Many people have heard about McKenzie exercises for sciatica and low back pain. If you had been to the doctor or ER lower back pain and sciatica these exercises may help you.
What are McKenzie exercises?
Many times people have been recommended McKenzie exercises for lower back pain and sciatica. Often times they are either standing lumbar extensions or prone press ups. A common misconception is that these are the only exercises or stretches given to patients after a McKenzie evaluation. The McKenzie method by Robin McKenzie was based on a thorough history of patients problem when it started, how it began, positions or activities that make their condition worse or better followed by the clinical evaluation. A clinical evaluation is a systematic evaluation of the movements and positioning of the patient to determine if the movement or posture can reduce or eliminate their back pain or sciatica. Our goal after evaluation is to give you one exercise to be performed on your own. We're showing you the ones that are most commonly given out patients clinic.
Anatomy of the lower back structures
We discussed the anatomy of lower back or lumbar region and the various structures including the intervertebral bodies, lumbar disc segments, sciatic nerve, intervertebral foramen. We discussed how the the bundle of nerve roots off the lower lumbar spine that come togehter to make up the sciatic nerve. In addition, we discussed how lower back pain and sciatica are simply descriptive terms but don't tell us truly what structures are affected. In that region disc abnormalities, arthritis, disc degeneration, bone supurs, facet arthritis are thought to pinch structure in the lower back and along the sciatic nerve region causing pain,tingling, numbness, weakness, muscle spasms into the back and lower extremities.
Chapters
0:00 Start of Video
0:27 What is a McKenzie Exercise (or McKenzie Method)
1:24 Understanding what the diagnoses of Low Back Pain or Sciatica
2:23 Anatomy of Lumbar Spine
4:50 Are these exercises safe? Centralization and Peripheralization
7:13 Understanding "red flags" is critical to safety
8:39 Start of Exercises
How can be sure I'm doing them safely or they are appropriate for my sciatica and low back pain?
We instruct patients to follow the rules of Central versus Peripheralization when beginning these exercises. Centralization means pain moves up the extremity and toward the center of the spine which is where we feel it is originating from. Even if the pain becomes more intense, as long as it moves up the extremity and toward the center of the spine it is centralizing. Peripheralization means pain moves further away from the lumbar spine or down the lower extremity. In some cases the patients may have only leg pain and upon performing these stretches they may develop as the lower back that may not have been present initially. It is very common for patients to experience pain while performing these stretches and only if is worse upon completion do we know these stretches for the lower back are "good" or "bad" for your own sciatica and low back pain.
Understanding Red Flags
Before we you begin these exercises it is important that if you are experiencing "red flags" such as: progressive weakness in the lower extremities, changes in bowel and bladder, saddle anesthesia, balance problems, fever, sudden weight loss or recent trauma you may need to see a doctor prior to starting to ensure you don't have a more serious condition.
See video in links for title See your doctor NOW! (BACK PAIN). Understand red flags for lower back pain for a more detailed explanation.
Here are the types of McKenzie exercises:
Standing Lumbar Extensions
Prone Prop with and without pillow support
Prone pressups with and without offset
Static props for time
All these exercises should be performed 10 times every two hours for about five sessions a day. After five days you should expect to see an improvement in your ability to move easier with less pain. If your condition is worsening you should stop doing these exercises immediately.
For a physical therapy consultation, wellness evaluation or hire Tom to speak at your next event email us at tomw@apexorthopedicnj.com
Check out our Free 12 Tips to Ease Back Pain by opening this link at
To you moving better! Have a great day!
Tom
DISCLAIMER: If you're experiencing pain, numbness, or tingling down into your arm or hand, or any of these exercises are making your condition worse I strongly encourage you to go get it checked out by a local doctor or physical therapist. The exercises I present in this video are very general and may of may not be indicated for your specific problem. You are encouraged to seek local help from a professional who can recommend treatment specific to your individual needs
I hope everyone has a better understanding of the McKenzie Method. In this video we show our most commonly used exercises for low back pain and sciatica and how to safely perform them. Please like or subscribe if this helped you out! #mckenzieexercises
Thank you for this at the minute I can’t do the laying on tummy and raising up I’m in agonizing pain had an MRI and showed bulging discs hitting of my sciatica nerve I have it 4 weeks now I’m doing sitting exercises but hopefully when I’m able I will be doing these, thank you 👍 I can’t even go to bed
@LOVE great to hear!
