Another self-help technique for back pain – the McKenzie method

I had lots of people getting in contact after my blog earlier this week on back pain, so wanted to quickly share this additional technique that has brought relief and recovery to many. I hope that some of you find that it helps.

For a lot of people (especially runners and cyclists it seems) back pain comes and goes episodically. For most the issue is a disc bulge (most people over 25 or 30 years-old seem to have them to some level), and the disc bulge moves slightly, compressing one of the 4 key nerves at that lumbar vertebrae level and sends white-hot pain, pins & needles and/or numbness down the leg, sometimes with symptoms in the bum cheek or hip as well.

Each nerve has a role for areas of the body and internal organs. If you are interested in understanding the link between the level of the spine (which vertebra) and the body, have a look at the spinal nerve chart: https://millerchiropracticclinic.com/spinal-nerve-chart/

A lot of people have found great relief through the McKenzie method

First of all, take this simple self assessment – answering yes or no to each of the questions:

  1. Are there periods in the day when you have no pain? Even 10 minutes?
  2. Is the pain confined to areas above the knee or above your elbow?
  3. Have you had more than one episode of low back pain or neck pain over the past few months or years?
  4. Do you feel worse during or immediately after prolonged bending or stooping; as in making beds, vacuuming, gardening, concreting, etc?
  5. Do you feel worse when sitting for prolonged periods or on rising from the sitting position, ie after watching TV or working on the computer?
  6. Do you associate your pain with any one particular activity but are generally pain-free when not engaged in this activity?
  7. Do you feel worse when inactive and better when on the move?
  8. Does your low back feel better when lying face down? (You may feel worse for a minute before the pain subsides, in that case, the answer to this question is yes).
  9. Does your low back pain feel better when you are walking?

The McKenzie Institute claims that if you have answered yes to more than 4 questions, your chances of gaining benefit from the McKenzie method is very good.

They say that if you answered yes to 3 or fewer, then you may require specialised assessment and treatment.

The McKenzie method is built on gentle spinal extension exercises

The theory behind the method is that most discs bulge out backwards, and therefore gentle extension exercises encourage the disc to change shape with more of the disc-matter at the front and take the pressure off the nerve that it is compressing.

Robin McKenzie’s book ‘Treat your own back’ is inexpensive and practical – giving a do-it-yourself plan for relief of lower back pain through postural changes, ergonomics, and simple exercises. It also provides a clear understanding of the causes and treatments of persistent back pain.

One last key tip

I think that anyone who goes to a physiotherapist with back issues is given spinal extension exercises. But I am not sure that everyone talks about technique, and it is really important. If you simply move into the spinal extension, then all of the muscles in the lower back shorten as you peel up. But if you engage your abdominals (especially the deep Transversus Abdominus) and then do the back extension, then the same muscles go into extension due to the reciprocal inhibition of the muscle pairing with the abdominals. This is what you want.

Back Pain? You really need to read this book before you do anything at all!

I challenge you to find better explanations and practical advice on back pain management anywhere!

Even though the pain can be so bad that you may not be sure that you can live through it, do not panic! Back pain affects 80% of UK adults at some stage in their lifetime (and usually in mid-life) and for the great majority of them, this passes within a week. For the 10% that it lingers more than a week, the scans and the words used by consultants can seem very scary.

I remember my Dad impressing on me the importance of avoiding spinal injury when I was a kid who loved climbing, abseiling and mountain biking. He was right that the back is a complex mix of bones, tissue, and nerves that drive everything, and the challenge is that the central nervous system is not very good at healing itself (medical experts are divided on what is possible vs impossible).

And back problems are not the end of your sport. 85% of male gymnasts, 80% of weightlifters, 69% of wrestlers, 58% of soccer players, 50% of tennis players and 30% of golfers have had back problems and the large majority of them have come back to their sport – albeit, for some of them, this has taken a little time.

Crucial advice for you before you go to any health professional!

This book ‘Back Mechanic’ by Stuart McGill claims to be ‘the secrets to a healthy spine your doctor isn’t telling you’. I would suggest that every athlete with back pain needs to get it and read it cover-to-cover twice before they take any action. It is very readable and contains truly excellent explanations, evidence-based plans, and case-studies from athletes where he has led their rehabilitation.

In the ‘Back Mechanic’ book, he explains why:

  • your pain may worsen after trying physiotherapy, especially with significant manipulation
  • why you can seem to be OK and then try to do something and be knocked out for 3 days straight
  • why it makes sense if you find walking faster is less painful than dawdling
  • why you may get told that the pain is in your head (which he completely refutes)
  • why just keeping a diary of your pain levels and painkillers is not enough
  • yoga and pilates may be recommended to you but may increase your pain
  • and many more questions answered!

A structured self-assessment and practical toolbox

The mid-section of the Back Mechanic book leads you through a highly diagnostic structured self-assessment of your back pain in static and dynamic movements.

From this, you can build up basic movement tools for simple, small, pain-free movements.

Then he moves into spine hygiene so that you can expand your pain-free abilities, with further sections on building a resilient back and restoring the hips, as well as specific conditions.

Will this help me avoid surgery?

There is a whole section on avoiding surgery, and the key decision points that will lead you to build an evidence base that suggests that you may not be able to move forward without surgery.

How to recover and trust your back

Many athletes who have come back from back problems say that one of the biggest challenges is regaining confidence in your spine. The second book – ‘Ultimate Back Fitness & Performance’ (which is more expensive and you may have to order from Canada or USA) gives a really excellent guide on building up from the end of the first book into using your back in performance situations but is a longer and harder read.

In summary

The message is – do not panic, don’t rush to the Doctor yet – read the ‘Back Mechanic” book and create a plan that you believe fits with your specific symptoms and responses to the static and dynamic tests in the book. It may take some time, but a good path to take given that 40% of people after surgery have ongoing pain and often end up having second and third spinal surgeries (each with considerably lower probability of successful outcomes).