McKenzie Method (Guest Lecture) Flashcards
4 Common Misconceptions of the McKenzie Method
- Extension exercises only
- Used only on the spine
- Hands off approach
- No manual techniques involved
Describe the McKenzie Method
A unique, dynamic, and comprehensive system of assessment, tx, and prevention for MECHANICAL disorders
3-5 Benefits of the McKenzie Method
- Can be applied to the whole body
- Provides a classification system
- Allows for rapid clinical decision making
- Research rich
- Relies on pt. empowerment and self rx
3 Causes of LBP
- Non accident related (NAR) - largest proportion
- Incident
- Trauma
Describe what makes the McKenzie Method different
The idea of categorizing pts. complains by subgroups of clinical presentation NOT on an anatomical basis
AND
Heavy reliance of pt. participation, re-evalaution, and education
Describe how the McKenzie Method is used
CAUSE AND EFFECT b/t hx of pain behaviors, mobility, function, and pain
Describe the most important measure to take for the McKenzie Method
BASELINE MEASUREMENTS (positions, movements, postures, activities)
Describe the difference between chemical and mechanical pain
Chemical = inflammation/infection, typically presents with swelling, redness, heat, if internal unrelenting constant pain
Mechanical = deformation/distortion/distention/disruption of connective tissues, typically presents as intermittent pain, intensity and location of pain can change
Defn: Mechanical pain
Pain sensation with a definite pattern that is related to movement of lack of movement i.e. positions and postures
Describe Robert McKenzie’s Theory behind the Method
That REVERSE force could possibly abolish pain and also restore function
Describe the direction of disc displacement with spinal flexion and extension
Flexion - disc displaced posteriorly
Extension - disc displaced anteriorly
2 Motions unique to the C-spine
- Protrusion (precedes flexion)
- Retraction (precedes extension)
Describe the upper and lower C-spine motion with protrusion and retraction
Protrusion: U=extension, L=flexion
Retraction U=flexion, L=extension
Describe the role of Mechanical Dx and Tx (MDT) for assessment
It’s the process of systematic applied mechanical forces (cause) and utilizing the pain response (effect) to monitor changes in motion/fucntion to determine tx
Describe what “starting with the end goal in mind” means in regards to the McKenzie Method
You are looking to identify movement preferences and baselines from the SE to confirm findings in the OE which will allow you to furter tx., pt. education, exercise instruction/progression
9 Components of the McKenzie Assessment Process
- Hx
- Posture
- Movement loss
- Mechanical tests
- Other tests
- Provisional Classification
- Reassessment
- Confirm Classificaiton
- Progressions
4 Major Aspects of the McKenzie Evaulation
- Detailed baseline symtpoms
- Use movement to determine SE/OE changes
- Determine Directional preference
- Determine Provisional classification
Describe the main goal of MDT
CENTRALIZATION of pain and AVOID peripheralization of pain
5 MDT Classifications
- Postural Syndrome
- Dysfunciton Syndrome
- Derangement Syndrome
- Trauma/Post-Surgical
- Inconclusive
Describe Postural Syndrome and it’s Rx
ABNORMAL stress on NORMAL tissue
- No limited motion or pain with movement, static positioning is the only pain producers
Rx = Re-Education
Describe Dysfunction Syndrome and its Rx
NORMAL stress on ABNORMAL tissue (ex. old injury healed in shortened position)
Motion limited in direction of dysfunction but not in other direction
Pain reproduced but not worsened with stretch
Rx = Remodel Tissue (i.e. stretching [enough to be sore 15-20 s/p])
Describe Derangement Syndrome and its Rx
ABNORMAL stress on ABNORMAL tissue (ex. disc bulge)
INTERNAL DISTURBANCE/DISPLACEMENT to the normal resting position of the affected joint sruface/articular tissue that causes pain until the disruption is corrected
OBSTRUCTION to movement
Rx = Reduce derangement, maintain reduction, recover function, and prophylaxis
Key points of Rx for the following classifications
- Postural
- Dysfunction
- Derangement
- Train postural habits
- Produce end range pain to initiate remodeling - “no pain no gain”, 15-20 min sustained stretch, EDUCATION
- Reduce=Centralize pain/Obstruction removed, Maintain=Posture correction, Recovery=Reduction is stable
7 Contraindications for MDT
- Infection/Inflammatory Disease
- Fx/Dislocation/Instability
- Cord/CE/CNS
- Osteoporosis
- Vascular abnormalities
- Advanced diabetes
- Psychological conditions (no movement/posture/position centralizes/abolishes pain)
Describe the Progression of Forces
Midrange to Endrange ↔ Patient Generated ↔ Patient Overpressure ↔ Therapist Overpressure ↔ Mobilization ↔ Manipulation
Describe how to fully reduce derangement
By taking the pt. to endrange
