What is the McKenzie exercise approach How and when is it applied

McKenzie's method includes both an assessment and intervention component and is commonly referred as a mechanical diagnosis and therapy (MDT). McKenzie's exercise philosophy is based on the finding that certain spinal movements may aggravate pain, whereas other movements relieve pain. McKenzie believed that accumulation of flexion forces caused dysfunction of posterior aspect of the disc. Most of McKenzie's exercises are extension biased. The positions and movement patterns that relieve pain are individually determined for each patient. McKenzie classified lumbar disorders into three syndromes based on posture and response to movement: postural syndrome, dysfunctional syndrome, and derangement syndrome. Each syndrome has a specific treatment and postural correction. Treatment objectives include identifying the directional preference of lumbosacral movement for an individual patient that induces centralization of the pain (change in pain location from a distal location in the lower extremity to a proximal or central location). Examples of McKenzie's exercises include:

• Repeat end-range movements while standing: back extension, side gliding (lateral bending with rotation)

• Recumbent end-range movement: passive extension while prone (Fig. 14-2), prone lateral shifting of hips off midline McKenzie exercises are most commonly prescribed for disc herniation and lumbar radicular pain.

Figure 14-2. McKenzie exercise: passive extension while prone.

Figure 14-2. McKenzie exercise: passive extension while prone.

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