MacKenzie Protocols
Robin McKenzie developed this system of diagnosis and functional evaluation of joint and soft tissue conditions to provide a framework for meaningful intervention with manual therapy, self-treatment, daily activity modifications, and to provide an appropriate framework for rehabilitative exercise and gradual reintroduction of normal movement. This system is famous for working with lower back and disc problems, but can be effectively applied to any joint or soft tissue in the musculoskeletal system.
Mulligan Concept
Brian Mulligan
developed this unique and special approach to joint, muscle, and neurological problems in which the practitioner is guided to diagnose and treat dysfunctions that tend to arise and create pain, or disorientation within certain positions and/or movements. The joint or muscle is gently repositioned, and while supported, the movement is performed again and checked for improved range and/or quality of movement, and the diminuition of pain or neurological symptoms. If the position is curative, the movement may be repeated several times to re-teach the pattern and condition the tissues. To insure the condition fully resolves, a home exercise routine may be prescribed that reenforces this improved function, and is actually a “self treatment” version of this corrective movement. The gamut of conditions that are effectively treated with this approach range from plantar fasciitis to disc problems, tennis elbow to vertigo, to chronic pain.
Mulligan was introduced to the field of manual therapy by Stanley Paris in the early 1960s, mentored by Freddy Kaltenborn, and influenced by the contributions of James Cyriax, Geoff Maitland, Robin McKenzie, Robert Elvey, and his own experience over several years of practice.
Muscle Energy Technique
MET uses the contractile force generated by the patient in select muscle groups coupled with careful positioning, to adjust muscle tone and correct joint alignment and function. Developed by Fred Mitchell DO, MET is another approach that teaches the mind and body to re-learn the position or function as it is treated.
Strain-Counterstrain
Developed in the 1960s by the osteopath, Lawrence Jones DO, this gentle and painless manual therapy technique aids in the alleviation of muscle and connective tissue tightness and pain, through the location of painful points and specific passive positioning and support, to allow the brain to lower it's alarm systems in the involved area. The position is held for up 3 minutes, until there is a slackening and "release" of the spasmed tissue. This allows for rapid diminution of pain, and with the tissues relaxed, normal circulation is restored, and inflammation begins to dissipate. This technique may be used as a stand-alone or in conjunction with other therapies.
Direct and Indirect techniques
These approaches may be used alone or in alternation, to increase and/or restore range of motion and restore normal neural tone in joints, muscle, and fascia. Whereas direct techniques take the involved tissues into stretch, indirect techniques take the tissues into a direction of ease and continues in that direction until the body "resets" tone and possibly produces a tendency for corrective movement. In addition, this facilitates a return to a direct technique if still needed, requiring far less force to produce a lasting effect. Indirect technique is particularly useful for acute pain and injury.
Deep Tissue Massage, Active Release, Myofascial Release
These are soft tissue methods used to release adhesions, restore tissue flexibility, and improve circulation through muscle and fascia, which is the web of support that connects our structure together, and, when functioning well, allows strength to move through our bodies without interruption.
Rehabilitative Exercise
Specific exercises employed to increase and balance muscle strength, stabilize structure, integrate or re-integrate mind and body, and re-pattern movement to speed healing and reduce the likelihood of future injury.