@LOVE I thought the pain was supposed to leave the lower extremities and localize finally in the back before it completely goes away. The pain should leave the foot first (if it’s there), then the lower leg, knees, thighs, buttocks, then finally the back in that order.
Hello! I believe I have sciatica and am trying to do these stretches. However my spine is fused from T6-L3. So doing the full push up may not be doable/okay for me to do. Do you have a suggestion of an alternate stretch? Is there anything in this video I should avoid doing?
With that type of surgery you may would benefit from a physical therapist evaluation to ensure the exercise are appropriate. Best of luck!
Great videos, thank you! I learned from your other video that I’m likely not extending enough when doing my press ups. I’m 2 months in to fixing an 8mm herniation on l4-l5 and I think my lack of extending is causing some of my delay in getting the pain out of my leg. How long should I expect it to take to heal from a herniation to where there’s no pain in walking and no pain down the leg? Also, do you do telehealth visits?
You may get relief within the next month. I do telehealth visits if you’re in New Jersey
Hi, I have numbness/pins and needles in my heel basically constantly (unless I’m walking) and close to both sides of the malleoli occasionally. As a PT student I could rule out piriformis, but disc issues aren’t confirmed by MRI yet. If I do a lateral hip shift I kind of feel like the pain in the foot and numbness goes a bit better, but suddenly feel very slight pain in my glut. med/min region. Does that qualify as centralization? Thanks
I would consider centralization if it remained in the buttock if you no longer have heel pain. To confirm you may have to do this for at least 10-20 reps for it to show a true pattern.
@Apex Orthopedic Rehabilitation Thank you a lot! I haven’t found a specific pattern yet. The numbness is still there and I barely have pain in general, if at all only few seconds (the numbness just seldomly goes away daily). I am doing 13-15 reps every 2 hours right now. The glute area feels very good after the excercises and I think the numbness in the heel is slightly less, but I am not sure. Is it common to mainly/only have numbness with less/low pain in disc issues? Sorry for the follow up questions.
This is very easy for me to practice
.Thanks for the Education.l will surely practice this always. I pray it will relieve my back pain that is preventing me in walking a distance..Despite the fact that I have done hip replacement
Thank you very much l appreciate
@Funmi Okunaiya Good luck and keep me posted
@Funmi Okunaiya zooooo
What exercise is suitable to me since I am experiencing pain between my but and thighs going down to the calves
@Apex Orthopedic Rehabilitation hi just letting you know I’m doing well I did go through agonising pain for months I could do nothing I couldn’t go to bed atall I had to sit on a hard kitchen chair the pain was unbearable I kept doing the sitting exercises and the helped me so much I’m doing the laying ones now everyday and I will always keep doing them, thank you again 👍
@Tina Quinn great to hear!
Okay, I read a bit and understand that you are contracting the superior side of the disc and stretching the anterior. Do these exercises also stretch surrounding muscles and tissue in a beneficial manner? I’m just trying to understand how the exercises improve symptoms and overall condition?
The theory is the disc material moves more In the center of the desk and off the nerve roots.
There has been certain cadaver models that have shown us this. Ultimately they should be an improvement in your range of motion and movements. Your condition should never worsen. If it does it’s the wrong exercise
Thanks for sharing this! I’m a 3rd yr Physical Therapist student and I really need to perform this exercise infront of my prof 🥺💗
Good luck!
When you do one of the last exercises where you hold the stretch (supported by ball or pillow) which muscles are stretched in the back? I’m so curious because I just finished PT and forgot to ask.
You are stretching many of the abdominal muscles, hip flexors in the front and compressing many structures in the back such as the disc and facets.
@Apex Orthopedic Rehabilitation thank you so much! Always curious as a nurse!
good to know there are exercises like this, i have sciatica problem and getting the lower legs are getting bad. Is there a video for arms thats hard to raise up esp in dressing up?
