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.
In the case of postural syndrome a healthy joint is stretched beyond its limits. For example, sitting in a slumped position repeatedly over time stretches the spinal ligaments eventually causing pain. If the pain is postural in nature, sitting erect corrects this problem immediately.
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.
Rolfing and the Mind – Body Connection
“Physical stress mirrors emotional suffering, relief from physical constraint markedly affects emotional misery.” – Dr. Ida P. Rolf
The Irish say, the past is not the past. Each of us has a history. We are formed by both our physical and emotional experiences. The important things that happen during our journey leave their mark upon us, and shape our structure. Your unique movement pattern reflects athletic and career choices, psychological and physical health, as well as your genetic predispositions.
We are all moving around our physical limitations. When we recognize someone a block away it is often their movement pattern that distinguishes them first. How we walk and move through life is idiosyncratic. Traumatic injury, such as a physical accident or an emotional wound becomes part of our structure.
Consider an ankle sprain. In response to pain, we hold the ankle rigid. This internal bracing is an unconscious and instinctual – we do it to avoid more pain. In a matter of weeks, the fascia, the fabric of the body that organizes the structure, adapts by shortening. This shortening becomes a part of our structural pattern. The fascial shortening influences our movement patterns and our pattern of organization.
What happens when the ankle sprain heals? The fascial shortening remains and stays with us. Without therapeutic intervention the new pattern often remains with us throughout our life. Our freedom of movement (range of motion) becomes limited by the injury and the internal “repair.”
Psychic injuries are also formative of the structure. We often absorb sexual violence into our physical and emotional bodies. The experiences that we are unable to process become “stuck places” in the structure. Young children who become chronically embarrassed will often go through their lives with their shoulders elevated and rolled in, and their head forward.
This defensive posture actually becomes cemented into the structure. The pectoral and upper trapezius fascia shortens and thickens. We may carry these structural changes throughout our lives. Both the ankle sprain and the embarrassment create chronic holding patterns that influence how we stand, move, feel and think.
It is with great tenacity that we propel ourselves forward into space despite our physical and emotional wounds. Our survival depends on our ability to move. We find inventive and unique movement patterns to compensate for our losses.
These compensations come at a cost. Sometimes, the price we pay is the loss of efficiency. It takes extra energy to stay upright and to move when the body is not well aligned. Sometimes, we pay with the loss of confidence. Emotional trauma becomes lodged in the structure.
Rolfing supports the structure to become better balanced. The Rolfer uses deep pressure to release the chronic shortening in the fascia. As the tensions in the fascial network become more balanced, the structure becomes more upright. The stuck places become “unstuck.”
The implications of releasing these chronic shortenings from old injuries are far reaching. As the body changes and becomes more open, the heart and mind changes too, inevitably.
Rolfers use a ten session format to work progressively through the structure. Each session works on a different part of the body. Our goals include helping you become more vertical and upright, with openness and span. Ultimately, we want to help you become more comfortable in your own skin.
Five Element Acupuncture is also a wonderful tool for addressing old wounds and creating balance within the structure. Each area of chronic holding is present in our energetic field as an energetic block. As the acupuncturist removes each of these blocks, the body and the mind and heart move towards balance. Change within the structure offers great possibility and promise for change within the heart and mind.
By David Frome • Acupuncture, Good Posture, Rolfing • • Tags: body-mind, emotional trauma, fascial shortening, five element acupuncture, mind-body, physical trauma, rolfing, structural integration, structural pattern, Traumatic injury