Posted by & filed under Mechanical Diagnosis and Therapy (MDT).

Scott Knoche, PT, Dip, MDT, CSCS

Early Career

As a new physical therapist who graduated from the University of Missouri in 1987, I was allowed the opportunity to work side-by-side with physical therapist trained in mechanical therapy (MDT).  My experience started in an outpatient clinical setting in St. Louis. I was introduced to my mentor.  He practiced with a focus on performing guided active treatment, in which the patients fully participate.  The mechanical therapy approach aims to provoke change in signs and symptoms with various body positions and repeated movements. The process required substantial questioning and dialogue with the patient resulting in hours of communication back and forth over multiple visits.

Change in Approach

This signified a major shift in practice away from passive modalities and inactive treatments that had been the “norm” for many years.  Historically, passive modalities including heat, ice, diathermy, electrical stimulation, and ultrasound were performed frequently with patients two to three times per week.  This approach would provide short-term pain relief at best and this was a common practice in physical therapy.  We hypothesized that patient’s body positioning likely contributed to some of their relief at this time.

Better Outcomes

Over the years, therapists were motivated to update their skill set to provide better long-term outcomes.  Educating patients where strength deficits existed, physical therapists were able to form relationships with patients.  It was great to see patients experience long-lasting change and progress in their function. Patients saw an increase the amount of time able to perform a favorite activity or being able to perform physical activities with more vigor.  The mechanical therapy approach to patient care has been very rewarding to practice over my 34 year career. This gradual but steady change in physical therapy has become the standard.  Therapists now look more carefully during evaluations with assessment of changing function.  The mechanical therapy method has been shown to be most successful to me. 

Summit Strength is a Certified McKenzie Clinic, one of the few in the KC area. Check out this blog post to learn more.

Certified McKenzie Clinic

Or, to learn more about Mechanical Diagnosis and Therapy, go to the McKenzie Institute website linked here.