McKenzie Exercises for Back Pain

McKenzie exercises are effective for reducing your back pain especially if it has been traveling down your leg.  People with back pain lasting more than 3 months are good candidates for McKenzie exercises.  Based on the latest research, the McKenzie Method of treating back pain is equally effective to other approaches.  This includes manual therapy and stabilization or strengthening exercise.  The key is to identify the right exercises for you to perform.  There is no one-size-fits-all approach for managing back pain.

What are McKenzie Exercises?

Actually there are no specific exercises which are unique to the McKenzie Method.  Robin McKenzie was a physical therapist from New Zealand who popularized his approach to assessing people with back pain.  His approach is more about how to assess a person with back pain, not special exercises.  The McKenzie Method of assessment and treatment is based on several key principles.  These are the principles your physical therapist utilizes when evaluating you on your first day.  Here is a very brief explanation of 3 of those principles:

  1. End-range movements. Exercises are performed through a full range of motion.  This may include exercising with some back pain.  The key is that each movement is performed through an increasing range of motion provided the appropriate response is occurring (see principle #3 below).
  2. Repeated movements. Once the correct exercise is identified, it is repeated often.  Multiple sets of 10 or more repetitions are performed several times per day.  Sometimes we recommend the exercise be performed every hour during the day. Most exercises are performed in and out of the range of movement instead of holding each stretch.
  3. Centralization. This refers to the location of pain you experience during and after the exercise.  In simple terms, you want your pain to decrease in your leg even if it increases in your back.  Pain traveling down your leg is a sign of a longer recovery.  You want the pain out of your leg as soon as possible.  Identifying the right exercise to alleviate your leg pain first is the responsibility of your physical therapist.

McKenzie exercises

Which Exercises are Right for You?

The 3 principles described above, help your physical therapist identify the right exercise approach for you.  The most important principle is that of centralization.  It is very important that your leg pain does not worsen during or immediately after performing your exercises.  Sometimes, your back pain gets a little worse as your leg pain gets better.  This is a sign of improvement.  However, if your back feels better and your leg feels worse, you are not on the right track.  Below are several common exercises we prescribe to help alleviate leg and back pain.

Flexion Exercises

If sitting or bending forward alleviates your pain, flexion exercises might be best for you.  Your physical therapist will conduct an examination to confirm whether or not these are the right exercises.  For flexion in sitting, position yourself close to the edge of chair.  Spread your knees apart.  Relax your back and slowly bend forward towards the floor.  Do not bounce or force the movement.  With each repetition, try to move closer and closer to the floor.  If you can touch the floor easily, try to reach behind you.  Remember, you do not want pain to increase or spread down your leg.  Perform 10 repetitions several times per day.

Extension Exercises

If walking or leaning backwards alleviates your pain, extension exercise might be best for you.  Your physical therapist will conduct an examination to confirm whether or not these are the right exercises.  The most effective extension exercise is performed in the lying position.  Your arms do all the work.  Your back remains relaxed.  With each repetition, try to move further and further.  Remember, you do not want pain to increase or spread down your leg.  Pain in your back is okay. Perform 10 repetitions several times per day.

Shift Correction Exercises


If you look or feel crooked, you may have a lateral shift.  Usually, people shift their shoulders away from the side of their back pain.  It is important to correct any shift before commencing with extension or flexion exercises.  This can be tricky.  It typically requires careful examination by your physical therapist.  The standing side glide is one exercise that is effective for correcting a shifted posture.  Start very gently and remember you do not want pain traveling down your leg.  Start with 10 repetitions several times per day.

Keys to Success with McKenzie Exercises

If you are struggling with back and leg pain, try these exercises.  Do any of these exercises feel good?  More importantly, do any alleviate or decrease your leg pain.  If so, continue with them.  Any movement or exercise which causes pain to spread down your leg is not right for you.  It is best to have your physical therapist examine you before starting.  This way you can avoid any unnecessary increase in pain.  If you would like some help, call your physical therapist to schedule an appointment.  We are here to help you move pain free.

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