The McKenzie Method is a system of assessment and treatment for spinal disorders developed by New Zealand physiotherapist Robin McKenzie. It focuses on identifying and addressing mechanical problems in the spine that may be causing pain and dysfunction. The method is based on the principle that certain movements and positions can either alleviate or exacerbate spinal symptoms. By understanding these patterns, healthcare professionals can develop individualized treatment plans to help patients manage their spinal disorders more effectively.
The main principles of the McKenzie Method for treating spinal disorders include active patient involvement, mechanical assessment, and self-treatment. Active patient involvement means that individuals are encouraged to take an active role in their own recovery by performing specific exercises and movements prescribed by their healthcare provider. Mechanical assessment involves identifying the specific movements and positions that either relieve or worsen a patient's symptoms. This assessment helps guide the development of an appropriate treatment plan. Self-treatment refers to the emphasis on teaching patients how to manage their symptoms independently through exercises and self-care techniques.
Back pain is a common ailment that many of us have experienced at some point in our lives. One specific type of back pain, known as discogenic low back pain (LBP), is characterized by pain originating from the intervertebral discs (IVDs) in the spine. Despite extensive research, the exact causes of discogenic LBP have remained elusive. However, a recent study conducted by Seiji Ohtori and his colleagues sheds new light on the underlying mechanisms of this condition.Animal Models and Discogenic LBP:Through the use of animal models, researchers have made significant discoveries regarding discogenic LBP. They have found that sensory nerves grow into the inner layer of the lumbar IVDs, and this nerve ingrowth is induced by certain inflammatory substances called cytokines. These cytokines, such as tumor necrosis factor-α and interleukins, stimulate the ingrowth of sensory nerves into the discs. Moreover, nerve growth factor has been identified as a key player in inducing this nerve ingrowth. Animal models have also revealed that disc degeneration triggers the production of collagenases, enzymes that break down collagen, leading to hypermobility and pain. Sinuvertebral NervesUnveiling Human Discogenic LBPFurther insights into the mechanisms of discogenic LBP have been gleaned from the examination of degenerated human IVD specimens. These specimens have revealed sensory innervation and nerve ingrowth, similar to what has been observed in animal models. The presence of cytokines in human discs suggests a shared mechanism with animal models. This indicates that the findings from animal studies can be applied to human patients as well. In addition to sensory innervation and cytokine involvement, sensitization of sensory nerve fibers innervating the IVDs is a crucial factor in discogenic LBP. When these nerve fibers become sensitized, they become more responsive to pain stimuli, leading to heightened pain perception.Psychosocial factors also play a role in the perception and experience of pain associated with discogenic LBP. Factors such as stress, anxiety, depression, and social support can influence an individual’s pain experience. Understanding the interplay between these psychosocial factors and the physiological aspects of discogenic LBP is important in developing comprehensive treatment approaches.Tackling Discogenic LBP: Treatment ApproachesUnderstanding the underlying pathomechanisms of discogenic LBP opens up avenues for potential treatment strategies. To effectively manage this condition, it is crucial to prevent sensitization of sensory nerve fibers within the IVDs. This can be achieved through targeted interventions that aim to suppress the pathogenic increases of cytokines. By reducing the levels of pro-inflammatory cytokines, such as tumor necrosis factor-α and interleukins, the ingrowth of sensory nerves into the discs can be controlled, thereby reducing pain.In addition to cytokine regulation, addressing disc hypermobility is an essential aspect of treating discogenic LBP. Hypermobile discs can magnify pain and further damage the disc structure. Treatment options such as physical therapy and specific exercises can help stabilize the spine, reduce hypermobility, and alleviate pain. Other interventions, such as spinal manipulative therapy and epidural steroid injections, may also be considered in certain cases to manage pain and promote healing.Conclusion:Discogenic low back pain is a complex condition with multiple underlying mechanisms. The research conducted by Seiji Ohtori and his colleagues has provided valuable insights into the pathomechanisms of this condition, highlighting the role of sensory nerve ingrowth, cytokines, and disc hypermobility. By understanding these mechanisms, health professionals can develop more targeted treatment approaches to help patients suffering from discogenic LBP.One innovative product that aids in the understanding and communication of discogenic LBP is the Professional LxH Dynamic Disc Model by Dynamic Disc Designs. This model accurately represents the structure and function of the intervertebral discs, allowing health professionals to visually demonstrate the impact of disc degeneration, nerve ingrowth, and hypermobility to their patients. By using this model during patient consultations, health professionals can help individuals better comprehend the nature of their condition and the rationale behind the recommended treatment approaches.Check out MMT's Exclusive Blue Nucleus model!Via Dr. Jerome Fryer - Dynamic Disc Designs Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below! Learn more online - new online discussion group included! Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion Group Live cases webinars lecture Live Q&A over 600 videos - hundreds of techniques and more! Check out MMT Insiders Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-07-31
