As a physical therapist, and one who took McKenzie’s courses when they were taught by McKenzie, I feel qualified to dispute this claim. Not that I’m against fostering self-care; I think this is absolutely essential if we health care professionals are to provide the best treatment. What I dispute is that McKenzie is “an effective alternative to traditional chiropractor treatment”. Let us dismiss consideration of the unethical chiropractors who simply crack backs and omit any self-care training. Mercifully, they are slowly losing favor among their own colleagues. But good, complete chiropractic care will include, besides manipulation, instruction in appropriate exercise – which could be the McKenzie extension bias and instruction in modification of movement habits. Good physical therapy should include this too – although all too often we physical therapists prefer the efficiency and revenue produced by grinding out patients on the passive modalities, e.g. hot packs, ultrasound, traction – the equivalent of the chiropractor’s manipulation (except that recent reports indicate that manipulation is more effective that other treatments in acute low back pain) and dispensing with the more time consuming functional training.
McKenzie was to spine rehabilitation what Freud was to psychology or Beethoven to music: they introduced ideas which, at the time, were considered bizarre but reformed the way we think about the subject. McKenzie took us away from the Williams Flexion era where all low back patients were taught to do full pelvic tilts and spend their time pulling their knees to their chests. He showed that restoring the normal inward curve of the lumbar spine (extension) decreased symptoms associated with excessive flexion associated with sitting and bending. His extension exercises remail very useful in the treatment of acute low back pain. Further, he put a strong emphasis on correction body mechanics. However like Freud and, as some, but not I, would say, Beethoven, he went too far. He teaches extension as a cure-nearly-all and if extension doesn’t work for you then you need to do mega-flexion. In truth, excessive, repetitive extension can result in microtrauma and avoidable degeneration of the spine. In my opinion, extension exercises should not be part on a spine patients ongoing, long term routine. Elimination the current pain – where McKenzie shows 80% success – is not the major battle. Avoiding joining the 60% who have another episode of severe pain within 2 years – the usual rate with back pain in general, is the sign of success. I feel that only with implementation of a neutral spine position stabilization program – with a strong emphasis on learning to maintain neutral spine position in daily activities is one likely to have success in the long term.
