Remembering Robin McKenzie
Robin McKenzie, a Physiotherapist from New Zealand, has been a major influence in my career and I was saddened to learn of his death earlier this month. Robin McKenzie pioneered a method of treatment of the lumbar and cervical spine which promotes self care through postural correction and specific exercises.
Robin based his practice on some simple tenets:
- Your back probably “went out’” because certain highly repetitive postures and/or movements that you do.
- If we identifying the problematic postures or movements that create your spinal problems, we can find the postures and movements which will reverse the problem, reducing and abolishing your back pain.
- You can learn to use these exercises and postural corrections to prevent future episodes of neck and back pain, and treat the pain should it recur.
Robin discovered an important principal in assessing back and neck pain called centralization. If your problem is moving toward the spine, (from the foot to the calf, or from the thigh to the buttock, or the buttock to the spine) it is centralizing, and that’s a good sign, you are getting better. If your pain or symptoms are moving away from the spine, it’s called peripheralization, and that is not a good sign. Your problem is becoming worse. This principal allows the practitioners and patients to determine if their treatment is working.
Robin had a good sense of humor. Story has it, he was driving along a highway in his native New Zealand, and he saw someone lying on the ground performing one of his exercises. Robin stops, gets out of his car and walks around the former patient. After a minute, he finally says, “Just checking,” and gets back into his car and drives away. He was also known to walk around airport lobbies checking the sitting posture of each person as they wait for their flights.
As a PT student at NYU, Robin’s work became the focus of my senior project. It was titled: “The Bio-Mechanics of Low Back Pain and The McKinzie Method of Treatment.” Soon after I graduated PT school, I trained and was certified by the McKinzie Institute in the treatment of cervical and lumbar spines. Later, I had the good fortune to study with Robin himself when he was teaching here in the states. Robin was a brilliant diagnostician and practitioner. The McKenzie method continues to evolve and I continue to study and practice it. To learn more about McKenzie, you can read our blog post called “Low Back Pain.“
In my 35+ years of private practice, we have treated thousands of patients with back and neck pain. We incorporate Robin McKenzie’s tools, Dr Rolf’s vision and Acupuncture in the treatment of acute and chronic cervical and low back problems.
Don’t hesitate to schedule on line call (973.509.8464 or 212.820.8719) for your next appointment.
Robin McKenzie’s Revolutionary Approach to Back Care
While some episodes of back pain are fairly short in duration, others last for weeks or even months. The severity and duration of pain often corresponds to the age, postural habits and the physical health of an individual.
Three stages of LBP are poor posture, dysfunction and derangement. These progressive stages are the principles of diagnosis identified by Robin McKenzie, a Physiotherapist from New Zealand.
With dysfunction syindrome, the normal freedom of movement in one or more joints is impaired. You probably have seen someone rise from a chair unable to stand erect. We commonly refer to this as stiffness. In fact, certain structures have lost mobility and are impeding normal movement. This problem is an example of dysfunction. Scar tissue, myofascial shortening, muscle spasm and tendonitis can all lead to dysfunction. Treatment of dysfunction involves restoring the normal ROM in the joints.
The most severe back problem is the pain that results from derangement. Derangement Syndrome occurs when the structure of the joint has been disrupted and the mechanics are compromised. When spinal derangement occurs, the spinal cord and peripheral nerve roots are often affected. Disc herniation, spinal stenosis and spondylolisthesis are different forms of derangement that often create nerve pain. Typically this pain is experienced along the sciatic nerve, which runs along the posterior lateral buttock, thigh, calf and foot.
Poor posture can lead to dysfunction and derangement within a segment of the vertebrae.
McKenzie also discovered an important principal in assessing back and neck pain called centralization of pain. If the pain is experienced closer toward the spine over time, (from the foot to the calf, or from the thigh to the buttock, or the buttock to the spine) symptoms are centralizing and healing. If the pain or symptoms are moving away from the spine, it’s called peripheralization, indicating a more involved problem. This principal allows practitioners and patients to determine if their treatment is working.
McKenzie pioneered a method of treatment of the lumbar and cervical spine that promotes self-care through postural correction and specific exercises.
Robin based his practice on some simple tenants:
1. Your back probably “went out’” because certain highly repetitive postures and/or movements that you do.
2. By identifying the problematic postures or movements that create your spinal problems, we can find the postures and movements which will reverse the problem, reducing and abolishing your back pain.
3. You can learn to use these exercises and postural corrections to prevent future episodes of neck and back pain.
4. Sometimes, the care of a professional is needed to help you manage a spinal problem. A qualified McKenzie therapist can diagnose, treat and help you learn the principles of self-care.
Robin’s has written two fine books, “Treat Your Own Back” and “Treat Your Own Neck.” We highly recommend these guides to help you understand the nature of back pain and provide you with tools for self care.
At Frome Physical Therapy we specialize in low back and neck care. In our practice we incorporate the tools of Robin McKenzie, Dr. Rolf’s vision and acupuncture in the treatment of acute and chronic cervical and low back problems.
The contents in this article are not meant to be diagnostic or prescriptive. Spinal problems are sometimes complex, and a physician should always be consulted before choosing a course of treatment.
By David Frome • Acupuncture, Good Posture, Physical Therapy, Rolfing • • Tags: acupuncture, centralization of pain, derangement syndrome, dysfunction syndrome, low back pain, low back problems, lumbar spine, myofascial shortening, Physical Therapy, postural syndrome, robin mckenzie, rolfing, scar tissue, structural integration