What is the McKenzie Method?
How does it differ from other assessment and treatment approaches?
Mechanical Diagnosis & Therapy (MDT), also known as the McKenzie Method, is a research proven, reliable and valid form of assessment and treatment.
It is used in over 28 countries in the world, and is commonly used in the USA, UK and NZ. It is less well known about in Australia as it is not taught in the university system, and is only offered as a post-graduate qualification.
What are the benefits of MDT?
- Patients are taught exercises to give immediate relief of pain
- Costs are significantly reduced as expensive imaging is not required as evidence shows the MDT assessment process is at least as reliable as MRI
(1997, Donnelson et al)
- Around 70-80% of people can be taught exercises that give relief and rapidly improve
- Those that will respond are usually identified in the first or second session, so time and money is not wasted, and those that need to be managed in another way are quickly identified
- Patients are taught strategies to decrease and prevent recurrences
How does MDT differ from other types of treatment including traditional physiotherapy?
- The assessment process involves the use of repeated movements, which are used to quickly identify a direction of movement that relieves pain and restores movement
- “Hands on” is used in only 30% of patients, often to give more information during assessment or to increase the effectiveness of the patient generated exercises
- Patients perform exercises for relief of pain
- There is a big focus in minimising visits to the clinic and on teaching prevention and empowering self-management
What kind of problems are rapid responders with MDT?
- MDT is most recognized for its effect in treating back and neck pain, with or without referred symptoms into the leg or arm
- Research shows that around 70% of neck and back problems show a direction preference, and will rapidly respond to direction specific exercises
(2012, May & Aina)
- Even in those with chronic pain, around 50% still rapidly respond to direction specific exercises, often despite failing to get better with a variety of other treatment approaches (2004, Aina et al)
- Extremity joints like the knee, hip and shoulder also frequently respond to direction specific exercises, with around 40% displaying rapid improvement
(2012, May and Rosedale)
- Other limb problems like tendon problems can be identified, and do not respond rapidly to direction based exercises, but will improve with gradual loading programs that are required to remodel the injured tissue
What if I do not respond to the MDT approach?
- Non-responders are quickly identified, usually within 1-2 sessions, meaning valuable time and money on ineffective treatment are not wasted
- The MDT evaluation process can identify the source of your problem, and direct what time of management you do require for your problem (eg. Referral to a Rheumatologist for a primary inflammatory cause of pain)
Aina, A., May, S. and Clare, H. (2004). The centralization phenomenon of spinal symptoms—a systematic review. Manual Therapy, 9(3), pp.134-143.
Donelson, R., Aprill, C., Medcalf, R. and Grant, W. (1997). A Prospective Study of Centralization of Lumbar and Referred Pain. Spine, 22(10), pp.1115-1122.
May, S. and Aina, A. (2012). Centralization and directional preference: A systematic review. Manual Therapy, 17(6), pp.497-506.
May, S. and Rosedale, R. (2012). A Survey of the McKenzie Classification System in the Extremities: Prevalence of Mechanical Syndromes and Preferred Loading Strategies. Physical Therapy, 92(9), pp.1175-1186.