What is the McKenzie Method® (Or: How We Help Patients Treat Themselves!)

The McKenzie Method is both a system of assessment and management focusing on a person's ability to self-manage musculoskeletal pain.
People doing upward dog in a yoga studio
Dr. Alexander Elahi
April 5, 2024

At our Frederick clinic, we do not want to create dependency in our patients - after all, then we would not be any better than a pill, injection, or surgery! We want to EMPOWER our patients to treat themselves and this is the beauty of the McKenzie Method®!

What is the McKenzie Method®?

The McKenzie Method of Mechanical Diagnosis and Therapy® (MDT) is a method that allows clinicians to assess ALL musculoskeletal problems in a reliable process.

MDT was designed in the 1950s by expert physiotherapist Robin McKenzie after a fortuitous miscommunication with one of his patients! McKenzie had a patient with low back pain that extended into his buttock and thigh. McKenzie asked this patient to lie face-down on a treatment table while McKenzie finished up from his previous appointment. What McKenzie did not know was that the head of the table was still up after having been raised for the previous patient. When McKenzie returned to treat the patient, he found that after five minutes of lying in this extended position, the patient reported feeling the best he had in weeks!

Since then MDT has grown to be an evidence-based exercise-based approach to assessment, diagnosis, and treatment that is both comprehensive and clinically reasoned. Further, it does not rely on expensive diagnostic imaging!

In addition, MDT treatment promotes the body’s ability to heal itself without passive modalities such as medication, heat, ice, ultrasound, etc. Education is a fundamental part of MDT so that patients are empowered to control their own symptoms - which has the nice benefit of reducing dependency on doctors!

McKenzie Method® Goals

In a timely and cost-effective approach, the McKenzie Method of Mechanical Diagnosis and Therapy® (MDT) has several achievable goals.

  1. Understand patients’ presentations and symptom behaviors
  2. Discover the most effective and appropriate treatment plan
  3. Abolish patients’ symptoms
  4. Restore full function
  5. Empower patients to manage their own symptoms
  6. Empower patients’ to know how to prevent recurrence
  7. Guide patients when (rarely) other medical intervention is needed

The Origin of Musculoskeletal Pain

Fortunately, most musculoskeletal pain has a “mechanical” basis rather than being due to a serious pathology such as cancer or infection. The mechanical basis of most musculoskeletal pain is due to abnormal forces or mechanics occurring in the body’s tissues. Moreover, these abnormal forces or mechanics occurred as a result of a position, movement, or activity that led to the beginning of pain.

And this idea that the abnormal forces or mechanics caused the pain leads to the conclusion that mechanical force will be part of the solution.

How Does McKenzie Method® Work?

The McKenzie Method of Mechanical Diagnosis and Therapy® (MDT) has four steps: assessment, classification, treatment, and prevention.

  1. Assessment: A detailed history of the patient’s symptoms and their behavior is taken. The patient will be asked to do certain movements and/or rest in certain positions. A distinguishing feature of MDT is the use of repeated movements as opposed to a single position. How the patient responds to these repeated movements gives the clinician information on how to classify the patient’s problem.
  2. Classification: Each patient’s presentation is classified according to its unique presentation and the symptomatic response to the assessment. There are four categories into which patients can be classified. The least common of these, the “Other” subgroup, which includes serious pathologies and non-mechanical causes, makes up only approximately 2% of low back pain presentations and similarly low rates for other body regions. 
  3. Treatment: After having been classified, patients will be given specific exercises and advice on postures to adopt and/or temporarily avoid. The goal in this step is to have the patient have a treatment that he/she can perform five or six times per day as this is more likely to be effective in a shorter period of time than having to rely on clinician-administered treatment once or twice per week. In certain more difficult mechanical presentations, an MDT-trained clinician may need to apply hands-on techniques until the patient can self-manage.
  4. Prevention: Once a patient has learned how to self-treat their current problem, the patient will have also learned how to minimize recurrences. If symptoms recur in the future, the patient will know how to rapidly deal with them and be in control of their treatment!

What Does a Typical McKenzie Method® Treatment Look Like?

McKenzie Method of Mechanical Diagnosis and Therapy® (MDT) treatment is individualized to the patient. However, there are some commonalities between the different treatment options. 

First, based on the idea that abnormal forces or mechanics led to the beginning of pain, one direction may provoke and increase pain while moving in the opposite direction eliminates pain and restores function. Second, the MDT assessment will explore these different movements and the patient’s response to them to determine which of these movements will be the patient’s individualized treatment. Thirdly, for any selected movement, the least amount of force needed to correct the problem is used with more forceful approaches only used if less forceful procedures have not proven sufficient.

If you’re an athlete or an active individual who is also experiencing musculoskeletal issues, then don’t wait any longer. Give us a call at (240) 206-0655 to book your McKenzie Method of Mechanical Diagnosis and Therapy® (MDT) Assessment today with Frederick’s only clinician Certified in Mechanical Diagnosis and Therapy®!

Do this next!

  1. Share this article with a friend or family member who has been dealing with constant back, neck, shoulder, hip, or knee pain that MDT could help!
  2. Call our office TODAY at (240) 206-0655 to book your MDT Assessment today.
  3. Keep an eye out for our next article!


Information for Patients. The McKenzie Institute® USA. (n.d.). Retrieved April 1, 2024, from https://mckenzieinstituteusa.org/method-patients.cfm


Information for Patients. The McKenzie Institute® USA. (n.d.). Retrieved April 1, 2024, from https://mckenzieinstituteusa.org/method-patients.cfm

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