The McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT) is an internationally recognised method of assessment and treatment for spinal and extremity pain. The MDT method was developed by New Zealand Physiotherapist Robin McKenzie and has been used all over the world for 30+ years.
MDT clinicians are trained to assess and diagnose throughout the musculoskeletal system. As a result, if a problem exists in or around the spine, joint or muscle, an MDT evaluation may be appropriate.
MDT is a philosophy of patient involvement and education which is trusted and used by all over the world for back, neck and extremity problems. This approach is one of the most researched physical therapy based methods available.
A key feature of the method is the initial assessment. The assessment is a safe and reliable way to identify an accurate diagnosis followed by the appropriate treatment plan. Costly tests such as MRI’s are often not necessary. Certified MDT clinicians are able to quickly determine if the method is effective for a patient.
In summary, MDT is a thorough approach based on principles and fundamentals that, when understood and followed, is highly effective.
The system of patient care known as the McKenzie Method® of Mechanical Diagnosis and Therapy® (MDT) is an approach that is trusted and used all over the world for common back, neck and extremity joint problems.
Most musculoskeletal pain is “mechanical”, meaning that everyday movements and postures cause pain. Using a systematic evaluation of his patients, New Zealand physiotherapist Robin McKenzie, found that specific movements and postures can often eliminate pain and restore function.
Robin McKenzie believed that when educated, most patients could learn to treat themselves. He felt that self-treatment empowered the patient and minimized their reliance on medical intervention. The McKenzie Method® promotes the body’s opportunity to heal itself without medication, surgery or other passive measures such as heat, ice or ultrasound therapy. It also addresses a growing demand for professional rehabilitation services that improve patients’ self-treatment skills using cost- effective and time-effective methods.
Spinal Pain Self-Assessment
- Are there periods in the day when you don’t have pain? Even short periods?
- Is the pain specific to areas above the knee or above your elbow?
- Have you had more than one occurrence of low back pain or neck pain?
- Do you feel worse during or immediately after prolonged bending or stooping; for example, when making a bed, vacuuming, gardening, etc?
- Do you feel worse when sitting for extended periods or on getting up from the sitting position? For example, after watching TV or working at a desk.
- Do you associate the pain with a specific activity but are mostly pain free when you are not engaged in this particular activity?
- Do you feel worse when you are inactive and better when you are moving?
- Does your low back feel better when you are lying face down? (Your back may feel worse before the pain subsides, if so the answer to this question is yes).
- Does your low back pain feel improved when you are walking?
If you have answered yes to 4+ questions, you have the potential of benefiting from The McKenzie Method®. If you answered yes to 3 or fewer questions, you may require a specialized assessment and treatment. In this case, you should contact a clinician specifically trained in the McKenzie Method®
Do you experience any of the following?
- Arthritic pain in hips or buttocks, shoulders or upper arms
- Challenges bending due to stiffness or pain in your lower back
- Pain that starts in the back or neck and extends to the buttocks or shoulders
- Periodic pins and needles or numbness in the feet or hands
- Aching pain in the elbows or knees that hasn’t improved by treatment to these areas
You may find relief from a trained McKenzie clinician. They are trained to assess and diagnose all areas of the musculoskeletal system. MDT clinicians are trained to assess your problems and help you understand how you can improve pain, stiffness and the ability to do work or other daily activities.
To improve your self-management, you may benefit from a McKenzie lumbar, cervical roll, or one of McKenzie’s self-help books: Treat Your Own Back, Treat Your Own Neck, Treat Your Own Shoulder, Treat Your Own Knee. These resources have helped millions of people worldwide treat, relieve and prevent their joint or muscle pain. Scientific studies have proven that the information and exercises shared in these books provides positive and lasting results.
What is it?
The McKenzie Method®
Step 1: Assessment
MDT begins with the clinician obtaining a detailed history of your symptoms. You will be asked to perform movements and rest in various positions. The main difference to most other assessments is the use of repetitive movements compared to a single movement. How your symptoms and movement ability changes with these repeated movements provides the clinician with information that can help classify your problem.