Do you mean you have a form of sciatica in the arms?
@Apex Orthopedic Rehabilitation I have osteoarthritis, would THESE exercises help me.?
@Cecilia Hink they may help but if you need modifications you may need guidance from a therapist.
Thanks for the video, it helped clarify things. In regards to peripheralization: I notice that the sciatic pain I have in the morning that occurs from hip to knee decreases significantly through the day when I decompress and perform these exercises, to the point it is hardly noticeable if I don’t “look for it” by doing something like rounding my back or sitting with poor posture. However, I notice mild pain in my calf, and sometimes through the leg when I perform a Valsalva maneuver by breathing deeply and bracing my midsection. What exercises or steps should one take after peripheralization?
If you no longer have a significant valsalva and full relativity painfree motion in the morning then I would test. Flexion in lying . If symptoms return then you are not ready and need to continue with the extensions. When Patients do it on their own I typically recommend one or two weeks prior to starting this phase called recovery of function
@Apex Orthopedic Rehabilitation Thank you so much!
Thank you for the video. I’m going to try these right now. I have been in pain for almost 2 months now and have had one PT session. I’m having a real hard time in the morning, can barely walk to the bathroom. Unbearable pain. After about an hour the pain is more manageable . I’ve been doing the other exercises the Physical Therapist has me doing. Do you think it would benefit me to go to chiropractor?
I would stay with one practitioner at a time.
Can this be helpful for a lumbar strain? I was diagnosed with a severe lumbar strain that’s lasted 6 months. Thanks!
It can but listen to the precautions we explained in the video.
Good evening Doc,i was diagnosed with a slip disc since July of last year.The pain in my lower back is not too bad now.Thanks to my physiotherapy.But i have terrible nerves pain in my left lower leg,starting a few inches away from my knee,going close to the ankle.Which is the best exercise for me?Because of my work schedule i am unable to go to therapy anymore.I have to stand up for long periods at my job.When i gets home i am in terrible pain.
Hey guys thanks for the video been doing this method for around 3 weeks with some relief finally is there a time when I should stop doing the stretches? As I didn’t today and haven’t had any pain 😍
Hi, like your video! Am checking it out for my husband who has pain in the right butt area, with low back pain. When he sits for long – behind the wheel of extended sitting posture. But right now doesn’t radiate to thigh and calf. Would these exercises help?
It may . You have to try them.
Me
When I perform my McKenzie standing exercises I like pressing my knuckles of both hands directly on my lower spine, as if pushing it forward while arching backwards, instead of just placing my hands on the sides as in the video.
About the same movement. Should be fine
@Apex Orthopedic Rehabilitation yes, I feel more relief and support. Sometimes I do the standing McKenzie by standing on my feet together, instead of shoulder wide separated, and I can feel a nice “relief click” on my sacro iliac lower spine section
Yes
These Mckenzie exercises help me with scaticia nerve running down my butt down one leg.If it help me to walk,which had problems could help anyone who suffered this dread pain.
6:40 when I do the mckenzie prone up, my pain gets worse in my feet + tingling.. So what should I do then? I know you should stop, but what should you do then? I have been waiting for a year, but looking for the best excercise.
What was the best exercise to heal it for you? Because I also have tingling in my feet / pain for months now…
I just did this for a few reps and already feel better.
Great to hear Gwen!
Hi , is you cured ?
I am got the same problem 😩
5-6 mm disc hernia l4 l5
@adam ek hey! I hope you start feeling better. I did the Makenzie method press ups with a practitioner, but basically it was 5-7 times a day I’d do 15 or so pressups. I then started integrating more forward movement, which helped once I had some relief from pressups. I’d recommend finding a good PT that can help guide you.
Thanks for the tips & exercises! I’ve had a spinal fusion of L4,5 due to bulging discs pinching my sciatica! It’s almost been 3 years & im still having pain. I’m going to try your exercises & will let you know if they help. I recently started working after 12 years of not. It’s been so painful to be on my feet for 4 hours!
I look forward to more videos!
Sincerely, Melissa
Where would you advise to go after this with regards to exercise, once the back pain has gone? 🙂