McKenzie Ds Flashcards
(19 cards)
Derangement 1
CENTRAL / SYMMETRICAL pain across L4/L5
RARELY into buttock or thigh
NO DEFORMITY
Derangement 2
CENTRAL/SYMMETRICAL pain across L4/L5
with/without buttock /thigh pain
DEFORMITY of lumbar KYPHOSIS
Derangement 3
unilateral or asymmetrical pain across L4/L5
with/without buttock /thigh pain
NO deformity
Derangement 4
Unilateral or Asymmetrical pain across L4/L5
with/without buttock /thigh pain
DEFORMITY of relevant lateral shift
how is lateral shift named?
direction of shoulders relative to pelvis
primary or relevant shift must be corrected before further mechanical treatment initiated
Derangement 5
Unilateral or Asymmetrical pain across L4/L5
with/without buttock /thigh pain
PAIN EXTEND BELOW KNEE
NO deformity
Derangement 6
Unilateral or Asymmetrical pain across L4/L5
with/without buttock /thigh pain
PAIN EXTEND BELOW KNEE
DEFORMITY of relative lateral shift
Derangement 7
SYMMETRICAL OR ASSYMETRICAL pain accross L4/L5
with/without buttock /thigh pain
DEFORMITY of accentuated lumbar LORDOSIS
Postural syndrome
(mechanical deformation of soft tissues as a result of prolonged postural stresses-pain relief with change of position or postural correction )
pain is INTERMITTENT
pain is NOT referred
no change in ROM or pain provocation with test movements or repeated movements
pain is produced by prolonged loaded posture: TIME DEPENDENT
NO CHANGE in intensity/location, immediate available ROM, c/o pain with the same motion each time
Dysfunction
Named for direction of limitation (adaptive tissue shortening-loose ROM in certain predictable directions, pain before full ROM, secondary lateral shifts)
pain is INTERMITTENT
END RANGE PAIN at end of available ROM (**except for adherent NR)
NO CHANGE in ROM immediatly seen w repeated movement (**except entrapment)
Treatment results are slow!!!!
Derrangement
pain is INTERMITTENT
END RANGE PAIN at end of available ROM (**except for adherent NR)
NO CHANGE in ROM immediately seen w repeated movement (**except entrapment), intensity and/or location of sx, c/o pain w same motion every time, immediate available ROM
Treatment results are slow!!!!
Tx postural syndrome
pt education
postural correction challenges
instructions in prevention
cores strengthening
if referred pain, neuro signs, pain repeats at specific point in the range suspect
adherent nerve root
12 weeks post herniation
reduced ROM into flexion, ROM into extension PP, increase ROM with repeated flexion, ROM can reach full range in one session, sx return without repeated flexion
entrapment
Tx dysfunction
stretch short tissues in direction of dysfunction
produce local pain, and then it should subside in 10-20 miin
may also experience new higher up in the spine across the shoulder
tx ANR
progress forces of flexion
tx entrapment
do the one most limited first and then add the others
ie flexion repeated daily followed by extension clearing
Derangement
mechanical deformation
altered position of fluid nucleus cause internal derangement –causes pain in motion segment of disc and vertebrae above and below
anatomical disruption and/or displacement of structures (disc bulge anteriorly, posteriorly, and/or laterally)
numbered 1-7
Pain can CHANGE from constant to intermittent
Signs and symptoms may CHANGE intensity, character, and location with repeated movements and/or sustained postures
Spinal movements can show rapid change in gain or loss of ROM with repeated movement and/or sustained postures
sx can be REFERRED
Neurological signs and sx may be present
demonstrates directional preference (ie flexion sx)
Demonstrates CENTRALIZATION or PRELIPHERATION
tx derangement 4 stages
- reduce derangement (start pt generated forces before PT)
- maintain reduction (sx not return for 72 hours)
- recovery of function
- prevent recurrence
