The McKenzie method of treatment for back and neck pain was developed in the 1970’s by Robin McKenzie, a physiotherapist from New Zealand. It is one of the most highly recognized and researched treatments for neck and back problems. Physiotherapists who use McKenzie treatment successfully have had specialized training from the McKenzie Institute. At Corydon Physiotherapy, all of our physiotherapists have McKenzie training, and Kelly Milan is certified in the McKenzie method.
The McKenzie approach starts with a thorough evaluation. That includes specific questions about a person's pain and determining the cause of pain by checking posture, and all the different movements of the neck or back. The assessment is the most important part. By determining which movements cause or relieve the pain, the condition is categorized into one of the following:
a) postural pain (syndrome) or
b) spinal dysfunction (shortened and tight muscles and ligaments) or
c) derangement syndrome (disc pain, injury, bulging)
McKenzie trained Physiotherapists are tested and certified to know how the body moves and how one area of injury can affect another area. For example, a person may have an ache or "pain in the butt". A McKenzie physiotherapist may discover that the problem is not the hip or "butt" creating pain, but it is a pinched nerve or bulged disc in the low back. The hip or "butt" area can be treated with massage, laser, acupuncture, etc and it will never get better because the problem is not there. The physiotherapist will then explain what the problem is and what is the best recommended treatment program. A treatment plan is made that best meets a person’s needs.
How does it work?
A) If the pain is from poor posture, (postural syndrome) the physiotherapist will teach proper posture for sitting or standing whether at a work station or during recreation. They will show proper exercises to relieve the pain, and will teach about good back support in a chair, proper workstation set-up, and good body mechanics when lifting, pushing and pulling.
The McKenzie method focuses on showing people how to self-treat their pain and create independence from healthcare practitioners.
B) If the condition is due to spinal dysfunction (tight, shortened muscles and ligaments and decreased flexibility of the neck or back), the physiotherapist will teach proper exercises that will eventually improve the movement in the spine. Two examples of important exercises to improve flexibility are neck retraction and the press-up as shown below.
Neck retraction exercise:
Assisted press up exercise:
There can be a time when the physiotherapist will also apply hands on techniques (manual therapy) to help speed up a person’s rehabilitation as shown above. Once the flexibility improves, the pain will also lessen or go away. Proper posture and back education is also provided.
C) Finally, if the condition is due to derangement syndrome (disc pain or a disc bulge/protrusion) the physiotherapist determines which movements and exercises are to be performed to reduce pain and reduce the disc bulge. McKenzie therapy get to the "root of the problem". Disc pain is usually caused by the gel center (nucleus) of the disc moving backwards and causing a bulging to some degree as shown below. Certain movements and techniques by the physiotherapist will "squeeze" and move the gel back to the center of the disc, and reduce the disc bulging. This would be similar to squeezing the jam back to the centre of a jam buster donut by pressing on the sides. One example of how to reduce a disc bulge is the assisted press up shown above.
How effective is McKenzie therapy?
There are many studies showing the effectiveness of the McKenzie approach. One study involved Corydon Physiotherapy. 312 low back pain patients were examined using the McKenzie method. The study found that patients who were given McKenzie treatment improved much more than if they were given non McKenzie treatment in terms of pain, medication use and daily function. This study highlighted the strength of the McKenzie system for developing a correct treatment plan (Long. A, Spine 2004). In another study, 136 patients were assigned to one of 3 groups. A McKenzie program group, mechanical low back traction group, and a back education group. The McKenzie group had a success rate of 97% based on their improved symptoms. The back traction group’s success was 50% and the back education group 38% (Ortho Trans 1986). Other large review studies have found McKenzie exercises to be more effective than other popular categories of back exercises for the short and long term (B.C. Physio Assoc. 2008).
McKenzie Physiotherapy focuses on the long term solutions for various conditions as well as short term pain relief. Patients are taught ways of easing the pain at home or at work. Programs are customized for each individual. For a thorough McKenzie evaluation, please contact us.