McKenzie Exercises

By Ehren Allen, DPT/Certified Orthopedic Manual Therapist

4 Common McKenzie Exercises

  1. Repeated Extension in Lying
  2. Repeated Extension in Lying (on elbows)
  3. Repeated Extension in Standing
  4. Neck Retraction

McKenzie’s exercises for the lower back often involves extension of the spine. This was a novel concept when it was first used.  Historically, patients with back pain avoided extension movements for fear of aggravating the symptoms.

This treatment model is now widely used and accepted as the first line of defense when treating back and neck issues.

To Learn How to do Some Basic Back and Neck Exercises, Read On.

Spine MRI Images can soft tissue abnormalities/

What are McKenzie Exercises

What is the McKenzie Approach?

The McKenzie Approach to treating back and neck pain is an effective way to help spine problems in some people. It involves exercises that are aimed at making radiating symptoms return to the source of the problem in the back or neck. This is called “Centralization” of symptoms. When symptoms are located at the source of the problem, it is a typically sign of improvement.

A skilled Physical Therapist or Physician can do a thorough evaluation to determine what type of issues a patient is experiencing.  Patients may have a “derangement” in a disk that can cause symptoms to radiate into the arm or leg.

Does McKenzie Mean Extension Exercises?

The quick answer is that sometimes they are used synonymously. While many now think of extension exercises when they think of McKenzie exercises, it’s not all about extension. McKenzie’s concepts were based on centralizing symptoms to the source and reducing them. This often involves extension exercises, but not always.

Robin McKenzie, a physical therapist, discovered that patients with low back pain often improved with extension exercises with repeated movements.  He also noticed the radiating symptoms often improved.

Why Does Extension Help with Low Back Pain?

The quick answer is that it can help encourage proper positioning of the fluid in the discs in the lumbar spine. There is a disc between each vertebrae that provides space and cushion between the bones.  The disc is kind of like a jelly donut.  The outer part is thick and fibrous, the inner part is like a viscous jelly. When we bend forward or sit a lot, the lumbar spine flexes forward and compresses the front of the discs.  This can force the fluid toward the back of the disc.  Over time, this can wear our the back of the disc and the outer portion can become inflamed or even bulge or herniate.

Disc hernation or bulge can sometimes be treated with extension exercises

Disc Herniation

By extending the spine, it is believed that this encourages disc fluid to move away from the inflamed area, back toward the front of the disc.  This allows for less stress on the injured part of the disc which allows it to heal and hopefully stop causing symptoms.

To learn more about Herniated Discs, watch this VIDEO.

How to Do McKenzie Low Back Exercises

Here are some examples of basic extension exercises for the lower back.

Repeat this 10 to 15 times.  Start face down and push up with the hips on the table as far as tolerated without increase in pain.

Prone press ups or repeated extension in lying is a common extension exercise for the low back.

Repeated extension in lying

Repeat 10 to 15 times. Start face down and press up on to the elbows.

Prone on elbows is a less intense extension exercise

Prone on elbows

Repeat 10 to 15 times. Start by standing erect with hands just below the lower back.  Extend backwards as far as tolerated.

Repeated extension in standing is an altenative extension exercise if you cannot lay down.

Repeated Extension in Standing

How to Do McKenzie Neck Exercises

Here is an exercise that can help to improve neck symptoms in some people.

Retract the neck like you are making a “double chin.”  Hold 5 seconds, 10 times.

neck retraction stretch

neck retraction stretch

If you have increased symptoms with any of these exercises, stop immediately.

McKenzie Exercises Summary

McKenzie Exercises are used by physical therapists to treat many issues. It is one of several effective approaches to treating spine issues. This article is a brief summary and clinical interpretation of the basics of the McKenzie Method. To learn more about the McKenzie Method and the research associated with this approach, click this LINK.

If you have back or neck pain that is not improving, the Jacksonville Orthopaedic Institute can help! To schedule an appointment, call JOI-2000, schedule online, or click the link below.  

Book An Appointment with a JOI Physician

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