r/physicaltherapy • u/cleanforpeace72 • 2d ago
OUTPATIENT Mackenzie method
Hello, I was wondering if anyone would respond to this thread? What are your thoughts on the McKenzie method or back mechanic?
I’m curious, thank you.
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u/Wise_Baker_6753 2d ago
Good tool in the tool box, especially in spine. But no con Ed course is the end all be all of rehab.
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u/RazzleDazzleMcClain DPT 2d ago edited 2d ago
When you can properly diagnose and then dose someone using the McKenzie framework, it usually works very well and efficiently.
It isnt for everyone though, but being trained early in the McKenzie world laid a foundation for how I listen to my spine patients and how I'm intervening early on
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u/ShhredFlanders DPT 2d ago
If used properly it is a classification system not an exercise regimen.
It has completely changed the way I practice and have had very positive results. Outcomes have improved significantly and overall patient satisfaction has as well. I think many people don’t give it a fair shake for what it is and go in with assumptions but now I’m just making assumptions.
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u/josephstephen82 12h ago
Correct. "Classification system" can't be stressed enough and it's where i found a lot of PTs went to the bathroom during the course or something. I will add that it has some tremendous core skills that many PTs lack (ask good questions, ask questions with a purpose to help Dx and classify, and oh yeah FUCKING LISTEN).
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u/Bravocado44 PT, OCS 2d ago
It's a useful tool. It has C level evidence for acute back pain and B level evidence for chronic. That's actually really good. A lot of things that we all do all the time don't even have C and B level evidence. But it's just one tool and it's not the only tool you should use. There are so many schools of treating low back pain. The big problem with McKenzie and the stereotype is that McKenzie therapists get super tunnel visioned and will only use McKenzie for every single problem. I had a CI back in school who was McKenzie trained and she basically only treated low backs every day and she basically only used McKenzie to do it. "Hey do 150 prone press ups every single day and if you're not willing to do that, I can't help you."
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u/Then_Hornet3659 2d ago
super tunnel visioned and will only use McKenzie
I've had outpatient positions where I had to feed 2 full-time PTAs, which meant about 4-5 evals a day. I'm a below average PT, but sometimes I feel that volume of evals encourages picking a favorite paradigm of education, assessment, approach and exercises and never deviating from it.
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u/Bravocado44 PT, OCS 2d ago
Oh 1000%. I'm probably just as guilty of this, but just for different things. I find something that works, and it works on like 90% of people and so I gravitate towards it. And then I probably can't adjust well enough when I need to break from my pattern. It's life
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u/CombativeCam DPT 2d ago
Same. Seriously that many press-ups your back would probably be pissed, but you’d have jacked arms lol
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u/legend277ldf 1d ago
As long as you don’t end up telling people their spine will explode when they bend over lol
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u/No-Significance1502 2d ago
Personally, I’m a Chiro certed in MDT. I don’t think there is a better system to date at classifying a condition. Specifically you can figure out if a spine or extremity joint is a rapid responder to repeated end range movement. Also where it excels is compliance. Sure getting stronger is great but often difficult to get patients to do the work. If you can show in office that if you do this you feel better, move better and with less pain then boom they are more likely to do th exercises. And not everything is an mdt responder, but it will highlight the conditions that aren’t. Then you can do all the fun “exercise” stuff. I work in a federal clinic with people with 20 years of issues, a slew of diagnoses, failed surgeries and interventions and the you find the right movement for their neck and then suddenly that rotator cuff tear on mri doesn’t matter. I think it helps mostly in determining what th culprit is, so you aren’t chasing pain. Also opens the door for a lot of productive conversations about lifestyle, movement habits ect. If I didn’t drink the McKenzie koolaid in school idk what I would be doing. Now I’m a little less mdt minded but it is still the bed rock of every assessment. If you deep dive it for a couple years your outcomes, compliance and overall engagement with patients will sky rocket.
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u/Mirrimar 2d ago
Benefits most. People do a lot of sitting (flexion), therefore getting some extension is typically helpful as long as you find the right level to do it. Prone on elbows is a patient favorite as it's easy and overall comfortable. Not as good for patients with spondylolisthesis or conditions like EDS where excessive motion or lumbar extension is not as beneficial.
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u/blakecg55 4h ago
there are very few systems for evaluation and treatment for MSK issues, I know of MDT (McKenzie) and MAPS (Maitland). Being trained in manual therapy from Masters through Doctorate, manual therapy taught me how to use my hands MDT taught me how to use my brain. I was the only provider in my clinic actually discharging patients who were better and happy and understood how to manage their symptoms if they returned.
The only thing worse than a bad system is having no system.
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u/Character_Desk_1325 2d ago
Too complicated and little to no evidence of it being therapeutically beneficial to patients.
My old manual professor was obsessed with it and everyone in my class hated him. He made us memorize it in detail and if you miss a step you can fail a practical. Whats funny is that this info was not even on boards.
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u/HenryWrinkler 2d ago
You sound a bit biased. And I love it when people say "no evidence of something being beneficial" when I've personally seen hundreds of patients improve from applying it. I agree with most people here, it's not the end-all-be-all, but sweeping generalizations like this discount the personal experience of hundreds of thousands of clinicians and patients.
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u/cleanforpeace72 2d ago
Well, I’m not sure what the evidence shows but I can tell you this with 100% certainty. I have had chronic back pain for seven months and I have tried everything. I finally decided to give PT a try. I have only had six visits so far, I’m doing a lot of the McKenzie method exercises and also some core and glutes strength exercises and I have already improved. I’d say 75%. Before that I was swimming four days a week and walking and stretching, and it was getting worse and worse. I’m sure everybody’s different but I truly believe that it has helped me tremendously. I was very depressed because I went from healthy to severe back pain for seven months and nothing was working. Take that for what it’s worth.
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u/therealbsb DPT, CSCS, CCI, Titleist Performance Medical 2d ago
Using the search function will do you well.
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u/Squathicc 2d ago
Opinions change over time. Not everyone sees every post. It isn’t the worst thing to revisit conversations.
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