Dear Colleagues, every fortnight, we drop one clinical question to test your MSK brain and keep you sharp. Please share this by forwarding to others in your clinic, or printing out the pdf below.
π¦ The Cult Courier
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A 29-year-old logistics coordinator for a doomsday cult complains of right-sided back and leg pain after 3 months of carrying canned goods and burying long-drop toilets on remote Southland farmland. He responds with an Amber Light of Decrease/No Better (NB) from Sustained Extension and Repeated Extension In Lying (EIL).
Whatβs your next best step based on Force Progression Principles?
A. Change direction to Flexion In Lying (FIL)
B. Try traction
C. Repeated Extension in Lying with Patient Overpressure
D. Immediately refer for imaging
β Correct Answer: Feel free to reply with your answer so you remember what you chose! Weβll share the correct one next time (and give you the why so you can learn something new).
π£ Share the quiz with your team
Make it a lunchroom challenge. Print our PDF quiz sheet and pin it up. Debate your answers. Brag when you get it right.
For credentialed or diploma clinicians who refer the most colleagues during launch month. Just forward the quiz or invite them using our form. β π McKenzie Book Spot Prizesβ We will also be giving away a few books as spot prizes.
*Prizes to be drawn on the 2nd of June, 2025. Terms and conditions here.
Theyβll thank you later!
Last Quiz Answer: π The Glam Bruiser
A 36-year-old former Miss New Zealand turned underground bare-knuckle fighter reports residual, central low back pain 12 weeks after βan unfortunate suplex incidentβ in a Hamilton warehouse and 2 weeks of bed rest. The pain is produced only at a limited end-range lumbar flexion, such as bending to tie shoes. There is no loss of any other lumbar movements. The pain is always localised and is no worse after repeated flexion. Which MDT classification is most likely?
A. Derangement B. Renal Colic C. Dysfunction Syndrome D. Other
β Correct Answer: C
π‘ Why: Dysfunction Syndrome is a clinical presentation where pain is produced exclusively by mechanical loading on impaired tissues.
Dysfunction Syndrome looks like local pain (except in the case of Adherent Nerve Root), intermittent pain, end range pain and end range loss with an onset greater than 8 weeks post injury. Patients will experience a Produce, No Worse response to repeated movement in one direction (for our Glam Bruiser it is repeated flexion).
Why do we use Classifications? β One size does not fit all. Classification systems in musculoskeletal care are used to organise your patients into subgroup presentations that have identifiable characteristic signs, symptoms, responses to testing and specific treatment strategies you can be confident will help them.
The McKenzie Method, through a detailed patient history and analysis of load testing, allows you to classify patient presentations. This classification then guides your clinical decision making to utilise the most appropriate interventions and management strategies for each patient's individual biopsychosocial presentation with confidence.
Gone are the days of βnon-specific low back painβ. This process gives you confidence you are treating this patient in a way that is specific to their needs.
Standing on the shoulders of giants.
We owe a profound debt of gratitude to the clinicians, researchers and educators whose work, shared over generations, has brought us to where we are today. To those who continue to push our understanding forward through their current research and teaching, thank you.
See you in 2 weeks π
NgΔ mihi, The McKenzie Institute New Zealand Team βWebsite | Socialsβ
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