Stop Using the McKenzie Method for Sciatica | Here's Why

If you’re new to our channel, I am Michael Hughes. I’m the founder of Gymnazo. We’ve spent the past 14 years building a radically successful 7-figure boutique facility in San Luis Obispo, CA.. Now we are sharing our proven process for programming intentional, sustainable programs that keep your clients exercising PAIN-FREE, long-term.

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If you want to get to the root cause of Sciatica pain, don’t just use the Mckenzie Method. When it comes to sciatica treatment and sciatica pain relief, Robin Mckenzie only presents a small window into the bigger picture of what’s really happening beyond the piriformis, a herniated disc, stenosis or spondylolisthesis.

In this video, Movement Specialist and CEO of Gymnazo EDU, Michael Hghes, talks about what the Mckenzie method is lacking in its traditional physical therapy approach, strategies for programming sciatica pain relief exercises and how he helped a client find sciatica pain relief.

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#GymnazoEDU #McKenzieMethod #MovementDysfunctions

[Gymnazo]

Thanks for watching! As a trainer, are you interested in learning more about problem solving to get to the root cause of pain?

[bodyinmotionpt]

You obviously have not done very much research about the McKenzie method if you think that it doesn't ask which movements cause pain. Directional preference is a cornerstone of the McKenzie method. It is not the one-size-fits-all methodology that you are describing. This is the danger of a non-credentialed trainer or therapist claiming to have "researched" an approach that credentialed McKenzie therapists have spent years perfecting. A thorough movement exam, including repeated movements and sustained positions are used to classify back issues into categories. Mechanical pain is only one of those categories, and extension is only one of the movements used to treat patients whose exam puts them in that category. The statement that McKenzie is all about extension exercises is completely false and harmful to people who are in pain and looking for help for their condition.

[steverobertson]

Wow, for me, a big portion of the frustration of having sciatica pain is how CONFUSING treatment methods are online. Everywhere I look I see videos saying "do THIS, not THAT", then more videos saying " no no, dont do THAT, do THIS". Its exhausting and confusing. I feel like im having to become an expert on human anatomy just to deal with my chronic pain.

[taylorkovacs]

Mckenzie method and foam rolling worked for me.
Sciatica for 2 years. I had a herniated disc. Worst pain ive ever experienced. PT and spinal injections. Consistently tried anything and everything I could find.
Nothing was better for my situation than the mckenzie method and foam rolling.
I'm not saying you're wrong. Just putting my experience out there. 😊

[noahhass]

The McKenzie Method is just a named technique for progressive end-range loading. What you have described in this video "Case study" is just end-range loading while standing, something that is included in the McKenzie diagnostic criteria. If the affected leg is behind and the hip is extended, then you have also extended the spine. Just like in the McKenzie method. the main mechanism of action in the McKenzie method is desensitization and inhibition of pain pathways from the thalamus. Look up pain gate pathway mechanisms, and you will find that is all you are doing. In short, you are rubbing a stubbed toe or rubbing your elbow after hitting your "funny bone" of something. Your "Chain reaction biomechanics" will have no significant improvement compared to seeing a musculoskeletal healthcare provider. I suggest you read peer-reviewed literature prior to making many false statements.

[biaedwards]

Very helpful explanation of the overall mechanism - and focus on the causes.

[sigalfamily]

Mackenzie works for me. But there’s no one size fits all for sciatica/herniated disc.

[nickp]

I appreciate the thought process my friend! Just wanted to mention this is pretty standard how all therapists should work. Mckenzie method is great, but its about simply finding methods to ease ones pain. Extension is great, and often needed for many individuals (including myself) during flare ups, but not everyone. It simply depends on the symptoms and response. it is not a bandaid, it is allowing one to progress through an acute phase of injury to begin rebuilding and tolerating loads of daily life. After this is accomplished of course one might want to try to further understand the prevention part, and that is further allowing might be causing there issue. You found an aggravator, had an idea, tried the idea, provided relief, and leaned into it. She may have been stiff in her lumbar spine (this is an assumption), striding increases extension, increasing hip extension requires less lumbar extension, and by adding other areas of movement, required less movement in the area of soreness, allowing to walk with less symptoms. Totally fine approach.