Andrew is back talking about a colleague's recent case. This is a new grad, only practicing for 5 weeks or so, but kudos to his differential diagnosis skills and applying the Wells Criteria for Pulmonary Embolism. If you're not familiar with it, its something you should keep in the back of your mind, especially with post op patients, those who have been recently immobilized, or with history of Cancer or PE. Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-07-26
Collagen Supplementation for Joint Pain and Arthritis: Does it Really Work?By Dr. Sean M.Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DNRecently I was presenting at the annual conference of Athletic Trainers' Association of Florida (ATAF) and I was overwhelmed by one consistent question: why didn't you talk about collagen supplementation? My talk was specifically on orthopedics for older adults and naturally I focused on osteoarthritis (OA) and how important exercise and diet are for that condition. I did touch on some supplementation, but I left off collagen because my last examination of this supplement, using one of my favorite websites Examine.com, yielded mediocre results. However the participants at the sports medicine conference piqued my interest and convinced me that perhaps I had missed something -- almost every single one of these participants had some form of joint pain or stiffness and felt significantly better after taking collagen daily. So, back to the literature, and asking some of my clients, I went!What is Collagen?Collagen is a protein found in the body that provides structure and support to various tissues, including joints, bones, tendons, and ligaments. It may play a role in maintaining joint health and may have potential benefits for individuals with joint pain. A few small-scale studies have shown positive results in reducing joint pain and improving joint function when individuals with osteoarthritis took collagen supplements. These studies often used specific collagen formulations, such as collagen peptides or hydrolyzed collagen, which are broken down into smaller peptides for better absorption by the body. However, it's important to note that the findings of these studies are not yet conclusive, and more robust research is necessary.The ResearchIt's worth mentioning that joint pain can have various causes, and collagen supplementation may not be effective for everyone. Factors like age, underlying health conditions, overall diet, and lifestyle habits can also influence joint health. For instance, a meta-analysis on collagen supplementation for OA showed improvements in the WOMAC, a functional score for knee arthritis, but it didn't yield significant results for knee pain. Meanwhile, another review article looking at collagen supplementation for joint pain, muscle protein synthesis, and body composition found that collagen did significantly reduce joint pain (it had effect on the other metrics). Here's a nice table listed in the article:The joint pain included in the review included knee pain and Achilles tendinopathy, all predominately in an athletic population. Another glaring observation is several of these studies included physical therapy and exercise prescriptions with the supplementation (Yay! Nutrition and Physical Therapy), which can also alter the results and effects of collagen as well. It's important to see the doses varied in the studies from 5, 10, to 40 grams per day; moreover, the collagen can come in varying form from peptides, hydrolyzed proteins, to denatured collagen. Having such variability in the type of collagen also likely explains the variability in responses and data.DosingSo, roughly how much and what type of collagen should a client take? Well, many studies have used dosages ranging from 8 to 12 grams of collagen peptides or hydrolyzed collagen per day for joint-related benefits. Research suggests that type II collagen supplementation may help reduce joint pain and improve joint function in individuals with arthritis, particularly osteoarthritis. It is believed to work by helping to restore and support cartilage health, potentially reducing inflammation and promoting joint mobility. It's important to note that collagen supplements are available in various forms, such as powders, capsules, and liquids, and their concentration of collagen can vary. Therefore, it's crucial to follow the manufacturer's instructions and consult with a healthcare professional to determine the appropriate dosage for your specific needs.It's also worth mentioning that collagen supplements are often combined with other ingredients, such as vitamins, minerals, or herbal extracts, which may influence their effectiveness. If you decide to try collagen supplementation for joint pain, it's a good idea to choose a reputable brand and look for products that have been tested for quality and safety. I suggest using Labdoor.com to help you or your client find a high-quality collagen supplement, if and when appropriate.SummaryIn the end, perhaps the participants at the ATAF conference were right -- there is something to say