The McKenzie Approach:

A Musculoskeletal Physiotherapy self-treatment for disc protrusions.

What is the McKenzie Approach?  

The Mckenzie Approach enables you to understand your back pain, take control and return to activity sooner.

If your pain pattern matches the criteria for the McKenzie Treatment Approach, the following advice and exercises should reduce pain and move it centrally. Leg pain should reduce. Stop the self-treatment if your leg pain worsens, spreads further into your leg, or produces pins and needles or numbness. Please phone or email me ( or Helen 93816166) if you  are unsure what to do.

Good News for Acute Back Pain

Most acute episodes of low back pain take less than weeks to regain pain free movement and return to function. Many people can be back at work within a few days.

Will I benefit from the McKenzie approach?

During my initial examination I test to see if repeated movements reduce and centralise your pain. If they do, then I show you how to self-treat at home and work. As a Specialist Physiotherapist, I choose the optimal treatment to get you better. There are many alternatives. My main aim is to reduce your fear and anxiety by helping you to understand what is happening and how you can take control. Movement and activity are vital.

What does McKenzie Treatment involve?

This approach uses frequent repetitions of relaxed extension in lying and in standing to reduce the amount of tissue being aggravated. Repeated movement of the lumbar spine aims to restore extension mobility to allow the discs, joints, ligaments, muscles and other tissues. This restores pain free function.

You can help improvement by minimising sitting or bending during the acute phase of recovery. Later you need to learn how to bend confidently again. I show you how to progress your self-treatment as your pathology improves. I then show you how to regain your confidence and the ability to curl, flex, and be active.

Lateral shift

  • If one of your hips may feel as if it is sticking out to the side, or you feel crooked, this is called a list. Your upper body moves to the side in response to the spinal irritation. When corrected, your pain should decrease or centralise. I will teach you how to perform this exercise at home.

Watch the McKenzie Exercise - YouTube

▶ 2:52

                               Repeat self-treatment exercises every 1-2 hours and after sitting x 5-10 times.

1.    Lean back with your thumbs in your low back (just above sacrum bone). Your pain should centralise or reduce.

2.    Improve Sitting to upright and tall.       

3.    Stand with a lumbar lordosis (mild arch in the low back)                        

4.    Lay on stomach (or start with pillow under stomach)

5.    Progress to prop up on elbows

6.    Full press up – sag into arch

7.    Lying supine (or pillow under knees)       

8.    Curling/flexion exercises

9.     Side shift exercise                       

Advanced exercises – Progress from Extension to curling (8) as pain reduces   

You need an accurate diagnosis and treatment plan prior to using home treatment. If McKenzie approach has helped you previously then start it immediately you suspect you may have overstrained your back.

Temporary taping your back may provide feedback to your brain to sit well. A temporary lumbar corset sometimes assists you to maintain an upright position and minimise bending and slumping in the first few days.


  • Maintain an upright position - minimise bending and slumping in the first few days.
  • Minimise flexion, or constant and prolonged physical stress in one posture, to reduce strain on repairing tissue in the first few days.
  • After symptoms settle, you need to regain the ability to curl forward and to move normally as we tend to lose resilience and motion after a pain episode.

Repeated passive extension of the spine in prone and standing is not appropriate for all back pain. Check with Helen Potter before starting.

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