Q&A Time! MDT Applied to Extremities | Modern Manual Therapy Blog

Q&A Time! MDT Applied to Extremities

I get asked this question a lot, so I thought I would answer it again for my inquisitive readers.

Would I recommend the MDT Advanced Extremities Course. In a nutshell, yes! The course format and progression has changed in the past few years and the McKenzie Method applied to extremities is now taught in Part C and D. Part E is now considered a progression, rather than a stand alone course.

Previously, you had to be at least CertMDT (credentialed after taking Parts A-D and passing the exam and practical) prior to taking Part E. Now Part E is part of the certification.

My experience in taking Part E was not a good one, it was earlier when the concept applying it to extremities was not fleshed out yet. It was all live patients and I would say 90% of them were slow responders, which does not make for a great 2 day experience.

Seeing several MDT Diplomats in action mentoring at my clinic completely changed the way I thought about using MDT for all areas and found that it makes short work of DNs and DPs for most areas, rather quickly. Like MDT for the spine, you check by looking for a directional preference, and in my experience, is often contrary to what the patient is often performing, painfully.

  • painful shoulder flexion/elevation, try repeated shoulder extension
  • painful closed chain knee flexion, try repeated knee extension
  • painful ankle dorsiflexion, try repeated plantarflexion
Here is a video I shot at an Eclectic Approach Seminar earlier this year showing common resets from head to toe in case you need a direction to try. As in the spine, due to repeated loading patients are performing, there are also common solutions.

Keeping it Eclectic....

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  1. So would you say the reset for limited shoulder internal rotation and extension would be flexion and external rotation, with speed?

  2. Not necessarily, as a pattern try extension and IR for most limitations