about collagen and joint pain. Not every study is exact and more research needs to be done on what dose, what age, what condition, and what exercises should be done with the collagen -- but that's why we practice physical therapy! Love to hear your thoughts and maybe some of your clients' responses to collagen. If you like what you see here then know there is more in our 3 board-approved continuing education courses on Nutrition specific for Physical Therapists. Enroll today in our new bundled course offering and save 20%, a value of $60! Earn CEUs in most states for PTs! Want to learn in person? Attend a #manualtherapyparty! Check out our course calendar below! Learn more online - new online discussion group included! Want an approach that enhances your existing evaluation and treatment? No commercial model gives you THE answer. You need an approach that blends the modern with the old school. NEW - Online Discussion Group Live cases webinars lecture Live Q&A over 600 videos - hundreds of techniques and more! Check out MMT Insiders Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
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Posted by on 2023-07-24
In this episode, Erson goes over a tough case of constant and flared up cervical pain with radiating complaints. What do you think of his solution? Have you ever had a similar case that responded to sustained holds better than repeated loading or traditional techniques? Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-07-17
Erson tells a story of getting back to rock climbing after a 20 year break. After a finger injury that wasn't healing, he got some totally unexpected great advice from another climber. What do you think of the solution and has anything similar ever happened to you? Untold Physio Stories is sponsored byThe Eclectic Approach Network - Check out Dr. E's all new private, non tracking and ad free network for rehab pros! It's free to join, has chat, feed, and all the features of other social networks without the creeping tracking.Check out EDGE Mobility System's Best Sellers - Something for every PT, OT, DC, MT, ATC or Fitness Minded Individual https://edgemobilitysystem.comCurv Health - Start your own Virtual Clinic Side Hustle for FREE! Create your profile in 3 minutes, set your rates, and Curv will handle the rest! From scheduling to payments, messaging, charting, and a full exercise library that allow for patient/clinician tracking, it's never been easier! Click to join Dr. E's new Virtual Clinic Collective to help promote best online practices. Keeping it Eclectic... This article was originally posted on Modern Manual Therapy Blog
Posted by on 2023-07-06
The McKenzie Method assesses and classifies different types of spinal disorders through a systematic process. Healthcare professionals use a series of questions and physical tests to determine the mechanical nature of a patient's symptoms. This assessment helps classify the disorder into one of three categories: derangement, dysfunction, or postural syndrome. Derangement refers to a mechanical problem that can be reduced or eliminated through specific movements and exercises. Dysfunction involves a loss of movement or flexibility that can be improved through targeted exercises. Postural syndrome relates to pain and dysfunction caused by poor posture, which can be addressed through postural correction exercises.
The McKenzie Method utilizes a variety of exercises and techniques to treat spinal disorders. These may include specific movements and positions, such as repeated extension exercises, to alleviate symptoms and improve function. Patients are often taught how to perform these exercises independently and are encouraged to incorporate them into their daily routine. Other techniques used in the McKenzie Method may include mobilizations, which involve gentle manual therapy techniques to restore normal movement in the spine, and education on proper posture and body mechanics.
Yes, the McKenzie Method can be used for both acute and chronic spinal disorders. The method is designed to address mechanical problems in the spine, regardless of the duration of symptoms. In acute cases, the McKenzie Method can help reduce pain and inflammation, while in chronic cases, it can help improve function and manage ongoing symptoms. The specific exercises and techniques used may vary depending on the individual's condition and stage of recovery.
The McKenzie Method is generally considered safe and low-risk. However, as with any form of exercise or manual therapy, there is a potential for risks or side effects. These may include temporary increase in pain or discomfort during the initial stages of treatment, muscle soreness, or aggravation of symptoms if exercises are performed incorrectly. It is important for individuals to work with a qualified healthcare professional who is trained in the McKenzie Method to ensure proper technique and minimize the risk of adverse effects.
The effectiveness of the McKenzie Method in relieving pain and improving function in individuals with spinal disorders has been supported by research and clinical experience. Studies have shown that the method can be effective in reducing pain, improving range of motion, and enhancing functional outcomes in patients with various spinal conditions, including low back pain and neck pain. However, the effectiveness may vary depending on the individual and the specific nature of their spinal disorder. It is important for patients to work closely with their healthcare provider to develop an individualized treatment plan and monitor progress over time.
