The Lumbar Spine- Mechanical Diagnosis and Therapy Vol 1.pdf

The Lumbar Spine

Mechanical Diagnosis & Therapy

Volume One

Ro bin McKenzie

CNZM, OBE, FCSP (Hon), FNZSP (Hon), Dip MT

Stephen May

MA, MCS, Dip MDT, MSc

Spinal Publications New Zealand Ltd

Waikanae, New Zealand

te Lumbar Spine: Mechanical Dia�osis & Therapy

FirsL Edition first published in 1981 by Spinal Publications New Zealand Ltd

Second Edition first published in March 2003 by Spinal Publications

New Zealand Ltd

PO Box 93, Waikanae, New Zealand

Email: enquiries@spinalpublicalions.co.nz

in a retrieval system or transmitted in any form or by any means

electronic, mechanical, including photocopying, recording or otherwise,

without the prior written permission of the copyri.ght holder.

ISBN 0-9583647-6-1

Design by Next Communications

Edited by Writers' Ink

Photography by John Cheese

Illustrations by Paul Pugh

Pri.nted and bound by Astra Print

Dedication

To dearJoy, whom I love so dearly - who, through

thick and thin, has patiently allowed my obsession

to freely flow and who has never once complained

about the hours, days and months of absence in

my search for the final goal.

ivl

Foreword

When it first appeared, The Lumbar Spine was a slim edition that

announced a new concept. It postulated what might be happening

in patients with low back pain, and it provided a system ofassessment

and treatment.

Since its inception, the McKenzie system has grown into a movement.

The system captured the imagination of therapists and others, who

adopted it. Their numbers grew to form an international organisation

that offers training programmes and postgraduate degrees in several

countries around the world. The system also attracted the attention

of opponents, critics and non-aligned investigators.

Over the years, tensions have developed as the McKenzie system has

tried to keep pace with advances in spine science, but also as spine

science has tried to keep pace with advances in McKenzie. In basic

sciences, our understanding ofthe structure, function and pathology

of the lumbar intervertebral disc has increased enormously. In clinical

sciences, the advent of evidence-based medicine has demanded that

interventions have evidence of reliability, validity and efficacy. These

developments have challenged the McKenzie system, but have not

threatened it. Indeed, in many respects, the McKenzie movement

has led the way in undertaking research into its precepts, and has

implicitly called upon other concepts in physical therapy to catch

up. No other system in physical therapy has attracted as much

research both from among its proponents and from its detractors.

This new edition of The Lumbar Spine has become a tome . It still

describes the original concept, albeit updated and revised, but the

edition provides students and other readers with a compendium of

all the literature pertaining to the lumbar intervertebral disc and the

massive literature that now pertains to the McKenzie system.

Readers receive an up-to-date review ofinformation on the structure

and fu nction of the disc, its pathology, and new data on its patho

biomechanics. Related entities, such a zygapophysial joint pain and

sacro-iliac joint, are comprehensively reviewed.

As befitting a text on this subject, The Lumbar Spine contains a

complete collection of all studies that have examined the McKenzie

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