The Cervical & Thoracic Spine Mechanical Diagnosis & Therapy- Vol 1,
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THE CERVICAL &
THORACIC SPINE
MECHANICAL
DAGNOSIS &
THEAPY
VOLUME ONE
ROBIN MCKENZIE
CNZM, OBE, FCSP (HON), FNZSP (HON), DIP MDT, DIP MT
STEPHEN Ay
MA, MCSP, DIP MDT
,
MSc
THE CERVlCAL & THORACIC SPINE
MECHANICAL DIAGNOSIS & THERAPY
BY ROBIN McKENZIE AND STEPHEN MAY
This book is essential reading for any health profesional involved in the management of
patients with cervical or thoracic pain. Descried within are the mechanical measures
required for the diagnsis and tatment of the common poblems. The precie identification
and management of subgroups in the sectrum of mechamcal cevical and thoracic disoders
has been aid to be a priority if we are to improve our methods of management of back and
neck problems. This latest book in the eies by McKenzie and May provides a system to
identiy subroups and consequently provide etter strategic solutions.
Robin McKenzie first published his landmark text outlining cenain principles and concepts
for the diagnosis and management of lumbar spine problems in 1981. Another volume
addressing the cervical and thoracic spine
s
published in 1990. His first publications
always stressed the importance of patient self-management and the relevance of this issue
s been belatedly recognied by others. Since thee publicatiOns considerable evidence s
demonstrated the imortance and relevance of thoe principles and concepts n e mdem
management of muculoskeletal problems.
This edition explains the centraliation and eipheraliation phenomena; the
e
of exee
to induce changes in pain lcation and intensity; the means of detecting the most effective
diection in which to apply theraeutiC exercie; differentiation
displacement. pain of contracture and pain arising from normal tissue; how to differentiate
the pain of nerve root adherence from entrapment and ciatica.
This second edition of
e
Cevical
t
Thoracic Spine: Mechanical Dianosis
t
Therapy
parallels the changes in the updated Lumbar Spine text. It
s
been thoroughly revied and
COnsiderably exanded and explos in depth the literature relating to mechanial syndomes
and neck and trunk pain In general. There are deSCriptiOns of the management of the three
mechanical syndromes -derangement. dysfunction. and postural syndrome -as applied to
neck. thoracic and headache problems. There is in-depth consideration of the literature
relating to a number of issues. such
as
the epidemioloy of neck pain. headaches. erious
spinal pathology and whiplash
.
Opeational deinitions. decriptiOns and numerous tables
provide clinical sins and symptoms to recognise or suspect mechanical syndromes or
other diagnoes.
Robin McKenzie and Stephen May have produced another evidence-baed and clinically
relevant text for the new century. augmenting the other volumes available that relate to the
lumbar spine and e.1remily problems. It provides a review of relevant general topics as well
as the detail of how to evaluate and prescribe appopriate specific exercises and manual
techniques. The system decribed in this bok achieves a new benchmark for the non
surgical management of mechamcal cevical and thoracic diorders
.
The Cervical & Thoracic Spine
Mechanical Diagnosis & Therapy
Volume One
Robin McKenzie
CNZM, OBE, FCSP (Hon), FNZSP (Ion), Oil' MDT, Oil' MT
Stephen May
MA, MCS, Oil' MDT, M
c
Spinal Publications ew Zealand Ltd
Raumati Beach, New Zealand
The Cervical
:
Thoracic Spine: Mechanical DiagnosIs
:
Therapy
Fist Edition irst published in 1990 by Spinal Publications New Zealand ltd
Second Edition irst published in April
2006
Reprinted February 2007, March 2008 by
Spinal Publications New Zealand Ltd
PO Box 2026, Raumati Beach, New Zealand
Email: en
q
uiries@spinalpublications.co.nz
©
Robin McKenzie
2006
All rights reserved. No pan of this publication may be reproduced by
any means, stored in a retrieval system or transmitted in any rorm or by
any means electronic, mechanical, including photocopying, recording or
otherwise, without the prior written permission of the COp)Tight holder.
ISBN 10 0-9583647-7-X
ISBN
13 978-0-9583647-7-5
Design by Next Communications
Edited by Autumnwood Editing and Jan McKenzie
Photography by John Cheese
Illustrations by Paul Pugh
Typeset and printed by Astra Plint
Dedication
To my patients who, from 1953 to 2003, taught
me all I kno.
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