McKenzie Exercises for Low Back Pain

McKenzie exercises are a series of therapeutic movements that are designed to help relieve pain in the extremities and lower back. The method was created in New Zealand in the 1960s by physical therapist Robin McKenzie. Some of the moves are designed to initially direct pain away from the extremities and into the back. Centralizing pain in this way presumably allows it to be dealt with more effectively. The goal is to identify and treat the source of the problem rather than just the symptoms.

Uses

• The McKenzie method is sometimes prescribed for individuals who are experiencing chronic low back pain. It is used to improve posture, function and mobility. This type of therapy is designed to minimize the need for repeated clinical visits. Instead of receiving repeated treatments at the office, a patient can be taught the self-administered therapy over a short period of time. Then the spine extension exercises can be done at home each day to provide ongoing relief for lower back pain.

Assessment

• Patients who have low back pain are given a physical examination before the McKenzie method is prescribed. A full medical history is also taken to rule out nonmechanical reasons for the pain. Conditions such as arthritis or a bone fracture would make it inadvisable to choose an exercise method for treatment.
  Next, the individual's full range of movement is assessed. The level of pain in each position and with each movement is documented. This information is used to select the precise exercises that will be used to reduce lower back pain.

Exercise Therapies

• There are three basic categories of therapy in the McKenzie method. Each set of exercises is linked to a different syndrome. The first one targets lower back pain caused by poor posture. Retraining the patient to stop slouching is a main goal of Postural Syndrome exercises. Dysfunctional Syndrome is typified by limited mobility and lack of flexibility. Gentle, persistent stretching is used to treat this condition.
  Finally, there is Derangement Syndrome. This condition often presents as lumbar pain caused by particular movements. The related exercise therapy focuses on body awareness and retraining of muscle groups and tendons. Each patient's treatment plan and set of exercises is fully personalized to address his specific symptoms.

Exercise Examples

• The actual exercises are very simple. They include moves such as standing or sitting while maintaining good posture. Bending from the waist to touch the floor from a seated or standing position may also be suggested. Lying on the floor face down and gradually raising the upper body off the floor in a "circus seal" position is another common exercise. Lying face up with knees bent and feet flat on the floor or drawing the knees into the chest are other variations. Relaxing the spine rather than holding it tense during these movements is critical.

Practitioners

• There are trained practitioners of the McKenzie therapy in about 30 countries worldwide. Although many physical therapists have some knowledge of these exercises, not all are actually certified to diagnose and treat patients using this method. The training process takes approximately 100 hours and covers five courses.
  Because the exercises prescribed must be based on an accurate assessment, finding a practitioner who is credentialed is important. If the wrong course of treatment is prescribed, it may have no effect. In some cases, it may actually worsen lower back pain.