Physio Referrer Online-
What is the McKenzie Method of Mechanical Diagnosis and Therapy?
Have you ever asked your patients about their physiotherapy treatment?
Have you noticed a difference in what your patients say about physiotherapy at Personal Best compared to patients attending other physiotherapy practices?
Would you like to understand more about our approach to treating pain and dysfunction in the musculoskeletal system?
In this issue of Physio Referrer, we outline The McKenzie Method of Mechanical Diagnosis and Therapy (MDT), an approach to treating musculoskeletal problems which we use everyday to help your patients reduce theirs symptoms and improve their function. The information presented here is a combination of content published on the McKenzie Institute of Australia website (https://www.mckenzieinstituteaustralia.org) as well as our experience using this approach over the past 12 years.
What is MDT?
MDT is a comprehensive system of classifaction and treatment for musculoskeltal pain that is trusted and used by clinicians and patients all over the world. Originally developed by New Zealand physiotherapist Robin McKenzie, it continues to be one of the most researched physical-therapy based methods available.
There are four key steps to MDT.
Step 1- Assessment
A key feature of MDT is the initial assessment- a thorough history and physical examination that leads to a Provisional Classification that guides treatment.
A key difference of MDT to most other approaches is the use of repeated movements. How your patient’s symptoms, movements and functions change with repeated movements provides the clinician with important information they use to categorise your patient’s problem.
Two essential findings within MDT are Centralisation and Directional Preference.
Centralisation: During repeated movement testing pain from the extremities (leg or arm) moves proximally towards the spine.
Directional preference: When a specific direction of repeated movement and/or sustained position results in lasting improvement in symptoms, movement or function, that spells success!
Step 2- Classification
There are three primary mechanical syndromes in the MDT framework (Derangement, Dysfunction and Postural Syndrome). Each syndrome is treated according to it’s unique nature. The Provisional Classification given in session 1 is either confirmed or refuted in the follow up sessions.
MDT is a comprehensive classification system that recognisess “OTHER” problems including inflammatory arthropathies, non- mechanical pain, stenosis, true chronic pain and specific problems.
Step 3- Treatment
Patients are always given exercises to complete independently as well as advice about which postures they should avoid to gain control of their symptoms.
Treatment that your patient can perform regularly every day is much more likely to be effective than treatment administered by the clinician once or twice per week.
The aim is to be as effective as possible with the least number of sessions, with an emphasis on your patient gaining control of their symptoms. For patients that have movement loss that doesn’t change with targeted exercise, force progression to clinician procedures are used to help them regain full movement.
Step 4- Prevention
By learning how to self-treat their current problem, your patients gain knowledge on how to minimise the risk of recurrance. They can also rapidly deal with symptoms if they recur, putting them in control of their treatment safely and effectively.
