Williams vs Mckenzie Exercises
Comparison of Williams Flexion and Mckenzie Extension
Both Williams and McKenzie are completely convinced that the stresses that are placed on the intervertebral discs as a result of poor posture are the primary factor that contributes to all cases of back pain. On the other hand, while they appear to share a consensus regarding the discal cause of back pain, they do not agree regarding the postural component. While McKenzie seems more concerned about the increasing extension in our world, Williams seems more concerned about the lack of flexion in our world.
Williams stated the following in a tone that suggested he was emphasizing his point: “Man, in forcing his body to stand erect, severely deforms the spine, redistributing body weight to the back edges of the intervertebral discs in both the low back and neck” (Williams, 1974). According to what I mentioned in my most recent article, Williams believed that the lordotic lumbar spine placed an excessive amount of strain on the posterior elements of the intervertebral disc, which led to the premature demise of the disc. To put it another way, Williams stated that the man complained of low back pain when he first stood in an upright position.
Additionally, McKenzie asserts that the disc is the primary factor in the development of back pain. However, in contrast to Williams, McKenzie hypothesizes that flexion, and not extension, is the cause of the problem. According to what McKenzie has written, an extended period of sitting in a flexed position is one of the risk factors that can lead to the development of low back pain. McKenzie identifies frequency of flexion as a second factor that can put a person at risk for the condition. Lastly, McKenzie postulates that one of the factors that makes us more likely to experience low back pain is a limited extension range.
In contrast to Williams, McKenzie maintains that an accumulation of flexion forces, not extension forces, is what increases the pressures on the posterior elements of the disc, and that this is what causes the problem. Williams, on the other hand, maintains that extension forces are what increase these pressures. I am aware that I am simplifying the situation here, but that is what they said!
Gary Jacob, a colleague of mine, was the one who stated that it wasn’t when he stood up that problems began; rather, it was when he sat down to think about it that problems began. While Williams claimed that man developed back pain when he stood up, I once heard Gary Jacob say that. To make sure that my point of view isn’t misunderstood, I don’t think the disc is the root of the problem. It’s possible that it is at times, but most of the time, it’s probably not involved at all. Here, all I’m doing is reporting what other people have written.
The Goals of the Treatment
Both Williams and McKenzie had similar treatment objectives in many ways, and those objectives were similar to one another. Both of them instructed their patients in various methods of self-control and attempted to educate their patients on the causes that, according to them, led to the onset of the patients’ back pain in the first place.
Williams was very clear about the objectives of his treatment. These objectives could be elucidated by him “The first rule to follow if you suffer from leg and back pain is… Always find a way to sit, stand, walk, and lie down that minimizes the amount of hollow that develops in the low back.” His main goal was to make the lumbar curve less pronounced and straighten out the spine.
McKenzie, on the other hand, was more inclined toward the utilization of extension as a potential treatment method. This was especially clear in the earlier works that he had produced. For the McKenzie aficionados who are reading this and are working up a sweat, let me assure you that I am well aware that McKenzie is much more than an extension. However, it does appear that the majority of patients can benefit from extension exercises; this is where the connection with extension comes from.
In the end, McKenzie desired a complete range of motion in all directions, which represents a significant departure from Williams’ goals in this regard. While Williams instructed everyone to use the same strategy, McKenzie tailored his procedures to meet the needs of each individual patient. In the beginning of his treatment for some patients, he had them perform extension exercises. In some of them, he started with the flexion. Still others begin with a lateral shift movement or whatever else is necessary in order to control and centralize their pain.
Initial Medical Care
In addition to providing treatment, both Williams and McKenzie made an effort to instruct their patients in proper first aid procedures and exercises. Williams preferred the squat and bounce technique, which is a method that I find to be especially helpful (the squat, not the bounce). McKenzie instructed his patients to perform various movements in order to centralize their pain, such as extending their spines by performing press-ups, bringing their knees to their chests, or sliding sideways.
Let’s look at the similarities between these processes, even though they might appear to be very different at first glance. Every single one of these clinicians instructed their patients on how to manage their back pain through physical activity. Although the movements that they suggested may have been different, the overall concept of utilizing movement as a means to control pain was analogous and novel.
The Various Methods of Treatment
When it came to the question of which kind of movement was more likely to be beneficial in terms of relieving back pain, Williams and McKenzie had opposing points of view. Williams’ way of thinking was somewhat more constrained than other people’s. He was certain that extension was undesirable while flexion was desirable. McKenzie was a little more adaptable and recognized that a treatment that is successful with one patient might not be successful with another. They both used movement, and they both encouraged self-control and activity, but McKenzie adapted his treatment methods to the requirements and reactions of his patients, as was stated earlier. He also varied his treatment procedures in accordance with these modifications.
Which Is Better?
If you have been waiting for me to tell you which of the two methods is superior, I will now do so. It depends: it could be Williams, it could be McKenzie, or it could be neither of them. I have my thoughts, but ultimately it is your responsibility to decide how to treat your patients.
Please take note that I recently came across an intriguing article, “The Control of Early Morning Lumbar Flexion for the Reduction of Chronic Low Back Pain That Is Not Specific to Any One Area of the Back A Study That Is Randomized And Controlled “(Snook et al., Spine, Dec 1, 1998;23(23):2601-7). The control of lumbar flexion in the early morning will significantly reduce chronic, nonspecific low back pain, according to the hypothesis that will be tested in the randomized controlled trial that is described in the article.
Randomization was used to divide 85 patients suffering from chronic or recurrent low back pain into two groups: the treatment group and the control group. The treatment group was given instructions on how to maintain control of their lumbar flexion in the early morning. A fake treatment consisting of six exercises that have been shown to be ineffective in reducing low back pain was given to the control group. Six months later, the treatment being tested was administered to the group serving as the control.
In the treatment group, there was a discernible lessening of the levels of pain experienced, but this was not the case in the control group. The control group’s responses after receiving the experimental treatment were very similar to those of the experimental group. There was also a notable decrease in the total number of days spent with pain, disability, impairment, and the consumption of medication. The authors came to the conclusion that a form of self-care that has the potential to reduce the pain and costs associated with chronic, nonspecific low back pain is to control lumbar flexion in the early morning.