Patellar tendinopathy, also known as jumper's knee, is a common overuse injury that affects the patellar tendon. Several biomechanical factors contribute to the development of this condition. These include excessive load on the tendon, poor lower limb alignment, decreased flexibility, and muscle imbalances. Excessive load can result from activities that involve repetitive jumping or running, placing increased stress on the patellar tendon. Poor lower limb alignment, such as excessive pronation or valgus collapse, can also lead to abnormal forces being transmitted through the tendon. Decreased flexibility in the quadriceps and hamstring muscles can further contribute to the development of patellar tendinopathy. Additionally, muscle imbalances, particularly weak hip and core muscles, can alter the biomechanics of the lower limb and increase the risk of this condition. Management of patellar tendinopathy typically involves a combination of conservative treatments, such as rest, ice, and non-steroidal anti-inflammatory drugs (NSAIDs), to reduce pain and inflammation. Physical therapy is also commonly used to address the underlying biomechanical factors contributing to the condition. This may include exercises to improve lower limb alignment, stretching and strengthening of the quadriceps and hamstring muscles, and correction of muscle imbalances. In severe cases, surgical intervention may be necessary to repair the damaged tendon.
Therapists employ various techniques to address muscle imbalances in individuals with scoliosis. They may utilize exercises that target specific muscle groups, such as the erector spinae, quadratus lumborum, and obliques, to help strengthen and balance the muscles surrounding the spine. These exercises may include stretching, resistance training, and core stabilization exercises. Additionally, therapists may incorporate manual therapy techniques, such as myofascial release and trigger point therapy, to address tight or overactive muscles and promote relaxation. By addressing muscle imbalances, therapists aim to improve posture, reduce pain, and enhance overall function in individuals with scoliosis.
Cryotherapy plays a crucial role in the acute management of sports injuries by providing immediate pain relief, reducing inflammation, and promoting tissue healing. The application of cold therapy, such as ice packs or ice baths, helps to constrict blood vessels, which in turn reduces blood flow to the injured area and minimizes swelling. Additionally, cryotherapy helps to numb the affected area, thereby alleviating pain and discomfort. The cold temperature also slows down metabolic activity, which can help prevent further tissue damage and promote the healing process. Furthermore, cryotherapy has been found to have a positive impact on muscle spasms and muscle stiffness, allowing athletes to regain their range of motion more quickly. Overall, cryotherapy is an effective and widely used modality in the acute management of sports injuries due to its ability to reduce pain, inflammation, and promote tissue healing.
Proprioceptive neuromuscular facilitation (PNF) is a stretching technique used in physiotherapy that differs from other stretching techniques in several ways. Firstly, PNF involves a combination of passive stretching and isometric contractions, which helps to increase the range of motion and flexibility more effectively than other techniques. Additionally, PNF utilizes the proprioceptive system, which involves the body's ability to sense its position and movement in space, to enhance the effectiveness of the stretches. This technique also incorporates the neuromuscular system, which focuses on the relationship between the nerves and muscles, to improve muscle strength and coordination. Moreover, PNF involves specific patterns of movement and muscle activation, making it a highly targeted and individualized approach to stretching. Overall, PNF stands out from other stretching techniques in physiotherapy due to its unique combination of passive stretching, isometric contractions, utilization of the proprioceptive and neuromuscular systems, and specific movement patterns.
There are several contraindications for using electrical muscle stimulation (EMS) in rehabilitation. Firstly, individuals with pacemakers or other implanted electronic devices should not undergo EMS as it may interfere with the functioning of these devices. Additionally, EMS should not be used on areas with open wounds or skin infections, as it may exacerbate the condition or delay the healing process. People with epilepsy or a history of seizures should also avoid EMS, as it may trigger seizures or increase the risk of having one. Furthermore, individuals with certain medical conditions such as cancer, deep vein thrombosis, or peripheral vascular disease should not undergo EMS without consulting their healthcare provider, as it may worsen their condition or have adverse effects. It is important for healthcare professionals to carefully assess each patient's medical history and condition before considering the use of EMS in rehabilitation.