What is The McKenzie Method

The McKenzie Method was discovered in 1956 when Mr. Smith, suffering from back and leg pain for 3 weeks, visited his physiotherapist, Robin McKenzie.

On arrival, Mr. Smith was instructed to lie down  in a spare treatment room until Robin could see him.
Mr Smith did exactly this, but one end of the table had been elevated, so he lay on his tummy bent backward (extended).

When Robin entered the room, 10 minutes later, he was concerned to see Mr. Smith lying in this position and assumed his pain would be worse as a result. Surprisingly, when Robin asked how Mr. Smith was feeling, he replied, “This is the best I’ve felt in three weeks.”

Upon returning to the standing position Mr. Smith reported that instead of feeling pain in the back and down the leg, he was now only feeling mild pain in the centre of the lower back (centralisation). Using this position as a treatment (directional preference), Mr Smith went on to make a rapid recovery. Interestingly, Robin had previously been treating Mr Smith, for several weeks, with massage and manipulation, but Mr. Smith had failed to respond. Naturally, this discovery got Robin thinking!

Robin, or perhaps Mr. Smith, had discovered 3 very important things that everyone with back or neck pain should know!

DIRECTIONAL PREFERENCE
CENTRALISATION
RAPIDLY REVERSIBLE PAIN
Over the following years MDT (The McKenzie Method) was significantly expanded upon and developed into as system of assessment and treatment aimed at identifying patients who can rapidly reverse their symptoms with the application of a single direction of movement. Typically, the movement that reduces and eliminates the pain is performed 10-15 times, after which pain remains better.

To be eligible to study MDT, a health professional must first hold a health science degree in physiotherapy, chiropractic, clinical myotherapy or osteopathy and have a minimum of 2 years clinical experience.
Training in the McKenzie Method is provided by the McKenzie Institute International and culminates in a comprehensive 7-hour examination. Therapists who have successfully completed this exam are referred to as Credentialed McKenzie or MDT therapists.

Treating Pain Using The Brain – Neuroplasticity

Treating Pain Using The BrainI attended a free public lecture on Wednesday night hosted by Arthritis Australia, the topic was, “Treating Pain Using The Brain”, presented by Dr. David Butler.
Anyone who has heard David present wouldn’t have been disappointed, addressing a topic with the potential for being a little tedious, he delivered his message in his trademark flamboyant, humorous fashion.
I believe Arthritis Victoria will be uploading this lecture to their website and I highly recommended those of you affected by, or treating persistent pain (chronic pain), to check it out.

Neuroplasticity – the brain & pain

If I can be so audacious as to summarise the key points:
1. Pain is not always a negative experience, it serves a purpose.

2. Sometimes it stays around for longer than we might expect, even after the point at which we would expect tissue damage to have healed. It becomes “persistent”.

3. Persistent pain is influenced by many factors in our lives, including the language we use to explain our pain. For example, “I’ve got an arthritic spine”, “my knee is worn out”, etc. It’s important to remember that many people with degeneration actually have NO PAIN and there are numerous studies to support this fact. Most people with degeneration don’t even know it, meaning degeneration may not be the cause of your pain.

4. This type of language can actually increase or prolong our pain by changing the wiring in our brain.

5. This wiring change can then result in experiencing pain in the absence of actual damage.

6. The WONDERFUL and REFRESHING thing is that we can rewire our brains and decrease and eliminate our persistent pain by obtaining a more complete and accurate understanding of our complaint and removing the negative language.

I understand that persistent pain is often a complex issue and I’m sure my summary hasn’t done David justice. So, I highly recommend visiting the Arthritis Victoria website and getting your hands on a copy of “Explain Pain” by David Butler. It might just change the way you think!

Don’t make your standing desk a pain in the neck

fit smart casual man  standing at height adjustment tableStanding desks are all the rage at the moment, primarily because prolonged sitting has been linked to a myriad of health issues.
One common problem arising from prolonged sitting is back pain. Many people with back pain, exacerbated by sitting, find relief by employing desks that can accommodate sitting and standing postures, what a great idea!
Unfortunately, if we’re not careful we might simply be shifting the load from our backs to our necks. To prevent this from occurring you need to make sure that your monitor remains at eye level.
As you can see from the picture, failing to do so will simply result in stress and strain on your neck.
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Pain getting you down?

