MCKENZIE METHOD

                                                      INTRODUCTION

McKenzie method is a technique used in physical therapy. It was developed by Robin Mckenzie, a New Zealand. This is also known as Mechanical diagnosis and therapy(MDT). It is a system comprising of assessment, diagnosis and treatment for the spine and extremities. 

In this, the physiotherapist finds out the relationship between causes, effects and the positions of the patients he assumes while sitting, standing or moving, and the location of pain as the result of these positions or activities.

So this approach requires the patient to move through a series of activities and tests movements to elicit the patient's pain response. Then therapist uses these information to develop an exercise program to reduce the pain.

                                                              AIMS

                          👉 Reducing pain

                          👉 Centralisation of symptoms

                          👉  Complete recovery of pain

                                                       STEPS

1. ASSESSMENT:- In this step, the therapist takes the history of the patient, checking the pain aggrevating and relieving positions and also rules out the RED FLAG SIGNS.

                                      *RED FLAG SIGNS like anorexia, weight loss history, presence of night pain and ON/OFF fever.

2. TREATMENT:- This is based on assessment and it varies from person to person. The therapist teaches the patient that positions which can relieve his pain.

3. PREVENTION:- This step is done to minimize the reoccurence of the conditions. It tells the patients about the factors and causes that will aggrevate the pain.

                                                    MCKENZIE CLASSIFICATION

                                       👉 POSTURAL SYNDROME:-  This is basically  due to attaining the wrong posture for longer period of time. Pain subsides after changing the posture. It is common in younger age group(below 30 years). The cause is the overstretching of the normal tissues because of poor sitting or standing postures or lack of stretching exercises in sedentary professions.

                                      👉 DYSFUNCTION SYNDROME:- This is caused by mechanical deformation of soft tissues affected by adaptive shortening. Pain is produced as shortened structure are stressed by end range.

                                     👉 DERANGEMENT SYNDROME:- In this, anatomical disruption or displacement occurs within the intervertebral disc. In younger age group, there is displacement of the annulus complex or fluid nucleus, whereas in older age group degenerated annulus or fibrosed nucleus may be present.

                                                DIRECTIONAL PREFERENCE

It describes the situation when movements in one direction will improve pain and limitation of range, whereas movements in opposite direction cause sign and symptoms to worsen.

    👉 CENTRALISATION:- In this, limb pain emerging from the spine is progressively abolished in a distal to proximal direction in response to treatment.

  👉 PERIPHERILIZATION:- Pain emerging from spine spreads distally into the limb by the treatment. If this occurs, the treatment strategy should be avoided.

                                                               TREATMENT

The treatment plan of Mckenzie depends upon the categorisation of symptoms.

          If patient has symptoms of postural syndrome, correction of position is the treatment of choice. The patient is advised to follow correct ergonomics, attaining good posture for sitting, standing, lifting. Postural correction involves stretching of contracted structures, strenghening of weak muscles, correction of malalignment with manipulation.

          If patient has symptoms of dysfunctional syndrome, treatment includes Mckenzie extension exercises to prevent the progression of the symptoms.

         If patient has derangement syndrome, then extension protocol doesn't improve symptoms therefore core stability exercises play an important role.