Step 2: Classification
Each syndrome is handled based on its unique nature, with specific mechanical procedures, including repetitive movements and sustained postures. MDT is a comprehensive classification system, and includes a smaller group of patients that cannot be classified into one of the three Syndromes, but are placed in the ‘Other’ Subgroup which includes serious pathologies, non-mechanical causes, true chronic pain etc.
Step 3: TREATMENT
Using the information from the assessment, the clinician will prescribe specific exercises and solutions regarding postures to incorporate and postures to avoid. If your problem has a more difficult mechanical presentation, a qualified MDT clinician may need to incorporate hands-on techniques until you are able to self-manage. The aim is to be as effective as possible in the most efficient manner. Treatment that you can perform numerous times a day is more likely to be effective in a shorter period of time compared to treatment administered by the clinician once or twice a week. The emphasis is on you being actively engaged in the treatment plan. This can lower the number of visits made to the clinic. Most patients can successfully treat themselves when provided with the necessary information and tools.
Step 4: PREVENTION
By learning how to self-treat the problem, you gain understanding on how avoid reoccurring issues. You can also quickly manage symptoms if they do return, putting you in control of your treatment safely and effectively. It is more likely to avoid persisting problems through self-maintenance than by passive care.
There are trained clinicians of MDT in 36 countries. Because the exercises prescribed must be based on accurate assessments, finding a clinician who has Credentials or a Diploma is critical.
History of the Method
Robin McKenzie revolutionized the way patients throughout the world treat back and extremity issues. The McKenzie Method of Mechanical Diagnostics and Therapy (MDT), which was developed by Robin in the 1950s, has since become a recognized standard. Robin devoted his professional life to the study and treatment of musculoskeletal disorders. His theories and treatments are now supported by scientific evidence.
In 1956 at his clinic in Wellington, Robin McKenzie observed an event which changed the nature of treating back pain. This unexpected event led to the development of the theories and practices which are the hallmark of the McKenzie protocols for assessment and treatment of mechanical disorders of the spinal column.
“My first experience with what I have chosen to call the ‘Centralisation Phenomenon’ occurred in 1956. A patient, ‘Mr Smith’, who had pain to the right of the low back, extending into the buttock and thigh to the knee, had undergone treatment for three weeks without improvement. He could bend forwards, but could not bend backwards. I told him to undress and lie face down on the treatment table, the end of which had been raised for a previous patient. Without adjusting the table, and unnoticed by any of the clinical staff, he lay face down with his back overstretched for some five minutes. After some time, when I entered the room I was aghast to find him lying in what at that time was considered to be a most damaging position. On enquiring as to his welfare, I was astounded to hear him say that this was the best he had been in three weeks. All pain had disappeared from his leg. Furthermore, the pain in the back had moved from the right side to the centre. In addition, his restricted range of extension had markedly improved. After standing upright, the patient remained improved with no recurrence of leg pain. The position was adopted again the following day and resulted in complete resolution of central low back pain. The movement of pain from the leg or buttocks to the middle of the back is now known as the centralisation phenomenon.” – Robin McKenzie
This chance clinical observation then led Robin to start systematically evaluating the effects that simple movements and positions had on a patients’ back pain. A clear assessment process then emerged. This system, now known as the McKenzie Method of Mechanical Diagnose is and Therapy (MDT), has received worldwide recognition and is now regarded as part of “normal” management for low back pain. His vision was that all patients with musculo-skeletal issues be trained on how to effectively manage their own pain.
By the 1970’s, Robin had developed his theories and became prominent in the United States, where his ideas were adopted with great enthusiasm. He was hired by the Kaiser group of hospitals and helped thousands of American workers overcome debilitating back problems. Honors quickly followed, and McKenzie was invited to the UK, many European countries, Japan and China.
In order to meet the demands of his work, it became clear that more education was necessary. Robin began to set up training courses to educate other physiotherapists and also founded the McKenzie Institute to carry out further research and training. The Institute was established in 1982 and has since grown into a multinational entity with 28 branches. For over 40 years, Robin McKenzie refined and perfected the procedures which made the McKenzie self-treatment system effective. He also invented the McKenzie Lumbar Roll and McKenzie Neck Roll to help patients prevent the recurrence of pain.