MDT(Mechanical Diagnosis and Treatment) also known as the McKenzie Method, is a classification-based system and treatment program for patients suffering from low back pain, neck pain, or pain in the extremities. If your pain is determined to be mechanical in nature, meaning pain that is affected by movement of a particular joint, then an assessment of that joint is carried out using directional loading strategies(repeated end range movements). Mechanical and symptomatic baselines are recorded, and how these baselines change following the applied loading strategy, can help classify your pain into one of several syndromes: Derangement Syndrome, Dysfunction Syndrome, and Postural Syndrome.

Each of these syndromes has a characteristic presentation and once a direction is found that relieves the symptoms and improves mechanics of the joint (Directional Preference), then your treatment plan will involve a graded progression of movements into that direction until pain-free movement is restored. Progressions are made as indicated by a positive response to a given load, so safety is ensured.

The most common Mechanical Pain Syndrome is the Derangement Syndrome and it is characterized by variability in pain levels and movement loss. Pain can increase and decrease rapidly in response to certain postures or movements, it can change in location, and the increase in pain is associated with an increased stiffness or movement loss. A careful history of your condition and how your pain responds to the activities of your daily life can often lead to a strong preliminary diagnosis before a movement assessment is carried out.

It is important to note that the McKenzie Method is safe and often effective in reducing pain and teaching you strategies to control your pain, but at SIMIO Physical Therapy we understand that joints and muscles don’t work in isolation and there are polyarticular muscle chains that become imbalanced from an early age due to symmetrical movement demands being placed on a body that is inherently asymmetrical. Further complicating the matter is the fact that it is our breathing that further perpetuates this problem. This dilemma likely existed before your condition started and will persist even once your pain is abolished if these imbalances aren’t addressed. We are trained at identifying these imbalances and will incorporate this into your treatment plan so that you can address your Mechanical Pain and then restore balanced muscle function and reciprocal movement so that you are less susceptible to mechanical pain syndromes in the future.

Nate Dykema

PT, DPT, Cert MDT

Nate Dykema is a 2011 graduate of Grand Valley State University’s Doctorate Physical Therapy program. Nate is a certified provider of the McKenzie Method of Mechanical Diagnosis and Therapy, and is actively engaged in PRI coursework and the study of patterned human asymmetry.