Self-Care of the Low Back and a Pioneering New Zealand Physiotherapist

Robin McKen­zie has been an influ­en­tial voice in the evolv­ing field of spine care over the past 20 years or more.  He’s a phys­io­ther­a­pist from New Zealand who’s been on a mis­sion — help­ing peo­ple take care of their own back prob­lems. 

Though I’ve nev­er been offi­cial­ly trained in the McKen­zie sys­tem, I do incor­po­rate some of his insights into my approach, and I want to share with you some of his basic prin­ci­ples.

Finding a favorable position or gentle movement

The McKen­zie method is based on the prin­ci­ple that most peo­ple with low back pain can dis­cov­er a rest posi­tion or gen­tle move­ment that gives them some relief. You can then build strate­gi­cal­ly on your favor­able posi­tion or move­ment to grad­u­al­ly rein­tro­duce your low back to a wider range of easy, pain-free motion, even­tu­al­ly elim­i­nat­ing your prob­lem alto­geth­er.

You may have to try more than one rest posi­tion (or move­ment) before you find the solu­tion that’s right for you. In Part 2 this arti­cle I’ll walk you through the steps you can take to find the right posi­tion for you. But before you try it for your­self, you need to under­stand a sec­ond prin­ci­ple of the McKen­zie method – the process of pain cen­tral­iza­tion.

How do you know if you’re on the right track?

As you search for the favor­able rest posi­tion or gen­tle move­ment that will give you relief, what are the cues to tell you that you’ve found the right solu­tion?

If you’re lucky, you’ll find a posi­tion that lessens your pain. That’s a clear sig­nal that you’ve found the right self-care approach for your­self.

But you can use a sec­ond clue, too. The pain can shift its loca­tion, retreat­ing from the leg or but­tock area and cen­tral­iz­ing in the low back alone. This is a sign of improve­ment. So if you expe­ri­ence pain cen­tral­iza­tion, you can also have con­fi­dence you’re on the right track.

Are you an extender or a flexer? Your strategy to put these principles into practice.

Here’s a pic­ture of one of the basic move­ments of the spine – back­ward bend­ing, known in med­ical cir­cles as spinal exten­sion.



Dr. McKen­zie esti­mates that, for about 60% of low back pain suf­fer­ers, the posi­tion or move­ment that gives relief is a gen­tle ver­sion of spinal exten­sion.

Anoth­er 30% of low back suf­fer­ers pre­fer a posi­tion of flex­ion.

spine flexion


The remain­ing 10% need to use a more com­plex com­bi­na­tion of flex­ion or exten­sion with side-bend­ing or rota­tion in order to get relief.

Read Part 2 to dis­cov­er how to put these strate­gies to work for you.


Deepen Your Body of Knowledge

Lum­bar spondy­lolis­the­sis and spondy­lolis­the­sis exer­cis­es

If you get back pain with exten­sion

Self-care of the low back, Part 2



About Ronald Lavine, D.C.

Dr. Lavine has more than thirty five years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods. His website,, provides more information about his approach. Please contact him at or at 212-400-9663.
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2 Responses to Self-Care of the Low Back and a Pioneering New Zealand Physiotherapist

  1. Thanks for this blog, I think its real­ly help­ful for many, and also may avoid unnec­es­sary expense to Docs.This is very nice thread dis­cussing on back pain.

  2. Gwen Gardner says:

    Hi Doc-
    Have been cruis­ing the web read­ing up on oth­ers’ blogs regard­ing back pain, spinal mobil­i­ty and exten­sion because we have devel­oped a new tool, for per­son­al and pro­fes­sion­al use, for just this thing! Would love to have you vis­it our site and take a look. We are sib­lings and chi­ro­prac­tors work­ing togeth­er to bring this new tool to oth­ers. Hope to hear from you! By the way, your blog is great…lots of infor­ma­tion!
    Dr. Gwen

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