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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.
When the shoulder is fixed, levator scapulae rotates to the same side and flexes the cervical spine laterally. When both shoulders are fixed, a simultaneous co-contraction of both levator scapulae muscles in equal amounts would not produce lateral flexion or rotation, and may produce straight flexion or extension of the cervical spine.
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.
They allow for flexion and extension and limit lateral flexion in the cervical spine. Pathological processes that can occur in these joints include degenerative changes or hypertrophic arthritis, resulting in foraminal stenosis and nerve compression. Foraminal stenosis at this joint is the most common cause of cervical nerve root pressure.
[medical citation needed] This is a preferred method of exercise during the sub-acute phase because it resists atrophy and is least likely to exacerbate the condition. Single plane resistance exercises against cervical flexion, extension, bending, and rotation are used. [citation needed]
Cervical X-rays may show osteophytes, decreased intervertebral disc height, narrowing of the spinal canal, and abnormal alignment (kyphosis of the cervical spine). Flexion and extension view of the cervical spine is helpful to look for spondylolisthesis (slippage of one vertebra over another).
Joint stability is easily evaluated by the use of flexion and extension lateral x-ray views of the spine. A summary of part of the DRE tables (6) give a guide as to the implications of the joint instability. If either translation or angular change is determined from flexion to extension to the degree shown in the table below, then Category IV ...
However, the cervical spine is comparatively mobile, and some component of this movement is due to flexion and extension of the vertebral column itself. This movement between the atlas and occipital bone is often referred to as the "yes joint", owing to its nature of being able to move the head in an up-and-down fashion.