🧠 We're Back! Is your brain ready?

#5 🔥 The Off-Grid Warrior

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Dear Colleagues, every month, we drop one clinical question to test your MSK brain and keep you sharp + answer of the previous quiz (at the bottom). Please help spread the quiz by forwarding this email to others in your clinic, or printing out the lunchroom pdf linked below.

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🔥 The Off-Grid Warrior ​ A 32-year-old ex-military survivalist who lives in a shipping container on the outskirts of Palmerston North, reports pain to the right lumbo-sacral region which is worse when running while hunting and crouching to skin game. The pain is with him most of the time, worse at night, and associated with 45–60 minutes of morning stiffness. He describes frustration because he also has both Achilles tendons causing him issues and an upset gut.

Which of the following best describes this presentation?

A. Articular Dysfunction
​B. Inflammatory Arthropathy
​C. Atypical Mechanical Condition
​D. Radicular Syndrome without directional preference

✅ Correct Answer: Feel free to reply with your answer so you remember what you chose! We’ll share the correct one next time (and give you the why so you can learn something new).

📣 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.

This quiz is about bringing clinicians together, through smart thinking and a bit of healthy competition.

To book: reply to this email or email minz@mckenzieinstitute.org

Last Quiz Answer: 🎡 The Fringe Performer

​A 45-year-old performance artist known for her one-woman show “My Hernia and Me” presents with shoulder pain following an interpretive dance sequence involving a wheelbarrow and two hula hoops. You find a limitation in flexion and abduction. After repeated shoulder extension, her movement improves significantly and remains better.

What does this suggest?

A. A structural rotator cuff tear
B. A frozen shoulder
C. A derangement in the shoulder
D. A cervical referral

✅ Correct Answer: C

💡 Why:
This is a non-spinal example of MDT working in the periphery. The rapid, significant change in range and symptoms after a mechanical loading strategy suggests a directional preference has been identified indicating the diagnosis of derangement, not a structural problem. MDT principles apply well beyond the spine, and often yield surprisingly fast improvements.

See you in a few weeks 👀

Ngā mihi,
The McKenzie Institute New Zealand Team
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