[conniebrown]

The gentleman doth protest too much, me thinks! (My adaptation from Hamlet by William Shakespeare; it's meaning: This phrase originally used the word Lady instead of gentleman, and today this phrase is more generally used to express disbelief in the face of someone’s protestations about their innocence of something they are suspected of being guilty of, due to their words or actions, or both.) Robin McKenzie, a physiotherapist developed the McKenzie Method in the 1960's(?) and called it Mechanical Diagnosis and Therapy. The McKenzie Method is known for its "lumbar" extension exercises, but it included trunk flexion exercises, as well. The McKenzie Method was trying to update the Williams Flexion Exercise protocol, that PTs were using, at the time. As a PT, I use the McKenzie Method and it's been very good in helping myself and my patients - yes, I said it, it works. Similar to you saying the extension is useful, but not because of the lumbar extension, but because of the hip extension. I'm glad you noted the importance of hip extension, but could the McKenzie Method be helping to take the pressure off the nerve if pressure is being exerted by a bulging or herniated disc? I would say yes - it's possible. You don't want to ignore a problem that might be the main culprit, causing pain. Give it time to heal - 8 weeks?, and then you will have other problems develop (if they hadn't been there before - musculoskeletal problems and nerve entrapment, too. Interesting, you showed a position you had a lady be put in, and it is doing similar things that are done in McKenzie. When the patient is standing with right leg behind and left leg in front with the upper torso vertical to the floor, you are creating back extension and the internal rotation of the right leg in the back position is creating possibly a lateral shift of the spine to the right. In the McKenzie Method, if the extension (used for a disc problem) causes pain, then the patients legs are shifted left or right and do extension with legs to the side where pain is decreased. By doing toe-in of the back leg (internal rotation of the hip) on this lady, you are side-gliding the right hip laterally. In McKenzie there is a protocol to combine this with the back extension exercise in prone or standing whether you have a disc problem putting pressure on a nerve, due to a mechanical injury, wear and tear from poor posture over time, or repetitive motions. I combine the McKenzie exercises with what I have learned in the Total Motion Release (TMR) process developed by a PT - Tom Dalonzo-Baker, over 20 years ago, and he also looks at the total body to see what might be causing the problem on a musculoskeletal and nerve level - just as you show, sciatica could be caused by a neuro-musculoskeletal problem anywhere in the spine, rib cage, or in the extremities. Tom has developed exercises to help locate the culprit areas, as often one sees, you can have several bad guys, as you yourself talked about in your video. So I will give you 1 star for that. (LOL!) So please, don't poo, poo physical therapy. It makes you sound prideful, very petty, like you've been slighted somehow. You don't need to do that. Your message is good, just your presentation is poor.

[jothishkumar]

Would like to know the evidence for this approach? McKenzie proven to be more effec comparing all options!

[munja]

When i do mcenzie pres ups it make my sciatica even worse so im confused.Everybody with disc herniation cant bend forward.And i cant forward and backword .So its really misteriy for me why

[Gabi-udcq]

Hi, I've been limping for 7 years due to a bad knee and now I'm limping for the sake of limping to oversimplify my story. I've been trying to explain to at least 10 medical professionals over the years how my now uneven hips make the one good leg shorter, which alone makes me limp, nobody could see that the hip of the affected leg is higher and turned in slightly. I can see it, I can feel it, I can measure it. Your video was my missing link. This one simple exercise you showed already put my foot of the shorter leg back on the ground and I've only tried it once. I put my limping leg behind and moved my (higher) hip around carefully. I have a herniated disc at L5/S1 because of the limp and because I was left alone to work on my hips and posture and in my dispair I did... I am aware that I shouldn't force your exercise on my body right now so I'll be very gentle or postpone it altogether. But it will make me come out of the vicious circle. Thank you!

[MsZahaa]

So glad someone is finally addressing this! I've been suffering from sciatica and most of the videos just talk about those other scapegoats he mentioned! I have disc degeneration in my lumbar spine so I get alot of muscle spasms in my back which affects my sciatic nerve.

[Theclassiccarnut]

Hi, why can't it just be a nerve root issue that's being pinched in lumbar spine? How about if tightness soreness is steady regardless of movement? Mine is bilateral running classic l4-l5 pattern.

