Robin McKenzie

Photo of a woman performing the upward dog yoga position.
The prone press up is an exercise that may help your low back pain or sciatica. David Lees/ Getty Images

About Robin McKenzie:

Robin McKenzie was a physical therapist from New Zealand and is the founder of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT). This is a specific evaluation and treatment method that is used by physical therapists worldwide.

Robin founded MDT while working as a physical therapist in the 1950's. He was treating a patient with low back pain and sciatica (leg pain coming from the back) when a chance discovery led him to notice that his patient could rapidly centralize and abolish sciatica by bending his body backwards while lying face down on a treatment table.

This chance discovery led Robin to investigate other patients with similar conditions, and he found that if he could have a patient perform an exercise that would centralize, or cause symptoms to move closer to the spine, then the patient was more likely to rapidly get better and have a speedier recovery.

Over many years of patient interaction and investigation, McKenzie described three distinct spinal syndromes: derangement syndrome, dysfunction syndrome, and postural syndrome. He published his first book, The Lumbar Spine, in 1981, and taught physical therapists and other healthcare practitioners about centralization and about spinal syndromes during his career.

The McKenzie Method of MDT is also used by physical therapists to treat neck pain and problems around the peripheral joints like knee pain, shoulder pain, and hip pain.

Robin McKenzie passed away in 2013, but his legacy lives on as thousands of physical therapists use his methods to help people with low back pain and neck pain each day.

Mechanical Diagnosis and Therapy:

The McKenzie Method of Mechanical Diagnosis and Therapy is different from other types of physical therapy. It is a classification system based on patient responses to static positions and repeated motions.

The method does not rely on looking at a specific pathology; rather patients are classified into one of the three syndromes based on their response to movement.

Therefore, your MDT trained physical therapist does not need to know what exact anatomical structure is causing your pain or mobility impairment. He or she only needs to understand how your symptoms, range of motion, and strength change as a result of specific loading strategies or exercises, and then use that information to properly treat your condition.

If you undergo an MDT evaluation as a patient, you will gain experiential knowledge of your problem. For example, if bending your spine forward increases your symptoms of low back pain and leg pain, and bending backwards seems to centralize and abolish your pain, then you understand right away which motion or position is making you better and which is making your symptoms worse.

Another benefit of the McKenzie Method is that patients are taught to be independent in their own care. Self-care strategies like specific exercises and postural correction are hallmarks of MDT, so if you visit an MDT trained physical therapist, be prepared to learn how to manage your own condition. This type of therapy is beneficial, especially if your symptoms return. You will then have the knowledge to manage your problems in the future without having to seek medical care.

Of course, if future problems persist or are getting worse, then a visit to your doctor or physical therapist is in order.

Physical Therapists Trained in the McKenzie Method:

In order for your physical therapist to become certified in the McKenzie Method, he or she must engage in rigorous coursework. Currently, therapists must complete five classes, each lasting three to five days. Then he or she must pass an exam that is administered by the McKenzie Institute. The exam includes both written and practical sections.

After passing the examination, your physical therapist can be credentialed in the McKenzie Method.

You can identify McKenzie trained therapists because they are allowed to put "Cert. MDT" or "Certified MDT" after their names when identifying themselves. If your physical therapist wishes to learn more about MDT, he or she can go on to study further and receive a diploma in MDT, in which case he may sign his name with a "Dip. MDT" at the end.

If you are having low back, neck, or joint pain and wish to see an MDT trained physical therapist, you can find one near you on the McKenzie Institute's website.

Source: McKenzie, R., & May, S. (2003). The lumbar spine mechanical diagnosis and therapy. (2nd ed., Vol. One). Waikanae: Spinal Publications New Zealand.

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