The McKenzie Method

Although the McKenzie Method or Mechanical Diagnosis and Therapy (MDT) is most commonly thought of, or referred to as extension exercises, it is so much more. In its purest application this method is a comprehensive approach to the spine and peripheral joints, based on sound principles and fundamental research. When these principles are understood and followed accordingly they are very successful. In fact, most remarkable but least appreciated is the MDT assessment process.


It is this process that sets therapists apart. Unique to the McKenzie or MDT Method, is a well-defined algorithm that leads to the simple classification of spinal-related disorders. This algorithm is based on consistent “cause-and-effect” relationship between historical pain behavior as well as the pain response to repeated test movements, positions and activities during the assessment process.

The McKenzie evaluation process uses a systematic progression of applied mechanical forces (the cause) which utilizes the pain response (the effect) to monitor changes in motion/function. This allows the underlying disorder to be quickly identified through objective findings for each individual patient. The MDT classification of spinal pain provides reproducible means of separating patients with apparently similar presentations into definable sub-groups (syndromes) to determine appropriate treatment.

The McKenzie Method has noted three definable syndromes which include: Postural, Dysfunction, and Derangement. Postural syndromes are noted having end-range stress of normal function. Whereas Dysfunction syndromes have end-range stress of shortened structures (scarring, fibrosis, myofascitis, and adherent nerve roots) Lastly Derangement syndromes are anatomical disruptions or displacements within the motion segment or disc.

Each distinct syndrome is addressed according to its unique nature with mechanical procedures utilizing movement and positions. The Derangement syndrome where the phenomenon of Centralization occurs is most common.

Well-trained and certified MDT practitioners will be able to identify those more difficult cases where advanced McKenzie techniques might benefit the patient versus those patients whose diagnosis is non-mechanical in nature, and those patients are then quickly referred for alternate care, thus avoiding unnecessary periods of inappropriate or expensive management.


McKenzie treatment uniquely emphasizes education and active patient involvement in the management of their treatment in order to decrease pain quickly, restore function and independence, minimizing the number of visits to the clinic. However if a problem is more complex, self-treatment may not be possible right away. A certified McKenzie clinician will know when to provide additional advanced hands-on techniques until the patient can successfully manage the prescribed skills on their own.

Fortunately, most patients can successfully treat themselves when provided the necessary knowledge and tools. An individualized self treatment program tailored to the lifestyle of the patient puts the patient in control safely and effectively.


Patients gain an exceptional education learning to self-treat the present problem. The management of these skills and behaviors will minimize the risk of recurrence and allow patients to rapidly manage themselves when symptoms occur.

Active Wellness Chiropractic and Rehabilitation is the only clinic in the world with 3 MDT Certified chiropractic physicians and we are pleased to note that Dr. Aaron, Dr. Gary, and Dr. Kurt are the only MDT Certified chiropractic physician in Iowa, and three of only 100 world-wide.