[apexmovebetter]

This does not properly described the McKenzie method and anyone who has taken a course or received a true McKenzie evaluation would understand that. I feel we should always be critical of our approach to helping patients but we should take time to understand the approach prior to dismissing it as outdated. This is a common misconception that the method relies only on extension.

[leeposton]

I apologize in advance for the long winded reply. But i just couldn't let this sit here with all the comments that feel this is actually a good video. When it bashes a method so horrible and outdated that it is in 40 countries and growing!
1. MDT is actually in 40 countries and is by far the most well studied methodology out there.
2. It consists of classes A-E, taking a certification exam and advance studies via Diploma program over a year. I can only assume none, since you are a personal trainer, you don’t qualify to even start the training. So, how this qualifies you to bash something you cannot even speak intelligently of?
3. Example: Prone lying and prone extension which is you description of MDT is only a technique used. It is not what MDT is. MDT is a classification system proven effective in actual clinical studies. You didn’t touch on Things like directional preference and Centralization, again proven indicators of correct treatment.
4. I am a McKenzie Diplomat (as well as a practicing GOATA Coach) using the system since 1999 and I can assure you, your description of what you believe MDT is, is actually laughable and as well as possibly liable. So, I will pass this on to McKenzie USA as well as McKenzie Institute International and their legal teams to see if it warrants further discussion
5. When you are describing anything that starts from the lumbar spine and or hip and talking about symptoms referring/radiating into the leg and start tying to negate the lumbar spine as a culprit before clearing it FIRST, speaks of your lack of education/knowledge on the topic. Then you talk about a tight hip flexor as a culprit. Muscles are always the symptom, never the cause.
6. I am very happy you feel you have found a way to treat something that is actually pretty easy to treat via the methods of Robin McKenzie. Robin McKenzie was a genius, as he makes me look great in the clinic every day. Thanks to him, We market ourselves and excel at treating the worst cases and preventing surgery!
7. So you have your own solution, awesome, but sure why you feel you have to bash on a treatment method that you have not taken because you don’t have the credentials. You haven’t read any studies, or your would know of it’s effectiveness. You haven’t read any of his many books or you wouldn’t describe it as prone lying/press ups.
8. Maybe treat 30, 000 patients plus, then come back with your findings and get laughed at and chastised as he was for 20 years until the world (MD’s who were threatened by him), realized he was actually right. Before you throw smoke about something you obviously have no clue about
9. By the way, the causes of Sciatica are also well documented. If you sit alot or bend alot you are at high risk for LBP. We all sit or bend 3-5000x/day. So, no amount of stretching or strengthening is going to fix that. No matter if you have a 6 pack or a 12 pack. As i have treated many elite CrossFitters who were shredded. Yet that did not prevent LBP. I have gotten folk > 50 lbs overweight pain free in 1 session, so obesity isn't the the reason. And the recurrence rate within a year is about 50-60%. However MDT training clinicians have reduced that to less than 10% recurrence rate w/ correct behavioral changes and maintenance program.
10. Side bar, Diploma Trained clinicians have been proven to be able to predict the outcomes of MRI's w/ 85-95% consistency and draw the fissure patten of a discogram with a Kappa value right at 1.0 which is phenomenal. So, I will say this again, Robin McKenzie was a genius.
I am more than happy to discuss this off line. Thanks

[Archangelsept]

🤯 I’ve been dealing with sciatica pain for a year I’ve tried everything and only epidural shots gave more freedom of movement without the pain but I can still feel that something is not right. I’ve always tried to explain to the doctors that only certain movements triggered the pain just like the lady in the video. But it was like talking to a wall medication it’s all they know but this has given me hope and I’ve always knew that I wasn’t a very flexible person so that could have been one of the root causes specially working construction.

[concepcionmolina]

Hope that O can find other method, I can not lay on my back, my shoulder also had pain .

[katrinaackerman]

I really loved the part where you described the femur moving a bit slower than the pelvis. Picturing the sequencing really helps understand what's going on inside.

[jessicaearp]

Ok how my clients have presented in this way? I think this is another tool and not something that discounts McKenzie method.. my experience with a professional spine specialist using this method was very positive. So I am super confused why we delete positive tools but rather add to it. I think all these ideas are a progression to not a dismissal of low back derangement...