McKenzie Method: The Exam
Bradley Muse 0:04
Hello everybody, Dr. Muse here with Dr. Ben Kraft. And we are going to continue to discuss the McKenzie Method, some of that we all use here at Columbus Chiropractic & Rehabilitation Center. But specifically, what we want to talk about today is what the exam actually looks like. So, oftentimes, when you go to a chiropractor, a physical therapist, a medical doctor, you name it, we deem what many people do as a condition-specific exam and treatment. And what we mean by that is, let’s use the knee as an example, if you go into whatever clinic it is, I’m not going to pick on any specific person here, but if you go in with a knee problem, oftentimes, the exam is solely focused on the area where you say your pain is, which oftentimes, is an okay thing. Let’s say like with an ACL tear, well, yes, you need to examine that knee and see if it’s compromised, but in some of these more sub-critical or sub-acute type injuries, there’s also going to be a functional compensation going on somewhere else in the body that needs to fully be examined.
Ben Kraft 1:11
And I think we talked about in the past of that there’s a significantly, or statistically significant portion of extremity problems that come from the spine. So, if we don’t do a full exam and look everywhere for the source of the problem, we could be missing it.
Bradley Muse 1:25
Right, because, oftentimes, people get caught up in the medical field, and they get treatment after treatment, the next new treatment on whatever areas that fall. But without a proper exam to begin the whole process, then, oftentimes, you’re chasing your tail. So, what the McKenzie Method exam looks like is, we deem it to be more of a patient-centered exam and treatment. So, every single person who comes in, let’s use back pain in this case, we’re going through the exam, we’re not throwing the same condition-specific therapy at that person. Some of the treatments that we use may look like and may be the same as some other people who are being treated for that, but, at the end of the day, we’re trying to take the guesswork out of the condition they’re coming in for so that we can be as specific to their complaint as possible. So, why don’t we start to talk a little bit about what does the McKinsey exam encompass?
Ben Kraft 2:15
Yeah. So, typically, it’s repetitive and range loading of a joint. And to McKenzie, there’s a dose response. So, we may go through a few movements, and then recheck. And so, if we establish a baseline is range of motion of a joint, and then we go through these exercises, and then retest it. We might use quality of the soft tissue, or their trigger points in the muscles in the area, then go through that series of exercises and recheck it because we want to see the response that we’re looking for.
Bradley Muse 2:45
Right. And what I usually tell my patients is pain’s important, that’s why most, if not, everybody comes in here, so we should probably address that. But pain is also extremely subjective. Dr. Kraft’s pain is different from mine, mine is different than the person down the hall. So, we need objective findings, kind of like what he just talked about. I need to know are things like the range of motion changing with our intervention? Are things like trigger points, hypervariable bands of tissue, are those changing? Are the joints beginning to move more fluidly? If we can change these objective things, then pain usually follows suit. So. as part of this McKinsey exam, we’re trying to figure out what the directional preference is. And we talked about this in another video so go back to the YouTube page and check that one out, but we’re trying to find a specific direction, like in the case of the low back, maybe extension is going to be the direction that reduces their symptoms. And there’s no way for us to truly know if it is the directional preference outside of using some of these audits we just talked about, and that’s where I feel a lot of medical professionals may not check their work. If we only use pain, well, we could throw a medication at somebody, and they may feel better, but we may not be changing function or what really got them into that issue in the first place. So that could just be a bandaid. We need to know if function is changing. Do the joints move better? Does the overall range of motion improve? Does the tissue tone and tenderness change? And we’re going to go back and forth, we’re going to have someone go through something like repeated extension for the low back. And then, I’m going to come right back and recheck that stuff. Maybe there’s a change, maybe there’s not, either way, it’s going to drive us in one direction or the other to continue to try to figure out this puzzle. So, the big takeaway with a McKinsey exam is this is patient-centered. And we’re checking our work consistently, we’re taking the guesswork out of this. We want to send our patients home with, preferably, one exercise to perform instead of a full packet of different exercises. And the McKenzie Method just does a great job in streamlining the whole process and giving the patient more ownership over their own issue. So, if you have any questions for us, be sure to reach out. Check out some of the other videos like I mentioned. And hope you guys took something away from this video. Thank you.