The McKenzie Method

THE MCKENZIE METHOD

It is within the framework of classification systems that the identification of three syndromes can be carried out in addition to the group: “OTHER”. Within these syndromes we can find: derangement, dysfunction, and posture.
They are based on the symptomatic and mechanical response, understanding the phenomenon of centralization through a direction of preference. It uses repeated movements to evaluate and treat emphasizing the independence of the patient to avoid dependence on the therapist using the minimum necessary intervention.

DERANGEMENT
SYNDROME

It is the most common of the three syndromes and presents a highly variable clinical pattern.
– The location of pain can be local, referred, radicular or a combination thereof.
– Symptoms can be constant, present throughout the day, or intermittent.
– Movements or postures can make the symptoms increase / decrease, centralize / peripheralize, appear / disappear altogether.
– Mechanical presentation that always includes decreased range of motion or obstruction of motion.
– There may be temporary deformation: kyphotic, lordotic, lateral shift.

DYSFUNCTION
SYNDROME

Produced by mechanical deformation of structurally damaged soft tissue. It can be the result of previous trauma, inflammatory, degenerative processes, etc.
It is characterized by a painful restriction at the end of the range of motion.
– The pain lasts for at least 8-12 weeks.
– Pain always localized except in adherence to the nerve root.
– Always intermittent pain. It occurs when the affected tissue is loaded.
– A proper repeated movement will produce symptoms, which will not get worse.

POSTURAL
SYNDROME

Caused by a mechanical deformation of the soft tissue or by a vascular insufficiency that comes from a maintained position or postural stress that affects the articular or contractile structure.
– Generally, occurs in young populations.
– Associated with a sedentary lifestyle.
– Local and intermittent symptoms.
– No pain with movement or activity.
– Poor posture – forward head, increased thoracic kyphosis, reduced lumbar lordosis.
– There is no loss of movement.

In order to identify the syndrome, the patient is presenting, it is an essential requirement to fill out a detailed assessment form where the following data are collected:
– Patient history: symptoms present, how long they have persisted, the reason why they began, how they behave, frequency of episodes, etc.
– Specific questions: medication, radiology, any surgery had by the patient, accidents, etc.
– Examination: posture, neurological assessment if required, assessment of loss of movement, movement test, etc.
– Classification: derangement, dysfunction, postural or other factors.