Faculty Advisor(s)

Brian T. Swanson

Document Type

Course Paper

Publication Date



© 2015 Ashley Bowser


Background/Purpose: The McKenzie Method of mechanical diagnosis and therapy (MDT) is supported in the literature as a valid and reliable approach to spine injuries. It can also be applied to the peripheral joints, but has not been explored through research to the same extent. This method sub-classifies an injury based on tissue response to mechanical loading and repeated motion testing with repeated motions identified during testing used to guide treatment. The purpose of this report is to demonstrate the assessment, intervention, and clinical outcomes of a patient classified as having a shoulder derangement using MDT methodology. Case Description: The patient was a 52-year-old female who presented with a four-week history of insidious onset left shoulder pain and a medical diagnosis of adhesive capsulitis. She presented with pain (4-7/10 on the visual analog scale (VAS)) and decreased range of motion that limited her activities of daily living and work capabilities (Upper Extremity Functional Index (UEFI) score: 55/80). Active and Passive range of motion (A/PROM) were limited in all planes. Repeated motion testing revealed her MDT classification to be derangement. Following repeated shoulder extension, immediate improvement was noted in all shoulder motions, as well as, decreased pain. Treatment involved specific exercises, primarily repeated motions, identified as symptom alleviating during the evaluation process. Outcomes: The patient demonstrated significant improvements in the UEFI (66/80), VAS (0-2/10), and ROM within 6 visits over 8 weeks. A/PROM was observed to be equal to the R shoulder without pain. Discussion: This patient demonstrated improved symptoms and functional abilities following evaluation and treatment using MDT methodology. The use of MDT techniques can be effective in the treatment of extremity pathology.


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