One of the more common questions I get from patients is a variant of the following: “I saw my doctor for my low back pain and she wants me to see a McKenzie therapist before I see a spine surgeon or get an MRI. So what is this McKenzie method all about?”
So what should you expect when you see a McKenzie certified therapist (aka someone who is a “Cert MDT”)?
MDT actually stands for Mechanical Diagnosis and Therapy. As part of your evaluation, your Cert MDT therapist will take a thorough history, specifically looking for activities that make your symptoms better or worse. This helps your therapist to determine if you seem to have a directional preference (more on this later). This history gives us an idea of where to start.
Checking spinal range of motion, muscle strength, and neurological involvement also gives us a baseline of your injury and helps us rule out anything that needs emergency medical attention.
After taking these measurements we immediately start looking for a “directional preference,” a direction that makes your pain better. Say you have pain traveling from your low back down your right leg. After you sit for 30 minutes at your computer, that same pain is traveling down your leg all the way to your ankle. You get up and walk around for 5 minutes and that same pain seems to have moved up your leg to just above your knee.
A McKenzie therapist would hear that and want to explore what response your pain has to some repeated movements into backwards bending as sitting actually places your spine into forward bending. If doing some version of the backwards bending shows the same response as walking (the pain travels up your thigh again or “centralizes”), we have found the directional preference and are well on our way to improving your symptoms.
The great thing about McKenzie therapy is that patients typically leave with a simple exercise that they can do on their own to reduce their pain. If we are able to find a movement that centralizes/reduces your pain, you’ll start to understand what movements to avoid throughout the day and what movements are ok.
This helps to take away fear of moving and gives you a tool to use to reduce your pain. I tell my patients to think of this exercise as their pain reliever. It is always preferable for a patient to be independent in managing their symptoms and that’s a huge aspect of the McKenzie Method!
Knowledge of a directional preference guides McKenzie therapists in giving recommendations for activities that the person can complete or those that the person should avoid. If I have someone bend forward once or twice, and their symptoms are now newly traveling down to their ankle, and they want to know if they can install all of their landscaping that weekend, I will advise against this. Conversely, if a person can bend forward 20 times before symptoms start to move down the leg, they are probably able to work for 10-15 minutes in their garden without suffering the same fate as my earlier example.
Lastly, the McKenzie Method is extremely well studied in the research literature. It’s been around for 50 plus years and has a lot of research studies showing that it is safe and effective. So again, not only is the McKenzie method great for patients, but we therapists like it too!
Hopefully, this quick description of what the McKenzie Method looks like and why it is such a great tool has piqued your interest. The Center has many McKenzie certified therapists who would love to help you on your healing journey. Please feel free to contact us with any questions or to schedule your initial assessment!
Want to learn more about the McKenzie Method? Visit our page here.