McKenzie And Williams Flashcards
William’s flexion exercises
Posterior pelvic tilt, SKTC and DKTC, HS stx
What are the benefits of William’s flexion exercises
Pelvic tilt - strengthen abs
SKTC/DKTC - opens posterior elements
HS stx - keeps post long lig taught
3 dx categories for McKenzie Method
Postural, dysfunction and derangement
Postural syndrome subjective
-younger
-insidious onset
-no acute episodes or trauma
-delayed onset pain w/ extended static positions
-localized ache
Postural syndrome physical exam
-abnormal sagittal plane postural (no lateral shift)
-fully correctable
-no movement limitations
-negative neuro scan
How to improve postural syndrome?
Education (proper biomechanics and ergonomics) and self management
Dysfunction syndrome: into flexion vs into extension
-into flexion (posterior element tightness)
-into extension (anterior element tightness)
Dysfunction syndrome subjective
-older and/or episodes of acute dysfunction
-localized pain (w/ exception of an adherent nerve root)
Dysfunction syndrome objective
-loss of normal posture
-negative neuroscan
-unidirectional stiffness
-movement into stiffness aggravates end range pain w/ repeated movements
Difference between postural syndrome and dysfunction syndrome
-dysfunction syndrome = loss of ROM w/ dysfunction
-postural syndrome = abnormal posture but full ROM
Flexion dysfunction syndrome signs
-increased lordosis
-limited forward bending
-loss of lumbar curve reversal
-HS tightness
Flexion dysfunction management
Posterior pelvic tilt, SKTC/DKTC, cat/cow, child’s pose
Extension dysfunction syndrome signs
-loss of lordosis
-limited backward bending
-BB x1
-BB x10
Extension dysfunction management
Cobra, ball extension
What is another name for derangement syndrome? What are some causes?
Disc lesion
-flexion and compression OR flexion and rotation
Posterior derangement syndrome subjective
Middle aged
Hx of progressive episodes
MOI: flexion/twisting/loading
Localized and/or referred symptoms
Posterior derangement syndrome objective - postures
Guarded flexion and lateral shift
Posterior derangement syndrome objective - neuroscan and repeated movements
Neuroscan - positive
Repeated movements - can quickly exacerbate shift, centralize or peripherally symptoms, quickly improve or worsen limitations in range
Posterior derangement assessment/physical exam motions
-lateral shift back to neutral
-forward bend
-backward bend
Okay and not okay findings from posterior derangement assessment/physical exam
If manual shifts or movements cause symptoms down the leg then it’s NOT okay
If the symptoms stay in the back then it’s okay
Reducible posterior derangement management. For acute pts?
Cobras, supine lumbar cushion
For acute, keep pts prone so gravity can help “push” disc into place
Irreducible derangement management (what to avoid and focus on)
-manual traction
-mechanized traction
-self traction
Avoid: end range loading
Focus on: traction and stabilization
What to target for dysfunction syndrome
Progressive end range loading to mechanically stx tissue over time
