McKenzie Exercises for the Neck

By KEITH STRANGE

Overview
The McKenzie rehabilitation method is a physical therapy methodology that teaches patients exercises to help manage pain that originates in the spine, according to Wellness.com. It is also effective at treating chronic neck pain that is caused by long-term force in one direction by helping to restore range of motion in your neck. You should always check with your doctor before starting any rehabilitative exercise program.

Lying Neck Stretch
This exercise is performed while lying on your stomach and can be effective at helping alleviate neck pain caused by stiffness. Lie down on your stomach with both arms relaxed at your sides and your head turned to one side. Relax and allow your body weight to stretch your neck in the direction your head is turned. Steps Physiotherapy recommends you hold this position for five to 10 minutes and perform this exercise several times throughout the day.

Chin Tuck
The McKenzie chin tuck, or head retraction, can be performed either from a sitting or standing position and can help lengthen the upper spine, according to Dr. Shane Mangrum. It is performed by keeping your eyes focused on something in front of your and pulling your head back toward your shoulders, while keeping your head as stationary as possible. On the website, BackExerciseDoctor.com, Mangrum suggests you perform the chin tuck multiple times daily to help alleviate neck pain.

Neck Mobility Exercises
These exercises can be performed from either a standing or sitting position, and include range of motion activities for your neck. Stand or sit with your mouth closed and your eyes facing forward. Begin by moving your neck to one side with your eyes still facing forward and hold this movement as prescribed by your doctor. Repeat on the other side. Follow these exercises by turning your head slowly to one side, then the other, using slow and controlled motions. Repeat these exercises as directed by your physician.

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Knee Pain? Solution: Work your glutes.

Many of us will experience different degrees of knee pain at least once in our lifetime. Factors that can affect the level of knee pain include: faulty movement patterns, muscle force and/or length, posture/alignment and physical activity (occupational, recreational, self-care activities). Many health practitioners choose to treat just the symptoms of knee pain; using modalities such as kineseotape, medication, ultrasound, and inconsistent massage which offer short term relief. To treat the underlying mechanisms of knee dysfunction it is prudent to include: therapeutic exercises to strengthen the glute maximus/medius muscles; self myofascial release with foam roller of quadriceps, hip flexors and gastrocnemius/soleus complex; corrective exercise to improve faulty movement patterns; and manual therapy such as joint mobilization.

After taking a continuing education course on Functional Biomechanics of the Lower Quarter taught by Christopher Powers, PhD, PT and Co-Director of Musculoskeletal Biomechanics Laboratory at U.S.C., I realized the relationship between hip/glute weakness and knee pain. Hip motions that can influence the knee are femoral internal rotation and adduction. These motions if unchecked by strong glute maximus/medius muscles will cause a Genu Valgus (knocked knee) stress on the knee complex. This hip extensor/abductor weakness combined with quadriceps overuse will cause increased patella-femoral joint reaction forces and thus knee pain.

Many personal trainers and even physical therapist would incorrectly treat knee pain with numerous quadriceps strengthening exercises, but this inherently leads to more quadriceps overuse and thus no significant improvement in knee symptoms. Therapeutic exercises to strengthen glute maximus/medius include: bridging, sidelying hip abduction with external rot/extension, quadruped hip motions, single leg stance activities with progression to functional/dynamic movements that require hip/knee stability.

Physical Therapy or Chiropractic, how do you choose?

If you are in pain from a recent injury or chronic condition, how do you decide which healthcare professional will get you the best results and help you manage your symptoms independently. Below are vision and mission statements of both the American Chiropractic Association (ACA) and the American Physical Therapy Association (APTA). Both professions tout: collaborating with other health care practitioners; promoting change in public policy and legislature, giving the most value per health dollars spent on care; and access equity for the consumer.

The APTA Vision Statement however distinguishes itself by establishing what will be the primary guiding system used to achieve results (The Movement System) and focusing on Consumer-centricity (Patient/client/consumer values and goals will be central to all efforts in which the physical therapy profession will engage). The ACA’s mission statement as read below would seem to be more concerned with protecting the chiropractic profession, changing legislature and promoting the growth of chiropractic care. There is little mention of what type of system will be used to achieve optimal outcomes or mention of how a patient’s specific goals will be incorporated into an individualized plan of care.  

ACA’s Mission: The ACA is a professional organization representing Doctors of Chiropractic. Its mission is to preserve, protect, improve and promote the chiropractic profession and the services of Doctors of Chiropractic for the benefit of patients they serve. The purpose of the ACA is to provide leadership in health care and a positive vision for the chiropractic profession and its natural approach to health and wellness. On behalf of the chiropractic profession, we accomplish our mission and purpose by affecting public policy and legislation, by promoting high standards in professional ethics and quality of treatment and by carrying out a dynamic strategic plan to help ensure the professional growth and success of Doctors of Chiropractic. (please go to www.acatoday.org for a complete statement).

Vision Statement for the Physical Therapy Profession: Transforming society by optimizing movement to improve the human experience. Guiding Principles to Achieve the Vision: the following principles are condensed (please go to www.apta.org/Vision/ for a complete statement).

Identity. The physical therapy profession will define and promote the movement system as the foundation for optimizing movement to improve the health of society. Quality.  Collaboration.  Value. Innovation.  Consumer-centricity (as stated above). Access/Equity. Advocacy. 

Lastly, in my over fourteen year experience as a physical therapist I believe the defining difference in ‘Chiro’ and ‘PT’ is that physical therapist from day one of treatment give our patients self-management tools to assist in treating their own symptoms/pain to include extensive home exercise programs. Our primary goal as physical therapist is to assist a patient in restoring, maintaining and enhancing their own health.

For more information or education on physical therapy and rehabilitation please contact:

Greg Sterner, Board Certified Orthopedic Clinical Specialist in Physical Therapy, Owner

San Diego Sports Physical Therapy

2750 Dewey Rd. Ste 101

San Diego, CA 92106