Misconceptions on McKenzie Concept:

 

The most basic, faulty assumption made about the McKenzie Method is equating it with only extension exercises – it is so much more.

 

The McKenzie Method is in its truest sense, an assessment process that identifies responders and non-responders in all populations. In cases when a patient does not respond mechanically, alternative means of treatment or referral for further medical evaluation is warranted. Also known as Mechanical Diagnosis and Therapy, the McKenzie Method^® is a is a comprehensive approach to the spine and joints with a philosophy of active patient involvement and education for back, neck and extremity problems. This approach continues to be the most researched physical therapy based method available. The key distinction is its initial assessment component—a safe and reliable means to accurately reach a diagnosis and only then make the appropriate treatment plan. Rarely are expensive tests required, Certified MDT clinicians have a valid indicator to know right away whether—and how—the method will work for each patient.

 

Unique to the McKenzie Method, the process begins with a thorough history and testing of movements to identify distinct patterns of pain responses that are: reproducible, objective, and reliable and reflect characteristics of the underlying pain generator.

 

The most common and meaningful pattern of pain response is Centralization, which is well documented now in literature as both a diagnostic tool and a prognostic indicator. This is defined as a patient’s referred or radiating pain (whether just slightly off centre, into the buttock, or all the way to the toes) promptly reversing, returning to the centre of the back, and then usually also abolishing. Centralization is clinically induced with clinically administered postures, positions and repeated movements.

 

Whether the patient’s pain is acute or chronic, if Centralization occurs through this logical step by step assessment process, good outcomes are favorable in acute to chronic patients. Centralization is independent of non-organic and positive behavioral signs seen in chronic pain. It provides a benefit to the patient and clinician by eliminating the need for expensive &/or invasive procedures. Research has evidenced that non-centralization is an early indicator of a surgical outcome.

 

Ultimately, it provides a rational guide to the most optimal treatment strategy for a specific patient. A series of individualized exercises subsequent to the patient’s responses during the assessment are prescribed and – most critically – are based on the Directional Preference that will centralize or abolish pain, i.e. extension or flexion, right or left lateral movement, etc.   That is, Centralisation indicates Directional preference.