Hands off – therapy according to Mc. Kenzie
Aims and effects: test movements: The therapist teaches the patient certain test movements, which the patient performs several times in a row. The test usually starts with movements in the direction of spinal extension, as these often lead to pain relief, while bending and rotating movements are usually pain intensifiers. During the execution of the movements, changes in pain sensation and sensitivity occur very quickly, which continue even after the test movement.
Pain reduction and centralization, i.e. shifting the pain from the leg towards the spine, are the decisive criteria for continuing the test movement in a daily exercise program. – Pain reduction
- Centralization, i.e. shifting the pain from the leg to the spine
- Improvement of the mobility of the spinal column
In the prone position, the forearms are supported and the spine is straightened up to the pain threshold. In the prone position, the hands are supported and the spine is straightened up to the pain thresholdIn the supine position, the arms are crossed at the neck and the closed, angled legs are moved from right to left until the pain thresholdIn the supine position, the legs are pulled against the body and the lumbar spine is thus brought to the pain threshold In standing, the spine is carefully stretched.
in standing position the spinal column is carefully unrolled vertebra by vertebra slowly until the pain threshold is reached in flexion, when straightening up go into slight knee flexionThe test movements result in the selection of self exercises (photos/description see at test movements) for at home, depending on the patient’s reaction A maximum of one new movement per day is recommended as an extension of the home exercise programme, in order to maintain control over the possible trigger in the event of a possible worsening of symptoms. Patients are instructed to observe their symptoms and assess symptom changes. Starting positions: see test movements Exercise performance: see test movements Dosage: the recommended exercises should be performed hourly with 10 repetitions if the patient’s situation allows.
Motivation: As the decrease of symptoms during and after the exercise is visible with successful therapy, patients are easily motivated to practice continuously. Note:The continuation of the techniques and exercises is only useful if the treatment is successful. After the first 5 therapy sessions and continuous practice at home during this time, it should be assessed whether the success of the treatment is satisfactory and whether continuation of the Mc. Kenzie therapy is indicated.
