200 Words Series: The McKenzie Method, Very Briefly

The McKenzie method, aka mechanical diagnosis and therapy (MDT), is an assessment and treatment approach for musculoskeletal (orthopedic) problems, head to toe. The assessment is crucial; successful patient outcomes only occur with correct classification combined with paired treatment. MDT’s focuses include utilizing repeated movements, patient self-treatment, and injury prevention.

The most common of the four MDT classifications is derangements (at least 70% of all orthopedic problems!). Derangements – misaligned joints – create pain locally or distant from the joint (eg calf pain coming from the spine) and obstruct movement. Importantly, they’re usually rapidly reversible using specific movements to restore proper alignment. Clinicians not trained in MDT most significantly don’t recognize derangements and therefore don’t efficiently treat the bulk of patients’ complaints.
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The other three are tissue dysfunctions, posture syndrome, and “other.”  Tissue dysfunctions include joint tissue problems (eg frozen shoulder) and muscle/tendon tissue problems (eg Achilles, patella, rotator cuff, and elbow tendinopathies). In general, treatment involves progressive tissue loading to stimulate remodeling, typically taking a few months. Posture syndrome is rarely encountered and is treated with education. “Others” are problems such as post-surgical conditions, centrally-dominated pain, structural deformities, inflammatory processes, and many others. They’re treated with protocols tailored to the individual issue. -- Laura