You may have heard about the McKenzie Method of Mechanical Diagnosis and Therapy (MDT), but are not exactly sure what the goals of the program are or what the exercises entail. A common misconception is that the McKenzie approach only comprises exercises that people can do on their own. While this is true, the McKenzie Method is really an overall program of assessment, treatment and prevention strategies (including exercise) that are usually best learned with a chiropractor or physiotherapist who is trained in the method.
What is McKenzie Method?
The McKenzie Method of MDT is an internationally acclaimed method of assessment and treatment for spinal and extremity (i.e., arms and leg) pain developed by New Zealand physiotherapist Robin McKenzie. It has been widely used all over the world for more than 30 years. MDT clinicians are trained to assess and diagnose all areas of the musculoskeletal system. That means that if a problem exists in or around the spine, joint or muscle, an MDT evaluation may be appropriate.
How is McKenzie different from other methods?
MDT encourages active patient involvement and education that is trusted and used by clinicians and patients around the world for back, neck and extremity problems. This approach continues to be one of the most researched physical therapy based methods available. A main feature is the initial assessment, which is a safe and reliable way to reach an accurate diagnosis and only then make the appropriate treatment plan. Certified MDT clinicians are able to rapidly determine whether the method will be effective for each patient. In its truest sense, MDT is a comprehensive approach based on sound principles and fundamentals that, when fully understood and followed, is very successful, and this notion is widely supported in the scientific literature.
The 4 steps of MDT
- Assessment. MDT begins with the clinician taking a detailed history about your symptoms and how they behave. You will be asked to perform certain movements and rest in certain positions.
- Classification. Each syndrome is addressed according to its unique nature, with specific mechanical procedures, including repeated movements and sustained postures.
- Treatment. Using the information from the assessment, the clinician will prescribe specific exercises and advice regarding postures to adopt and postures to temporarily avoid. If your problem has a more difficult mechanical presentation, a qualified MDT clinician may need to add hands-on techniques until you can self-manage.
- Prevention. By learning how to self-treat the current problem, you gain knowledge on how to minimise the risk of recurrence. You can also rapidly deal with symptoms if they recur, putting you in control of your treatment safely and effectively.
Does McKenzie Method require extra training?
McKenzie clinicians are highly trained individuals who have undergone further training, beyond the level of university training, to learn effective methods in managing musculoskeletal disorders. The McKenzie Institute International (MII) provide two levels of MDT training, these are:
- Credentialed (Cred MDT)
- Diplomat (Dip MDT)
To become credentialed in the McKenzie Method, clinicians must undergo 4 post-graduate courses (neck and thoracic, low back, upper limb and lower limb), which are run over 3 days each (total 112 hours of training). Generally, this takes approximately 2 years to complete. Once these four courses are completed, clinicians must undergo a final vigorous written theoretical and practical examination to receive Cred MDT status. This final examination is also run over 3 full days.
To receive a Dip MDT, clinicians must first complete the Cred MDT and also meet additional competencies, including: completion of 300-hour theoretical portion, a 360-hour clinical residency portion and passed an advanced final examination. Attainment of the Diplomat in MDT is the highest level of training in the MII post-graduate education program and recognises excellence in the practical application of MDT.