The McKenzie Method - How it all Began
Robin McKenzie changed the way patients worldwide treat back and extremity issues. The McKenzie Method of Mechanical Diagnostics and Therapy (MDT), developed by Robin in the 1950s, has become a standard in the field. Robin devoted his professional life to the study of musculoskeletal disorders and their treatment and his theories are now supported with scientific evidence.
It was in 1956 at his clinic in Wellington, that Robin McKenzie first observed by chance a remarkable event which has changed the nature of treatment administered for the alleviation of back pain worldwide. This serendipitous event led to the development of the theories and practice that have become the hallmark of the McKenzie protocols for assessment and treatment of mechanical disorders of the spinal column.
“My first experience with what I have chosen to call the 'Centralisation Phenomenon' occurred in 1956. A patient, 'Mr Smith', who had pain to the right of the low back, extending into the buttock and thigh to the knee, had undergone treatment for three weeks without improvement. He could bend forwards, but could not bend backwards. I told him to undress and lie face down on the treatment table, the end of which had been raised for a previous patient. Without adjusting the table, and unnoticed by any of the clinical staff, he lay face down with his back overstretched for some five minutes. After some time, when I entered the room I was aghast to find him lying in what at that time was considered to be a most damaging position. On enquiring as to his welfare, I was astounded to hear him say that this was the best he had been in three weeks. All pain had disappeared from his leg. Furthermore, the pain in the back had moved from the right side to the centre. In addition, his restricted range of extension had markedly improved. After standing upright, the patient remained improved with no recurrence of leg pain. The position was adopted again the following day and resulted in complete resolution of central low back pain. The movement of pain from the leg or buttocks to the middle of the back is now known as the centralisation phenomenon."
- Robin McKenzie
This chance clinical observation then led Robin to begin systematically evaluating the effects that simple movements and positions had on his patients’ back pain. A clear assessment process gradually emerged. This system, now known as the McKenzie Method of Mechanical Diagnosis and Therapy (MDT), has achieved worldwide recognition and is now regarded as part of “normal” management for low back pain. His vision was that all patients with musculo-skeletal pain be taught how to manage their own pain.
By the 1970’s, Robin had developed his theories quite robustly and became known in the United States, where his ideas were adopted with great enthusiasm. He was hired by the Kaiser group of hospitals and helped many thousands of American workers to overcome their debilitating back problems. Honours quickly followed, and McKenzie was invited to the UK, many European countries and to Japan and China.
In order to meet the demands of his work, it soon became apparent that more education was necessary. Robin started to set up training courses to educate other physiotherapists and also established the McKenzie Institute to carry out further research and training. The Institute was founded in 1982 and has since grown into a multinational entity with 28 branches. For more than 40 years, Robin McKenzie refined and perfected the procedures that have made the McKenzie self-treatment system unique. He also invented the unique McKenzie Lumbar Roll and McKenzie Neck Roll to help patients prevent a recurrence of pain.
In 2004, the American PT magazine Advance for Physical Therapists and PT Assistants published a survey of 320 randomly selected physical therapists who work in the orthopedic field . It had been asked about the people who have influenced their opinion, the orthopedic physical therapy most. The physiotherapists could call 10 people and write reviews from 0 (no influence) to 4 (very large impact).
- Robin Mckenzie 2.55
- James Cyriax 2.44
- Florence Kendall 2.33
- Geoffrey Maitland 2.24
- Stanley Paris 2.00
- Shirly Sahrmann 1.81
- Brian Mulligan 1.80