McKenzie/Williams and Tissue Injury Flashcards
What are the three McKenzie syndromes?
Derangement, dysfunction, postural
Loading strategies centralize or make the symptoms better with what McKenzie syndrome?
Derangement
Which McKenzie syndrome only has pain produced at limited end range?
Dysfunction
Which McKenzie syndrome has pain only on static loading with no effect of repeated movements?
Postural
Which McKenzie syndrome involves end-range stress of normal structures?
Postural
Which McKenzie syndrome involves end-range stress of shortened structures?
Dysfunction
Which McKenzie syndrome involves anatomical disruption or displacement within the motion segment?
Derangement
What are the most common motions for postural syndrome?
Lower cervical and lumbar flexion
What is the “motto” associated with the dysfunction syndrome?
No pain, no gain (stretching of the shortened tissue to gain ROM)
What is the PROCESS in which distal SX that began in the spine are abolished in a distal to proximal direction and remain better over time until all pain is abolished?
Centralization
What is the term for what occurs DURING the application of the loading strategy distal SX are being abolished?
Centralizing
What is the term for what happens AFTER the application of the loading strategy all of the distal SX have been abolished and only back pain remains?
Centralized
Centralization characteristics only occur in which syndrome?
Derangement
What type of change is ALWAYS seen with derangement syndrome and its centralization characteristics?
LASTING
What does it meant when peripheralization occurs with derangement syndrome?
Symptoms move away from the center of the body into the extremities
What type of antalgia is seen with posterior derangement? Anterior? Relevant posterolateral?
Posterior = kyphotic antalgia
Anterior = lordotic antalgia
Relevant posterolateral = extreme coronal/lateral antalgia
What are examples of extreme coronal antalgia seen with relevant posterolateral derangement?
Acute torticollis or lumbar scoliosis
What motion is decreased with posterior derangement?
Extension (good flexion because it’s flexion antalgia)
How do you treat posterior derangement?
Increase extension ROM and compress discal material (“push it back where it belongs”)
What would the treatment times and duration be for posterior derangement?
10 times every 2-3 hours
Does anterior derangement come with increased lordosis or kyphosis?
Lordosis
What is the treatment for anterior derangement?
Flexion loading to increase ROM and compress discal material
What motions are used to treat relevant posterolateral derangement?
Sagittal plane loading (either flexion or extension)
What are the conditions called for posterolateral derangement that don’t respond to sagittal plane loading?
Relevant (because lateral motion is required)
What ROM is normal with relevant posterolateral derangement and which is impeded?
Flexion = normal Extension = impeded
What is the treatment for relevant posterolateral derangement?
Lateral glide loading of disc followed by extension loading (remember, flexion is OK)
William’s exercises use what type of pelvic tilt to reduce lumbar lordosis?
Posterior tilt (stretch of hamstrings and hip flexors)
What are the three phases of tissue injury/healing?
Inflammation, repair, remodeling
What is failure tolerance?
Failure of tissue occurs when load exceeds strength of tissue
What concepts can affect failure tolerance?
Time, load, repetitions, characteristics of lifter
What level of odds ratio indicates reduced risk? Increased risk? Same risk?
Increased is OR > 1
Decreased is OR
Is heavy work alone a risk factor for low back pain?
No….but being in the same position constantly IS (must have alternating movements)
What is the definition of capacity?
Amount of activities of daily living, work recreation, etc. a person can do
Are disc bending and ligamentous stress higher in the morning or evening?
MORNING (300% higher for disc and 80% for ligament)
54% of the disc fluid loss occurs when?
First 30 minutes after rising in the morning
Why can exercising be more dangerous in the morning?
Increased risk of injury (should avoid full lumbar flexion to reduce back symptoms)
Besides in the morning, when is another time to try to avoid exercising due to increased tissue stress in a flexed position?
After long periods of sitting like work or school
