Dr. Laura Mannering DPT, OCS, Cert. MDT
1. How exactly does the McKenzie method (MDT) work?
Care begins with a thorough history-taking and physical exam to classify (diagnose) the patient's problem. After measuring mechanics such as motion, strength, nerve tension, and the ability to perform an activity (like lifting a bag or squatting), the patient performs repeated movements. We are looking for a specific movement that improves symptoms and/or mechanics. In most cases, the patient will then repeatedly perform the movement we found to be helpful at home - performing a set of movements roughly every two hours. Subsequent visits follow a similar pattern in that we continue to seek a movement that produces positive change. We may need to add time to the movement, alter the level of force, change the direction of the movement, etc. The last step of the method is ensuring that the body is able to move and function in all directions without limitation or pain and finalizing an individualized program to prevent recurrence.
2. Can you diagnose my problem?
Yes! My education at the doctoral level and specialized post-doctoral orthopedic training give me the knowledge to diagnose pathology as well as treat pathology. My diagnostic ability stands out because I don't specialize in one joint or one area of the body and am therefore able to confidently examine the entire musculoskeletal system when looking for the root of the problem. Furthermore, I don't diagnose by looking at an image. Images are fraught with abnormalities in people with no symptoms. Diagnosing must be based on clinically evaluating the integrity of a patient's joints, muscles, nerves, etc. - not by looking at a picture in time. Lastly, by spending 60 minutes with a patient for the evaluation, diagnostic thoroughness is enhanced.
3. How many visits will I need?
The amount of visits it will take depends on your diagnosis and the information gleaned from the evaluation on the first visit. However, the average number of visits is 6 to proceed through the method. With the McKenzie method, the patient is empowered to treat himself/herself and visits are minimized as much as possible. That being said, the number of necessary visits is also based on how compliant the patient is with the home exercise program.
4. How long will it take to get better?
As with question number three, this is better answered once I can evaluate a patient and determine a diagnosis. In many cases, it will take less than a month. However, in the event a patient has had symptoms for many months or years, or in the case of certain diagnoses, the expectation could be that it will take months. In those instances, visits are spaced out and held at intervals based on the patient's progress.
5. Will I be given a home exercise program?
Absolutely. We will find the movement that addresses your specific problem and that will be your homework. You will need to perform that one exercise (or possibly two) many times per day. It will take just a minute or two each time. In nearly all cases, you will be instructed on how to make postural changes in your daily life as well, which entails adjusting how you sit and sometimes how you sleep.
6. What happens on the first visit?
I will take a verbal history first so that I have a clear understanding of the problem. Next, I will perform the mechanical exam, which focuses on assessing motion, nerve function, and functional movements. We will then start moving your body in order to find the movement that positively changes your symptoms and/or the impairments from the physical exam. I will thoroughly explain what I find and how we will proceed. To wrap up, I will provide your home program and answer any questions you may have.
7. Do you accept insurance?
I do not.
8. How can I pay?
I accept credit cards.
9. Do you accept health spending account or flex spending account credit cards?
10. Will my insurance reimburse me for my out-of-network visit(s)?
I don't know; you will have to ask your insurance carrier. I am happy to provide an invoice for you to submit to your insurance company in the event that they do. Please check your insurance company's requirements for reimbursement as they vary.
11. Are evening and weekend appointments available?
12. Where are you located?
At this time I am only available for telehealth (video) appointments - not in person.