McKenzie Method and Williams Flexion Exercises

Question 1

Who created the McKenzie Method?

Answer 1

Robin McKenzie

Question 2

Is the McKenzie Method only extension exercises?

Answer 2

No, it’s a comprehensive approach to the spine.

Question 3

What does the Assessment include?

Answer 3

1. ) History and Symptom presentation

2. ) Identify patterns of movement

Question 4

What is included in identifying patterns of movement?

Answer 4

1. ) Applied mechanical forces
2. ) Pain response to monitor changes in motion/function
3. ) Identify the underlying cause and sub-group patients into syndromes
4. ) Syndrome dictates the appropriate treatment

Question 5

Loading strategies centralize or make the symptoms better

Answer 5

Derangement

Question 6

Pain only produced at limited end range

Answer 6

Dysfunction

Question 7

Pain only on static loading, no effect of repeated movements

Answer 7

Postural

Question 8

What are the other causes of MDT not consistent with the 3 mckenzie syndromes (NOT derangement, dysfunction and postural)?

Answer 8

Chronic Pain Syndrome

Inflammatory

Mechanically inconclusive

Mechanically unresponsive radiculopathy

post surgery

SIJ

Spinal Stenosis

Trauma

Question 9

Which syndrome is: end-range stress of normal structures?

Answer 9

Postural Syndrome

Question 10

Which syndrome is end-range stress of shortened structures?

Answer 10

Dysfunction Syndrome

Question 11

Which syndrome is anatomical disruption or displacement within the motion segment?

Answer 11

Derangement Syndrome

Question 12

What is it called when end range loading takes time to produce symptoms in postural syndrome?

Answer 12

“End Range Loathing”

Question 13

Healthy tissues with an abnormal amount of _________ or ________ = PAIN?

Answer 13

LOAD or DURATION

Question 14

What is the most common postural syndrome?

Answer 14

lower cervical and lumbar flexion

Question 15

What is the treatment for postural syndrome?

Answer 15

Patient Education, avoid the posture, overcorrect the posture with extreme lordosis and head retraction

Question 16

Normal load on shortened tissues leads to symptoms is an example of what syndrome?

Answer 16

Dysfuntion Syndrome

Question 17

What is the treatment for dysfunction syndrome?

Answer 17

Stretch the shortened tissue, load tissue at the shortened end range (no pain, no gain)

Question 18

PROCESS in which the distal symptoms that began in the spine are abolished in a distal to proximal direction and remain better over time until all pain is abolished.

Answer 18

Centralization

Question 19

DURING the application of the loading strategy distal symptoms are being abolished.

Answer 19

Centralizing

Question 20

AFTER the application of the loading strategy all of the distal symptoms have been abolished and only back pain remains.

Answer 20

Centralized

Question 21

Only used in derangement syndrome

Answer 21

Centralization

Question 22

Used rapid and ALWAYS LASTING change

Answer 22

Centralization

Question 23

Occurs in response to loading strategies

Answer 23

Centralization

Question 24

Symptoms retreat toward the center of the body

Answer 24

Centralization

Question 25

Symptoms move away from the center of the body into the extremities.

Answer 25

Peripheralization

Question 26

What is the treatment for derangement syndrome?

Answer 26

Pursue centralization

Question 27

What type of antalgia occurs with posterior derangement?

Answer 27

Kyphotic

Question 28

What type of antalgia occurs with anterior derangement?

Answer 28

Lordotic

Question 29

What type of antalgia occurs with Relevant Posterolateral Derangement?

Answer 29

Extreme Coronal

Question 30

With this type of derangement there is good flexion and poor extension of the lumbar spine.

Answer 30

Posterior

Question 31

How is posterior derangement treated?

Answer 31

Extension (10x every 2-3 hours) to increase ROM, compress discal material and push it back where it belongs

Question 32

How is anterior derangement treated?

Answer 32

Flexion loading to increase ROM, compress discal material and push it back where it belongs

Question 33

How do most posterolateral derangements respond to sagittal plane loading?

Answer 33

Respond well and don’t require coronal plane movements.

Question 34

The posterolateral derangements that dont respond to sagittal plane loading need what movement?

Answer 34

lateral motion

Question 35

This derangement may present with acute torticollis, acute scoliosis, flexion ROM normal, and extension impeded

Answer 35

Relevant Posterolateral

Question 36

What is the treatment of relevant posterolateral derangement?

Answer 36

Lateral glide loading of the disc followed by extension loading

Question 37

When were the Williams exercises created?

Answer 37

1937 by Dr. Williams

Question 38

What is the theory with the Williams exercises?

Answer 38

Lumbar Lordosis causes back pain so encourage lumbar flexion and discourage lumbar lordosis (This method is rarely used)

Question 39

Which way should the pelvic tilt to reduce lordosis?

Answer 39

Posterior

Question 40

What other exercises can be performed to help with lordosis?

Answer 40

1. ) Single and Double knee to chest
2. ) Partial sit-up (with pelvic tilt)
3. ) Hamstring and hip flexor stretch
4. ) Squat
   * ALL done with back straight or flexed