Centralization. Once again, there is no one size fits all series of exercises that will work. At RehabAuthority every single patient is assessed and given a unique set of exercises specifically matched to their problem. In essence, the treatment must match the assessment findings or the results will be inferior.

Furthermore, as Robin McKenzie states in his original textbook “if no movement or position can be found to Centralize or reduce the patient’s presenting pain, the patient is not a suitable subject for Mechanical Therapy.” This should be a welcomed relief for many patients who have been forced into a “cookie cutter” exercise or treatment routine in which they have received dozens and dozens of treatments only to find they aren’t any better at the end.

In our experience as well as various scientific studies, we find about 70% of back and neck pain patients respond well to MDT. This allows us very quickly to determine who we can help and which patients might require further medical evaluation.

Step 3: Preventative Strategy

Most patients who do respond favorably to MDT can successfully treat themselves and minimize the number of visits to the clinic when provided the necessary knowledge and tools putting him or her in control of their treatment, safely and effectively.

Patients who stick to the prescribed treatment protocols are less likely to have persistent problems. Thus, by learning how to self treat the current problem, patients gain hands on knowledge on how to minimize the risk of recurrence and how to quickly manage themselves if symptoms do occur.

These methods are very powerful and give patients various “tools” they can use if they experience a flare up of symptoms in the future. If a patient starts to notice symptoms they know what to do to treat themselves immediately rather than having to wait days or weeks to see a clinician. Patients often tell us if they have a flare up their symptoms will now last a day rather than weeks or months like they did in the past.

Our offices work for YOU!

The best way to understand the McKenzie Method is to actually go through the assessment process. At RehabAuthority Physical Therapy our clinics are not like a typical Physical Therapy clinic. They are clean and attractive and offer a wonderful environment for your recovery. We offer extended business hours and we will work around your schedule. We will also schedule you within 24 hours of your phone call. We know that back and neck problems can severely impact your life and we want the opportunity to SOLVE your problem not just treat it.

Partially adapted from: The Power to Control Pain, McKenzie Institute USA and Mechanical Diagnosis and Therapy Volumes I and II Robin McKenzie and Stephen May 2003.

RehabAuthority offers the physical therapy solutions such as back pain, shoulder pain and knee pain in Boise and throughout Idaho.