Mckenzie method

Question 1

Williams flexion exercises

Answer 1

1) posterior pelvic tilt to strengthen the abdominals
2) single and double knee to chest to open the posterior elements
3) hamstring stretch to keep the posterior longitudinal ligament taught

Question 2

Accepted medical model of back pain before the 70s

Answer 2

• back pain in caused by a disc lesion
• extension is bad for the disc because it pushes it posteriorly and narrows the foraminal spaces
• diagnosis imaging in limited to radiograms and myelograms

Question 3

Presuppositions of Mackenzie method

Answer 3

1) a mechanical diagnosis for a mechanical problem (anatomic problem)
2) major underlying systemic disease is ruled out
3) major structural pathology of the spine is ruled out
4) diagnostic criteria are limited to mechanical disorders of the spinal elements

Question 4

3 main categories of McKenzie method

Answer 4

1) postural
2) dysfunction
3) derangement

Question 5

Postural subjective

Answer 5

• younger
• insidious onset
• no acute episodes or trauma
• delayed onset of pain with extended static positions (pain increases over time with bad psoture)
• localized ache

Question 6

Postural Physical exam

Answer 6

• abnormal sagittal plane posture (no lateral shift)
• fully correctable (able to cue into posture)
• no movement limitations (close to normal ROM)
• negative neuroscan

Question 7

Postural syndrome management

Answer 7

education and self management

Question 8

Flexion dysfunction

Answer 8

• posterior element tightness
• Increased lordosis
• limited forward bending
• Loss of lumbar curve reversal
• Hamstring tightness

Question 9

extension dysfunction

Answer 9

• anterior element tightness
• loss of lordosis
• limited backward bending (limited extension ROM)

Question 10

Dysfunction syndrome subjective

Answer 10

• older and/or episodes of acute dysfunction (muscle strain, facet dysfunctions)
• localized pain (with the exception of adherent nerve root)

Question 11

Dysfunction syndrome objective

Answer 11

• loss of normal posture
• negative neuroscan
• unidirectional stiffness
• movement into stiffness aggravated end range pain

Question 12

dysfunction syndrome with repeated movements

Answer 12

• pain relatively unchanged
• motion unchanged or mildly better

Question 13

flexion dysfunction management

Answer 13

promote flexion, Williams flexion, child’s pose, cat

Question 14

extension dysfunction management

Answer 14

do extension, cobras, wheels, etc.

Question 15

Posterior Derangement Syndrome subjective

Answer 15

• Middle age or order
• Hx of progressive episodes “thrown out back”
• Mechanism of injury usually flexion, twisting, loading
• localized and/or referred symptoms (irritations form nerve root)

Question 16

Posterior Derangement Syndrome objective

Answer 16

posture: Guarded flexion or lateral shift
Neuroscan: positive
Repeated movement: exacerbate shift, centralize or peripherally symptoms, and can improve or worsen limitation in range

Question 17

Posterior Derangement Syndrome Assessment Steps

Answer 17

1) fix posture
2) have them do repeated motions

Question 18

Posterior Derangement Reducible Management

Answer 18

symptoms centralize with posture change and repeated movements. Do extension exercises

Question 19

Posterior Derangement Irreducible management

Answer 19

symptoms peripheral with postural change and repeated movements. Avoid end range loading and focus on traction and stabilization