The chance encounter that changed the course of musculoskeletal medicine

Dr. Jordan Duncan

Sometimes the most important discoveries happen by accident.

This was the case of Scottish biologist Alexander Fleming, who returned from vacation to find a bluish-green mold growing around the bacteria in his Petri dish. After leaving the mold open, he not only found the mold, but also discovered that it secreted a substance that inhibited the growth of the bacteria. This eventually led to the development of the antibiotic penicillin.

A similar chance encounter changed the course of musculoskeletal medicine.

It happened on Wednesday, 1956, when a young New Zealand physiotherapist, Robin McKenzie, was treating a patient. In particular, a male patient known as Mr. Smith was scheduled for that afternoon. For the past three weeks, Robin has been treating pain in his lower back on Mr. Smith’s right side. Despite the use of conventional treatments at the time, Mr. Smith’s symptoms did not improve at all.

When Mr. Smith arrived for his appointment, Robin asked him to lie face down on the treatment table in the next room. It was up to 45 degrees. Instead of lowering the table, Mr. Smith did as Robin instructed. The position he found himself in was a sharp lift of his torso relative to his lower body, called spinal extension.

About five minutes later, Robin Mackenzie knocked on the door and entered the room, seeing Mr. Smith and instantly froze. It was intended to damage the

Robin’s terror continued until she asked Mr. Smith how he was doing, at which point Mr. Smith exclaimed that he felt the best he had felt in three weeks. All the pain in his leg was gone, leaving only the pain in his mid-back. Additionally, when Robin got Mr. Smith to get up off the table, his range of motion was much better. Robin asked Mr. Smith to come back the next day and repeat the same “treatment”, and after lying in this stretched position again, Mr. Smith’s remaining back pain was gone.

Following this discovery, Robin began giving back pain patients the same extension position. He found that quite a few got better, some got worse, and others stayed the same. It has been found to be more effective for many people than

Over time, he found that people who either did worse or didn’t change with spinal extension did better with movement or repositioning in other directions. I discovered that some people take longer to recover, and how to tell the difference between these groups.

As he continued his inquiry, some patterns began to emerge regarding how patients’ symptoms and range of motion responded to these movements and positions. and was essential in understanding what was needed to fix it.

Over the decades, a unique clinical evaluation process has emerged known as the Mackenzie Method or Mechanical Diagnosis and Treatment (MDT). Through this assessment, it has become possible to identify distinct syndromes, each requiring specific management strategies. Treatment was most often in the form of highly precise movements tailored to the patient’s condition, allowing self-treatment and allowing future relapses to be managed or prevented.

And it didn’t just stop at the waist. Robin found that these same patterns were also present in the joints of the neck and mid-back and extremities. Most cases of musculoskeletal pain of the spine and extremity joints can be classified as MDT syndrome.

With the help of countless people who followed in Robin’s footsteps, the Mackenzie Method eventually grew into a world-class institute, providing postgraduate education to physical therapists, chiropractors, physicians, and other medical professionals. did. This method has been extensively studied and has demonstrated good reliability and efficacy in well-trained clinicians.

Studies have also shown that identification of MDT syndrome allows for more accurate diagnosis and management strategies compared to traditional surveillance methods, which tend to have high false-positive and false-negative rates.

When talking about MDT’s ability to diagnose disc problems in the spine, Dr. Charles Aprill, a noted radiologist and researcher, was known to say: of dollars for equipment (such as an MRI). “

Those whose care centers around the McKenzie Technique tend to have better results and require less invasive procedures. have been shown to reduce surgery by 78%, injections by 39%, MRI by 49%, and total cost by 51%.

For this reason, the Mackenzie Act has motivated surgeons and other medical professionals to think outside the box. MDT is now used in major hospitals around the world, including Midwest Orthopedics in Rush, Chicago and Midwest Orthopedics in Rugpoli, Europe, to help select or exclude patients for surgery or other invasive procedures. increase.

A Fortune 500 self-insurer has also contracted a provider specializing in the Mackenzie Method due to its high reliability and superior results to reduce musculoskeletal costs while providing better care to its employees. We are starting to offer.

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