4001 Lake Otis Pkwy, ste. 201
Anchorage, Alaska 99508
Tel (907) 561-1711
email: IPTalaska@gmail.com
McKenzie Approach

MDTThe McKenzie Method is not merely extension exercises as many incorrectly believe. In its truest form, McKenzie is a comprehensive evaluation and treatment approach. It is an assessment tool, as well as a treatment approach. The principles can be used in the extremities (arms and legs) with the same outstanding results seen in the spine. Based on sound principles and fundamentals that when understood and followed accordingly are very powerful. In fact, the most remarkable, but least appreciated aspect of the McKenzie approach is the assessment process. The McKenzie Method is well-defined leading to the simple classification of disorders. It is based on a consistent "cause and effect" relationship between historical pain behavior as well as the pain response to repeated test movements, positions, and activities during the assessment process. A progression of applied mechanical forces (the cause) utilizes pain response (the effect) while monitoring changes in motion/function. The underlying problem can then be quickly identified. This process optimizes and specifies the treatment to be used in your recovery. In a 2014 study the findings revealed that patients with low back pain who were being treated by clinicians with McKenzie training had better functional outcomes and required less total visits to attain them (Deutscher, D. et al. 2014).

The McKenzie classification system provides a reproducible means of separating patients with apparently similar presentations (such as "Low back pain", or "Sciatica") into definable sub-groups (syndromes). Once this is done, it can determine the appropriate treatment. McKenzie has named these three mechanical syndromes: Postural, Dysfunction and Derangement. Postural: End-range stress of normal structures, Dysfunction: End-range stress of shortened structures (scar tissue, fibrosis, nerve root adherence), and Derangement: Anatomical disruption or displacement within a joint (such as a lumbar disc). All three mechanical syndromes – postural, dysfunction, and derangement – occur in the cervical as well as thoracic and lumbar regions of the spine. They can also occur in the extremities (though the classification system is slightly larger for the extremities). Each distinct syndrome is treated according to it's unique nature. This is part of what makes the system so effective as well as unique.

The Derangement syndrome where the phenomenon of "centralization" occurs is the most common. This is the cause of many patient's Sciatic and Low Back Pain. It is not uncommon to see large and rapid decreases in a patients pain during the evaluation process. That means a significant pain reduction the very first treatment day. The patient then can take that information home with them self treating and start feeling better from day one. This is commonly found for the extremity patients as well as the neck and back patients.

Well-trained McKenzie practitioners will be able to identify more difficult cases where advanced McKenzie techniques might benefit the patient versus those patients whose diagnosis is non-mechanical in nature. Patients of non-mechanical origin are quickly referred for alternate care. This helps the patient avoid unnecessary periods of inappropriate or expensive management with failed treatment. McKenzie treatment uniquely emphasizes education and active patient involvement in the management of their patients. This allows a rapid decrease in pain restoring function and independence. This can minimize the number of visits having to be made to the clinic. If a problem is more complex, self-treatment may not be possible right away. However, a McKenzie trained clinician will know when to provide additional advanced hands-on techniques until the patient can successfully manage the prescribed skills on their own. Ultimately, most patients can successfully treat themselves when provided the necessary knowledge and tools. An individualized self-treatment program tailored to the lifestyle of the patient puts the patient in control safely and effectively. This is an essential part of the treatment philosophy.

Preventive. Patients gain an education learning to self-treat the problem. The application of these skills and behaviors will minimize the risk of reoccurrence and allow patients to rapidly manage themselves when symptoms occur. The goal is to have the patient be independent in managing their own symptoms so that they no longer have to get "treated" any time they have pain. They themselves will be armed with the education and proper exercises to manage the symptoms, independently.

At Integrative Physical Therapy we have staff Certified by the International McKenzie Institute to use this approach. The clinic director has earned a Diploma level of certification using the technique. This required an additional 600+ hours of training above the base postgraduate certification training level. He is currently the only Diploma Level MDT certified clinician in private practice within the state of Alaska.

Learn more about the system HERE.

Learn more about training and Job opportunities at IPT HERE.

References:

Deutscher, D., et al. (2014). Physical Therapist' Level of McKenzie Education, Functional Outcomes, and Utilization in Patients With Low Back Pain. JOSPT, 44 (12) pp 925-936.

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