McKenzie - Dysfunction - Adaptive Shortening

Question 1

Age

Answer 1

> 30

Except when following trauma or derangement

Question 2

Pain

Answer 2

Intermittent, local
Located in low back
No pain when in neutral posture

Question 3

History

Answer 3

Hx of trauma

Onset gradual

Question 4

Cause

Answer 4

Due to adaptive shortening of soft tissues

Question 5

Change in pain

Answer 5

Worsens with static and/or dynamic loading at end ranges that stretch shortened tissue
Does not worsen with activity and postures that DON’T place shortened tissue at end range

Question 6

Examination

Answer 6

Pain only felt at end range
Pain stops shortly after commencing
Pain remains no worse and does not change in location as a result of test movements

Question 7

Intervention

Answer 7

Provide exercises that stretch pt into the painful movement
Pain with flexion? Treat with a flexion-based program
Pain with extension? Treat with an extension-based program

Question 8

Shift

Answer 8

Most often, no shift present
BUT
Could be shifted toward side of pain

Question 9

ROM into Flex & Ext

Answer 9

Limited ROM into 1 direction

No limitation with ROM into other direction

Question 10

Pain with ROM into Flex & Ext

Answer 10

Pain will commence at the end of range into the movement that is also limited
No pain with ROM into the direction opposite of the limitation
Pain should not be worse after completing either movement

Question 11

Deviation ROM into Flex

Answer 11

Most often, no deviation present
BUT
Could deviate toward the side of pain/limitation in ROM

Question 12

Pain with repeated Flex & Ext

Answer 12

Pain does not commence or increase with repeated movement into the direction that was painful when tested initially
Pain should commence at the end of range
Pain should not be worse after completing either movement

Question 13

ROM into SG

Answer 13

Most often WNL

Could be limited with movement away from the side of pain

Question 14

Pain with ROM into SG

Answer 14

Most often, no pain with SG
BUT
Could commence with movement away from side of back pain/shift
If pain occurs, should occur at the end of range
Should not be worse after completing either movement

Question 15

Pain with repeated SG

Answer 15

If there is pain with ROM into SG away from side of back pain/shift initially, does not increase with repeated testing
Pain should occur at end of range
If there is pain, should not be worse after completing either movement