The McKenzie Concept
SYNDROMES / TYPES
DYSFUNCTION
DERNAGEMENT
POSTURAL
Symptoms/characteristics
Treatment
Description: Related to sustained postures at EOR
Description: Adaptive shortening (posture or contractural)
Symptoms/Characteristics
Treatment
Symptoms/Characteristics
Treatment
Description: Disruption/displacement in IV disc
ASSESSMENT
Test Moves
Repeated Movements
Objective
Subjective
Lying (passive pt applied moves)
Standing (active pt applied moves)
Flexion
Extension
Side Glide
Flexion
Extension
RATIONALE
DEFINITION: Treatment of non-specific mechanical low back pain using pain patterns and behaviours. Invented by Robin McKenzie, developed on throughout 1960s
30 year olds
Inactivity Hx
Pain mid spine but can be from neck down
Not movement related
Doesnt refer
NEVER constant
Pain on stretch
Loss of range one direction
Can e second to postural
20-55 year olds
Directional preference
Area
Adjacent
Radiating
Local
Types (based on area of pain
D4
D5
D3
D6
D2
D7
D1
Diagnostic,prognostic, therapeutic, prophylactic
Guides movement/exercise
Avoid
Encourage
Education
D1-6 treat extension
Direction - of centralisation
D7 treat in flexion
Correct deformity - lateral first
Moves not to pain
Educate first
Moves in direction of pain
Gradual stretch, aim EOR
Passive Stretching
4 stages
Maintain reduction
Recover function
Prevent recurrence
Reduce derangement
Evidence: McKenzie more effective than Manips at 2 and 12 months for pain/dysfunction
Red FLags
Remove stressor
Educate
Promote movement/position changes
Stages of Healing
Centrallising/peripheralisation moves
Tasks
Occupation
Onset/causes/aggs
Posture
Spinal curvatures
Lateral shift
Leg Length
Range
Deviations through range
Flexion
Extension
Lateral tilt
Lateral glide (rotation and Lateral flexion
Directional preferences
Other Conditions
Atypical
Inflammatory
Prior
During