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McKenzie Method vs. this one?

MBE
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McKenzie Method vs. this one?

I have seen a physical therapist who advocates bending backward from a prone position, like doing a push up, but keeping the legs and pelvis area down on the floor(he calls them "press ups".  Ithink it is part of the "McKenzie Method." I got relief from this in the past, but it's not helping much now that I work at a computer all day long. My problem is lower back pain, sometimes light pain going down the right side of my leg, but primarily mid-back pain from too many years writing at a computer.  How does this stretchsitting, etc., compare to McKenzie?

Esther Gokhale's picture
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That's like asking how does digging with a jack hammer compare with archeology! Here are some differences:

  1. Rationale. The justification for the Mckenzie approach (from the introduction to his book) is that McKenzie once had a back pain patient go into a room with V-shaped platform, MacKenzie got caught up with an office task, the patient lay face down on the platform/bed, McKenzie has horrified to see this when he returned, the patient surprisingly improved. Based on this incident all back pain patients are encouraged to bend their spines backwards! The rationale for the Gokhale Method is that whole populations have J-shaped spines and bend, stand, walk, etc. in ways that are different from how we in modern industrial societies conduct our bodies; these populations have significant lower incidences of musculoskeletal problems.
  2. Multitude of techniques. As far as I can tell the McKenzie Method is mainly a few variations on press-ups. The Gokhale Method revisits the way you sit, lie, stand, bend, exercise, walk, carry, etc.
  3. Who benefits. I think the McKenzie-style press-ups can be useful for people who have diminished L5-S1 curvature and are stiff enough higher up in the lumbar spine that they are protected from arching/swaying as they do press-ups. I see this pattern in a few older people who over the years have developed some protective stiffness. For people without stiffness in the upper lumbar spine or knowledge and strength to avoid swaying the upper lumbar spine, I consider the McKenzie Method to be counterproductive. For (the many) people who habitually sway their backs and have compression issues related to swaying, I consider the McKenzie Method dangerous. The Gokhale Method will benefit anyone, old or young, stiff or flexible, in pain or not. If done as recommended, there is no downside to the approach.
  4. Time taken from daily life. McKenzie, like almost all approaches out there, is a matter of taking time out of your life to do exercises that few consider interesting or fun. Compliance is often (understandably) a problem. The Gokhale Method, once learned, takes no time. We sit, stand, bend, walk, etc. as part of our lives and this approach helps you edit the way you do these everyday activities. To figure out why the McKenzie Method worked in the past for you and not this time, I would need more information. Keep in mind that most acute back pain resolves on its own. It's the pain from cumulative damage that is a bigger problem. Years of sitting poorly at a computer doesn't help anybody. Sounds like it is time to revisit those habits and not just look for a press up or a pill to mask the problem. Maybe you want to present your PT with a copy of 8 Steps so they can support you better?
MBE
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Wow, what a thorough response, and SO fast! I just cataloged the "8 steps" book for the library I work for, and am impressed by its concepts as well as this forum.  Question: Does the stretchsit cushion really make it easier to learn to stretchsit?  I seem to be able to lengthen my lower spine but am having trouble "getting" how to hitch my upper back to the backrest. Will the cushion really help?
Esther Gokhale's picture
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You need a backrest that juts out enough to give you a place to hitch to. It also needs to be somewhat firm and have some friction or it will let you down. I think the Stretchsit cushion is fantastic. I'm biased, of course, having spent two years designing it. Most poeple who try it are very happy with it. It fills a gap in modern chairs, thus circumventing the need to throw away old chairs. Most chairs, with the Stretchsit cushion, become decent chairs.
Nancy
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I went to PT after injuring my back and they had me doing the McKenzie method.  Being the dedicated patient I faithfully did the exercises.  I started having pain in my upper back and neck and also much pain in my lower back.  It did, however, seem to relieve my sciatica symptoms.  When I asked the PT about the other pain, her response was that I was not flexible enough and that I needed to keep doing the MacKenzie method to gain that flexibility.  I had much more success after visiting a chiropractor and adopting the 8-Steps method, and doing the exercises in the back of the book.  I haven't been back to the chiropractor in over a year and am doing pretty well managing my symptoms. 

Patrick
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Interesting I attended a course teaching this method to chiropractors. To be fair it isn't just about extension (arching). Depending on examination findings and history, flexion (bending forward) exercises may be prescribed instead. Having said that the instructor said, kind of off the record, that if extension doesn't improve the patient or makes them worse, try flexion and vice-versa! Also, I agree with Esther the Gokhale method has more to offer, because posture during activities of daily life are targeted, which are usually the source of the trouble.
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12/15/2013 - 1:49pm

I'm currently in PT doing McKenzie program for possible ? lumber disc issues ( dx by PT) 

The chiropractor is certain the sciatica is related to a tight piriformis.  I get relief with adjustments.

IN the meantime, my friend loaned me the stretchsit cushion.

Of all the 3 interventions, the cushion by far brings relief.  While in use it is giving me feedback about my posture and helping me to tighten weak abdominals and rearranging and relaxing gluteal muscles.  It feels wonderful to sit up straight.

I will see over time if the sciatica decreases. I'm inclined to curtail PT and move forward with chiropractor and readi 8 Steps to Pain Free Back.  

 

azeleniak
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Hello,

I have a question about press-ups.  I had an L5/S1 herniation that caused some motor and sensory loss.  I started with a PT program that was basically spine extension.  With in a month much of the motor loss has recovered as well as the sensory.  I am on my second month of PT and I feel worse now then after the first month.  I think I may have a sway back.  Why is it dangerous to perform the press up with a sway back?  I have stopped doing the press up before reading this but am curious why.  The press-up has seemed to caused other issues not so much pain but discomfort and tingling/bussing sensations.

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