McKenzie Exercise Program

by Maria Cruz Lillo Lopez
(Bristol)

Extension Exercise

Extension Exercise

I have heard of a type of exercise called the Mckenzie exercise program, based on extension of the back.I have heard is good with acute lower back pain, but also that you have to practice the exercises for about 10 times a day? I am a bit apprehensive as I work in an office full time and I don't think I would be able to practice them as much.

Would I benefit from this type of exercise if I am not strict with the number of times I practice them? Do I need to see a Physiotherapist before starting on this type of exercise? I will be very greatful if you could feed me some information on Mckenzie exercise, thank you.
sincerely,
Mari Cruz Lillo

Answer:

Hi Mari

This question has two parts:
1. Is McKenzie exercise any good for acute lower back pain
2. How often do exercises need to be done to make a difference?

To get the answer to the first part have a look at this McKenzie Exercise Program page first.

Now, if you have read that you will see that there isn’t a great deal of evidence for using this method in acute lower back pain (Machado et al. 2006) , in fact all the latest guidelines suggest that simply keeping active is better for you than any specific exercise. There is even less support for its use with chronic pain.

However, I do think that exercising the lower back is good for you and the latest guidelines support exercise as a useful way of helping to manage lower back pain after the first few weeks (Prodigy 2005).

One of the real benefits of the McKenzie exercise regime is that it requires you to regularly change your position. We know from the literature that sustained poor postures can increase the chances of you getting back pain. If you feel the exercises help with that then it is worth doing them, even if you cant manage them very often. I'm not sure where the 10 times a day comes from – there is no evidence that I know of that supports that – perhaps someone can let me know if I'm wrong!

But I don’t think just doing one thing 10 times a day is the answer. Lower back pain is usually caused by a combination of things including sustained poor postures, stiffness and/or lack of muscular support (core stability) around the spine and a lack of general physical fitness. Anxiety and worry about the problem makes it all much worse. In order to effectively manage lower back pain you have to think about all of these things.


Should you see a physiotherapist? Yes, they will help you by examining you and planning treatment based on your individual needs.

Prodigy 2005. Back pain - lower: Simple low back pain - follow-up and reassessment. http://www.cks.library.nhs.uk/back_pain_lower/

Machado, L.A.C. et al., 2006. The McKenzie method for low back pain: a systematic review of the literature with a meta-analysis approach. Spine, 31(9), p.E254-62.

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