McKenzie exercises (named after the physical therapist Robin McKenzie) can be helpful during the time when sciatica pain becomes acute as well as inflammation occurs too (even they have an advantage as a preventive exercise form). McKenzie exercises are mostly linked with extension i.e. spine’s backward bending, but actually they are related to testing for, and after that exercising in, stretches and positions that ease or create symptom’s "centralization".
The meaning of centralization is that the symptoms move nearer to the spin e.g. if you experience low back pain with sciatica (leg pain), centralization would be actually the point where the symptoms lessen or leave in the leg, no matter whether the pain remains stays the same or it gets worse in the low back or butts. With the passage of time, in several cases the low back and buttock pain will improve in conditions where early centralization is attained.
Most of the time there is an advantage of the spine’s extension in order to reduce or centralize pain, McKenzie exercises are mostly known as "McKenzie Extension Exercises", but original McKenzie Technique in reality tests for the position(s) that are good for every single patient.
McKenzie exercises mostly involve extension of the spine but they can also involve flexion too (forward bending), rotation and/or side bending- it depends on the position that reduces or centralizes the symptoms.
The following stretches/positions from McKenzie technique are the most common ones that are helpful. Some other positions can be helpful too. Initially you may feel some pain because you start moving into a new position. Once you get into one position, wait for 30 seconds to one minute in order to see the reaction on symptoms. Remember to find a position that relieves the symptoms i.e. away from the spine.
The best position is the one that moves the pain away especially if you have sciatica pain all over the foot. If your sciatica is in the butt and thigh, the best position is the one that helps in moving the pain away from the butts and thigh, even though it becomes severe in the low back.
Avoid any such position that can make the symptoms WORSE. The best thing is to continue testing various positions till you find the best one to reduce the symptoms i.e. away from the spine. Hold that position for a minute or 2 and after that take 30 seconds break i.e. in neutral position. Repeating this position frequently can be beneficial, if it continue to offer relieve from the symptoms i.e. away from the spine.
For the most commonly effective helpful McKenzie exercises here are some illustrated instructions.
- Exercise #1 - At first lie on your stomach on a firm surface like the floor and prop up upper part of the body on your elbows whereas keep your hips/pelvis on the floor. At a time hold this position for at least 30 seconds to one minute or more. Bend your upper part of the body left and right just to know the position that centralizes or alleviates the symptoms the most. You can repeat this quite often in a day especially during acute flare-ups.
Low Back and Sciatica (Acute Symptom Care):
- Exercise #2 - An alternate exercise is the "Cat" stretch. For this exercise just get on your knees and hands and gradually relax your abdominal and back muscles in such a way that your stomach hangs down while your lower back curves downwards. Your head must be raised, looking ahead of you. Keep this position for at least 30 seconds to one or two minutes. You can repeat this often in a day whenever you need it.
- Exercise #3 - As shown in figure you can use an exercise ball to stretch the back in extension. For balancing on the ball, take someone’s help to hold the ball still. You can maintain this position for several minutes, but do not forget t your head up after every few minutes in order to avoid lightheadedness. In case if you do not have an exercise ball, use one or two pillows and place it below the low back to keep it in extension.
- Exercise #4 - McKenzie exercises are generally linked with spinal extension (backward bending), but actually, McKenzie technique make use of any position that centralizes or alleviates symptoms in which flexion is included too (forward bending). As illustrated flexion stretch of the spine can be performed on an exercise ball, or stack of pillows can be used to perform, or even sofa’s arm. Do not use this position for longer duration i.e. not more than a minute as it can cause worsening of disc problems.
These exercises can be continued as a preventive measure even if the once symptoms are vanished. Use of just straight extension in absence of any symptoms (like in Exercises 1 and 3) works effectively for the purpose of prevention.