Back pain is the leading cause of disability throughout the world, according to a June 2018 article published by the Journal of Orthopaedic & Sports Physical Therapy. Prolonged postures can contribute to back pain. Many people spend long periods of time in a seated position.
Being seated promotes a flexed spinal posture which can cause intervertebral discs — little cushions between the stacked bones in your spine — to bulge outwards resulting in pain and inhibited spinal extension.
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McKenzie's exercise series is designed to encourage the displaced disc to move back into its correct position which will alleviate the pain and allow freer spinal movement.
Read more: Causes of Upper Right Back Pain
Five Stages of McKenzie Exercises
McKenzie exercises for back pain are a series of five progressive positions. If your back pain is especially acute, you may not be able to work through all five stages straight away. In this case work through as many stages as you can and only progress further as your pain subsides.
The five stages of McKenzie's exercises are prone lying, prone lying while resting on elbows, prone push-ups, progressive extension using pillows and standing extension. Numerous variations of the McKenzie sequence exist which add or remove stages according to interpretation of the original sequence.
The McKenzie Method
McKenzie's exercises are designed to reposition any displaced intervertebral discs. This is initially done by using gravity to draw the discs back into the spine and then actively to consolidate the effect of gravity. To facilitate disc movement, you must relax as much as possible when performing the exercises and maintain relaxed and even breathing for the duration of the exercise.
McKenzie exercises can be categorized as either passive or active, and the passive exercises should always be performed first.
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McKenzie Exercises: One and Two
To perform the passive stages of the McKenzie exercise sequence lie face down on an exercise mat. Place your hands on either side of your head and your forehead on the floor. If this position is uncomfortable, place a small pillow beneath your abdomen to lessen the stress on your lower back.
Remain in this position for five minutes. From this position move to stage two; rise up onto your elbows and place your forearms flat on the floor. Lift your chin slightly and hold this position for a further five minutes.
McKenzie Exercises: Three and Four
Stage three is 10 prone push-ups — sometimes referred to as cobra push-ups. Place your hands beneath your shoulders and, keeping your hips on the floor, raise your chest off the ground by pressing with your arms. Gradually increase your range of movement as the set progresses.
On completion, place a pillow beneath your chest and relax in this extended position. After a few moments, add another pillow to further increase spinal extension. If you are still comfortable, add a third and final pillow and then hold this extended position for up to 10 minutes.
McKenzie Exercises: Five
The fifth and final stage of McKenzie's exercises for lower back pain is standing spinal extensions. Stand with your feet hip-width apart and your hands on your lower back. From this position lift your chest and lean back.
Hold this position for 20 to 30 seconds before relaxing and repeating. This movement is an effective stand-alone exercise if you have been sitting for a long period of time and do not have space or time to complete the full McKenzie exercise series.
Frequency and Considerations
If your lower back pain is chronic you will benefit from performing McKenzie's series of exercises two, three or even more times a day. Morning, noon and night is a good schedule to ensure that you perform the exercises often enough for them to be beneficial.
Once your back pain is under control, you may find that performing the exercises once a day is sufficient to stop the pain from returning. If you spend an especially long time sitting down, increase the frequency of your McKenzie exercises to stop your back pain returning.
Although McKenzie's exercises can be very effective for relieving some causes of back pain; they are not a cure-all for all lumbar conditions. Make sure you get your back pain diagnosed properly before trying the McKenzie series of exercises to ensure they are appropriate for your back condition.