Take a look at this study! 45 volunteers with NO history of hip pain, injury, symptoms, or surgery were given an MRI. (Average age of volunteers: 37.8 years.) MRI's of these asymptomatic participants revealed abnormalities in 73% of hips, with labral tears in 69% of the joints.
I clearly love saying this: just because it's on an image doesn't mean it is causing problems. You need a quality McKenzie mechanical evaluation in the clinic to find out what is actually causing symptoms. --Laura
Check out the short study here: http://ajs.sagepub.com/content/40/12/2720.short
Thanks to Dr. Agawarl MD, Cert. MDT for allowing us to see how the McKenzie method can work so easily and quickly! -- Laura
Check out how the US compares to other nations in terms of back surgery prevalence. Most are unnecessary! A McKenzie evaluation and treatment usually does the trick - and saves the patient from a lot of stress, risk, lost time, and cost. -- Laura
Those receiving care in today's American medical system usually don't know, quite frankly, what is going on or even what is happening to them. That especially applies to which professionals provide what. I want to shed some light on that issue when it comes to the world of physical therapy. First, you have a physical therapist (PT). Decades ago, that degree was a bachelor's degree. Then it became a master's degree. Now it's a clinical doctorate degree. Physical therapist assistants work under the direction of physical therapists. To be a physical therapist assistant (PTA) an associate's degree is required. In many settings you are also likely to find physical therapy aides or technicians (techs). There is no degree or license requirement to be this form of helper. As students in PT and PTA programs must fulfill internship requirements, students are also commonly found in the various physical therapy settings. Settings, for example, include outpatient clinics, inpatient rehabilitation venues, and acute care in hospitals. If you are ever wondering who is administering your care, by all means ask. --Laura
I realize I have been saying recently that McKenzie physical therapy is unlike "traditional" physical therapy, which is absolutely true. While some orthopedic conditions take a long time to get better (such as some forms of Achilles tendon problems), the McKenzie method is able to rapidly produce results in a majority of cases. That's one reason why the large majority of my patients require fewer than 5 visits. This assessment and treatment approach is unparalleled in the current world of physical therapy in my opinion for just this reason. -- Laura
There are many misconceptions associated with the McKenzie Method, several of which are listed below:
Courtesy of www.mckenzieinstituteusa.org:
MDT = (the McKenzie Method of) Mechanical Diagnosis and Therapy
"1. MDT is NOT a series of exercises
Although exercises are important, MDT is an assessment process and problem solving paradigm. The clinician takes clues from the history about the effects of specific loading strategies on symptoms. During the history, the clinician begins to formulate a differential diagnosis. First, is it a problem with a mechanical influence, a medical influence, a biopsychosocial influence or any combination of the above? Second, if mechanical, which of the syndromes is likely the diagnosis: derangement, dysfunction, posture or "other?". The physical examination which includes a series of loading strategies confirms or refutes the postulated diagnosis.
2. MDT is NOT only about derangement
Although very common, Derangement syndrome is not the only syndrome in MDT. The other two syndromes – Contractile or Articular Dysfunction and Postural syndrome are important clinical entities. The fourth classification is 'Other' which consists of a number of sub groups of pathologies that can recognised by MDT Clinicians and managed appropriately e.g stenosis, chronic pain state, sacro-iliac, joint pathologies etc.
3. MDT is NOT just extension
Although a common treatment recommendation, all planes of movement are considered in both assessment and treatment. The direction of exercise utilised in treatment is dependent on the symptomatic and mechanical response to repeated movements or sustained positions during the assessment process.
4. MDT is NOT just about repeated end range movements
Static positioning and mid-range movements are all part of the spectrum of force progressions.
5. MDT is NOT just about the intervertebral disc
Whilst the disc model is a useful way of explaining Derangement in the spine the actual source of most low back pain is not known. It needs to be stressed that MDT is not reliant on a patho-anatomical diagnosis but is based around a sound research proven classification system, and this in itself guides the clinician to the required management strategy.
6. MDT does NOT ignore biopsychosocial influences
In fact, with its emphasis on education and patient empowerment, MDT is a very strong biopsychosocial system of clinical management. MDT clinicians are trained to recognise psychosocial factors including fear avoidance behaviour and passive coping strategies.
7. MDT does NOT exclude manual therapy
Although we take a "hands off" approach first, mobilisation and manipulation are all part of the continuum of force progressions. MDT's focus is primarily on education and self-directed treatments in order to reduce dependency on the clinician and to empower the patient to control their symptoms. Where this is not successful the use of hands-on techniques such as mobilisation is considered. However, the use of hands-on techniques is only used to enable the patient to return to self-treatment. We put our hands on, only to take them off again.
8. MDT is NOT just about the spine
The concepts of assessment and classification can be applied successfully to the extremity joints as well.
As a brief summary, MDT is a classification system. It seeks to differentiate between mechanical and non-mechanical sources of pain and functional limitation. Symptomatic and mechanical changes are assessed using repeated end range movements and sustained positions "
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