The McKenzie System

The McKenzie System

The McKenzie Method (Mechanical Diagnosis and Therapy, MDT)

MDT is a system of management of spinal and musculo-skeletal disorders was developed by New Zealand physiotherapist Robin McKenzie. Mechanical Diagnosis and Therapy is a research based method of assessing and treating patients that is currently being used in over 40 countries around the world. Full documentation of the system can be obtained in Robin McKenzie’s textbooks which cover assessment and treatment of the lumbar spine, cervical spine and the extremity joints, muscles and nerves. In addition, McKenzie has written two information texts for the patient, “Treat Your Own Back” and” Treat Your Own Neck.” These books have been translated into a dozen languages and have sold over 4 million copies.

Many current literature supports the use of mechanical therapy for the spine:

  • In 2004 a paper in Spine (Does it matter which exercise? A randomized control trial of exercises for low back pain.) patients were evaluated by a certified MDT spine therapist whom determined a directional preference for movements had over 90% improvement in two weeks.
  • The exercise group moving in the opposite direction improved 20% in two weeks (large percentage of this group dropped out secondary to increase in pain) and the last group using a traditional back school program improved 40%.  There were further significant differences between the groups in back and leg pain, functional disability, and depression.
  • In 2001, a paper was presented at the International Society for the Study of the Lumbar Spine which demonstrated that patients with chronic recurrent low back pain were able to achieve significant reduction in their pain over a 5 year period. The patients had no interventions aside from reading “Treat Your Own Back”.

The McKenzie system of assessment and treatment has been extensively researched. In 1997, the Danish Health Department published a position paper on spinal pain following an extensive review of appropriately designed medical studies. They concluded that the McKenzie assessment was recommended for all spinal disorders and that the treatment principles were recommended for particular spinal conditions. For more on the research literature go to

The essence of the system is to teach the patients to treat their own mechanical musculo-skeletal problems through education and a symptom specific exercise program. Treatment is based on a partnership in rehabilitation between patient and therapist.

Example of MDT exercises for neck and shoulder pain.