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The McKenzie protocol also now includes flexion protocols and stresses the importance of differentiating whether flexion or extension improves patient's symptoms. As a result, McKenzie principles are used by many physical therapists in the treatment of low back pain, whereas Williams Exercises are no longer taught as a physical therapy protocol.
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
Waddell's signs are a group of physical signs, first described in a 1980 article in Spine, and named for the article's principal author, Professor Gordon Waddell (1943–2017), a Scottish Orthopedic Surgeon. [1] [2] Waddell's signs may indicate non-organic or psychological component to chronic low back pain.
The straight leg raise is a test that can be performed during a physical examination, with the leg being lifted actively by the patient or passively by the clinician. If the straight leg raise is done actively by the patient, it is a test of functional leg strength, particularly the rectus femoris element of the quadriceps (checking both hip flexion and knee extension strength simultaneously).
Spinal manipulation appears to provide similar effects to other recommended treatments for chronic low back pain. [57] There is no evidence it is more effective than other therapies or sham, or as an adjunct to other treatments, for acute low back pain [58] "Back school" is an intervention that consists of both education and physical exercises.
"Bend your left ear down towards your left shoulder and then your right ear down towards your right shoulder" to test for pain free cervical spine lateral flexion. Now test for stiffness or pain flexing or extending the cervical spine: "bend your neck forwards to try to touch your chin against your chest." "bend your neck back to lift your chin."
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Exercises that enhance back strength may also be used to prevent back injuries. Back exercises include the prone push-ups/press-ups, upper back extension, transverse abdominis bracing, and floor bridges. If pain is present in the back, it can mean that the stabilization muscles of the back are weak and a person needs to train the trunk musculature.