McKenizie Approach Flashcards
what is the McKenzie approach
- an evaluative and treatment system based on the response of pain patterns to end range spinal movements
McKenzie syndromes
- postural
- dysfunction
- Derangement
What is Postural syndrome
- prolonged stress to normal tissue results in pain
- local and intermittent pain
- normal range of motion
- repeated motions fail to produce pain
What is Dysfunction Syndrome
- End range stress to shortened tissue
- immediate pain with stretch
- local and intermittent pain
- always loss of motion and function
what are the potential sources of Dysfunction Syndrome
- discogenic
- apophyseal
- ligamentous
- muscular or aponeurotic in nature
- something has shortened
What occurs during the evaluation with Dysfunction Syndrome
- test movements produce pain at end range in the direction of restriction
- pain is relieved when stress removed
- symptoms worse as a result of test movements
What is derangement syndrome
- anatomic disruption and/or displacement of structures
- altered tension in structures within and around the intervertebral disc
Derangement Syndrome signs or symptoms
- increased mechanical deformation will immediately or eventually produce pain
- always loss of motion and function
- often constant pain, commonly assoicated with peripheral pain
- test movements in one direction will produce, increase and/or peripheralize symptoms
- symptoms REMAIN worse
- test movements in opposite direction will centralize, decrease or abolish symptoms
- symptoms REMAIN improved
What is commonly seen with derangement syndrome
structurally
- deformity of kyphosis or scoliosis is common
Definition
Increases
symptoms already present are heighted
Definition
Decreases
symptoms already present are reduced in intensity
Definition
Produced
no symptoms at rest movement creates symptoms
Definition
Abolished
symptoms are present movement eliminates symptoms
Definition
worsens
symptoms present or produced are increased with movement and remain elevated as a result
Definition
not worsened
symptoms present or produced are increased with movement but do not remain elevated as a result
Definition
better
symptoms present or produced decreased or abolished with movement reamin decreased as a result
Definition
Pain during movement
pain appears or increases as movement occurs, pain disappears or reduces when movement stops
Definition
Pain at end range
pain does not appear until ER is reached pain disappears when ER released
Definition
In status Quo
movement has no effect
Definition
No better
symptoms are decreased or abolished with each movement
DO NOT remain reduced
centralization phenomenon
- movement of symptoms from a distal or a proximal orientation
- occurs only in derangement
- May increase in the central LB but decrease in the periphery which is okay
- suggests disc bulge is reducing
- reliable predictor of correct movement
Treatment of
Postural syndrome
correct sitting, standing, and lying postures
Treatment of
Dysfunction syndrome
- controlled stretching into the direction of the limitation and pain
- allow elongation without microtrauma
- stretch every two hours
- posture correction
Treatment of
Derangement syndrome
- reduction of derangement using self-gerated forces (move nucleus away from overstretched tissues)
- progress to increasingly greater reductive forces
- maintain reduction with exercise and posture
- 24 hour program
- recovery of function
- prevent recurrence/prophylaxis
gradually reintroducing flexion while maintaining extension prophylaxtically =