Pain and our emotional state have a close relationship, with numerous studies demonstrating a higher incidence of depression in those suffering from chronic pain, than the general population.

Sometimes, ongoing pain is caused by a problem with the muscles, joints, nerves or discs (mechanical pain) and depression/emotional upset occurs as a result. However there are also times when our emotional state and nervous system can give rise to pain in the absence of a mechanical problem. I’m sure most us are familiar with the sayings:

  • a pain in the neck
  • a pain in the butt
  • a weight on my shoulders
  • it’s my Achilles heel
  • I feel hamstrung

Where do you think these came from?

While it’s common for mechanical pain and emotional pain to interact and coexist, one usually predominates.

If you have an ongoing pain complaint the first step is to identify whether it’s primarily mechanical pain or emotional pain.

If your pain is mechanical then your emotional response to it will be eliminated when the physical problem has been successfully treated.

If your pain is primarily emotional, identifying your emotional triggers and working through these, will be much more effective.

At times the line between mechanical and emotional pain can get a little blurry, leaving those suffering from ongoing pain in an uncertain place. In fact, you may not even realise that your pain and emotional upset are related.

Following a logical plan will help you get to the source of your problem.

Step 1.
A thorough mechanical assessment
In my opinion, this is best achieved by seeing a qualified   McKenzie method practitioner. The McKenzie method, otherwise known as MDT or Mechanical Diagnosis & Therapy, employs a unique set of questions in combination with thorough a series of repeated movements to identify whether  pain is of a mechanical nature or not.

MDT is an advanced area of training available to health    professionals who already hold a degree in health science.

For more on MDT visit spinesmart.com.au or mckenziemdt.org.au

Step 2.
When it’s emotional pain and the triggers are too overwhelming to deal with on your own or through talking to friends/family, you may need more skilled help.

Contact the Australian Psychology Society and ask for a psychologist who specialises in helping people deal with pain. www.psychology.org.au

Please feel free to share this with anyone you know who experiences back problems.

The 5 biggest mistakes when it comes to taking care of your back


1. Slumping
– No posture is good posture if sustained for long periods. However if your lower back, hip or leg pain is aggravated sitting or with repeated or sustained forward bending activities like gardening or lifting, then your back problem has an important postural component. No amount of acupuncture, massage or spinal adjustments/manipulations can change this fact.

2. Ignoring the early warning signs – Severe bouts of back pain are often preceded by lower back stiffness. Patients will often inform me that they encounter back stiffness on waking, rising from sitting or simply standing. This is not normal, nor is it just a sign of aging. Don’t ignore it.

3. Lifting weights is bad for your back – Poor technique and rapid progressions are likely to lead to lower back pain, however, when sufficient emphasis is placed on technique, lifting weights is not bad for your back, in fact it can reinforce efficient and safe movement patterns.

4. It’s just tight muscle – While massage may feel good and “target all the right spots” it often falls short when it comes to eliminating back pain. Although muscle tightness can give rise to lower back pain, it’s not the most common cause and simply addressing muscle tightness or spams will generally not have a long-term effect. It can in fact make certain back problems worse.

5. Back pain is recurrent – Research demonstrates that roughly 40% of people who experience back problems are likely to have ongoing issues. While we all want pain relief, it’s very important to make sure you implement prevention strategies. This does not mean regular visits to your health professional, but learning how YOU can prevent pain from returning and what to do at the first sign of symptoms returning.

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What is Sacroiliac Joint Dysfunction?

I commonly encounter patients with lower back pain who have been told their pain is the result of sacro-iliac joint dysfunction (SIJ dysfunction).

A diagnosis of SIJ dysfunction is based taking a verbal history and a number of movement and palpation tests that have been well documented within manual therapy textbooks.

Unfortunately, these tests demonstrate poor diagnostic accuracy and a lack of reliability.

For those interested in a thought provoking and scientific appraisal of SIJ dysfunction and SIJ pain, I suggested having a look at the link provided below.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582421/Sacroiliac Joint