McKenzie Extensions: The Athletic Trainer’s Guide to Relief and Recovery
As an experienced athletic trainer, I’ve seen firsthand how McKenzie extensions can change the game for athletes and clients alike. These seemingly simple exercises often pack a punch when it comes to managing lower back pain, improving posture, and supporting spinal health. Whether you're new to McKenzie techniques or looking to refine your understanding, this guide will walk you through everything you need to know—including how to use them safely and effectively.
What Are McKenzie Extensions?
McKenzie extensions are part of the McKenzie Method of Mechanical Diagnosis and Therapy (MDT), developed by physical therapist Robin McKenzie. These exercises focus on spinal extension movements, helping to restore proper alignment and mobility to the lumbar spine.
The exercise itself is straightforward: lying face down, the individual gradually extends their spine by propping themselves up on their elbows or hands. While it may look simple, McKenzie extensions are a targeted, therapeutic movement designed to reduce pain and improve function.
Why McKenzie Extensions Are So Effective
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Counteract Prolonged Flexion: In today’s world, we spend a lot of time sitting—whether at desks, in cars, or on couches. This prolonged flexion compresses the front of the spine and overstretches the back muscles. McKenzie extensions counteract this by gently decompressing the spine and restoring its natural curve.
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Reduce Disc-Related Pain: For individuals with conditions like disc bulges or herniations, McKenzie extensions can help centralize pain (moving it away from the legs and back toward the spine). This is a positive sign that healing is occurring.
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Improve Mobility: Extensions improve range of motion in the spine, often relieving stiffness in the lower back and surrounding muscles.
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Support Posture: By restoring the spine's natural curve, McKenzie extensions can help alleviate forward head posture and slumped shoulders, promoting better alignment and reducing strain on surrounding muscles.
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Empower Self-Management: One of the greatest benefits of McKenzie extensions is that they are easy to learn and can be done almost anywhere. This empowers clients to take control of their recovery.
Step-by-Step: How to Perform McKenzie Extensions
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Start with Prone Lying:
Lie flat on your stomach on a firm surface. Place your arms at your sides and relax. Breathe deeply and let your body adjust to this position. -
Move to Prone Prop on Elbows:
Prop yourself up on your elbows, keeping your hips in contact with the surface. Your lower back will naturally extend. Hold this position for 10-20 seconds and return to the starting position. -
Progress to Full Extensions (Cobra Pose):
Once comfortable, place your hands under your shoulders and slowly push your upper body up, extending your arms while keeping your hips grounded. Avoid overextending or forcing the movement. Hold for 5-10 seconds, then return to the starting position. -
Repeat:
Perform 8-10 repetitions, up to 4-5 times a day, depending on comfort and the advice of your therapist.
Contraindications and Precautions
While McKenzie extensions are safe for many people, they are not suitable for everyone. Here are key contraindications and precautions to keep in mind:
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Acute Injury or Trauma:
Avoid McKenzie extensions if there’s a recent spinal injury, such as fractures or severe sprains. These movements may worsen the condition. -
Severe Pain or Neurological Symptoms:
If the exercise causes sharp pain, increased numbness, tingling, or weakness in the legs, stop immediately and consult a healthcare provider. -
Spinal Stenosis or Spondylolisthesis:
Extensions may exacerbate pain in individuals with these conditions, as they involve spinal compression. -
Post-Surgical Recovery:
Anyone recovering from spinal surgery should consult their surgeon or physical therapist before attempting McKenzie extensions. -
Pregnancy:
The prone position (lying face down) is generally unsuitable for pregnant individuals, particularly in later stages. -
Abdominal Conditions:
Conditions like hernias or abdominal discomfort may make extensions uncomfortable or unsafe. -
Significant Structural Deformities:
Severe scoliosis or ankylosing spondylitis may limit the ability to perform extensions safely. -
Osteoporosis:
Older adults or individuals with osteoporosis should proceed cautiously, as excessive extension may increase the risk of compression fractures.
Tips for Maximizing Benefits
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Start Slow:
Always begin with gentle movements and increase intensity only as comfort allows. -
Listen to Your Body:
A slight stretch is normal, but sharp pain is a red flag. Stop if discomfort increases. -
Incorporate Other Exercises:
Combine McKenzie extensions with other core-strengthening and mobility exercises for a well-rounded approach. -
Stay Consistent:
Like most therapeutic exercises, the benefits of McKenzie extensions come with regular practice. Encourage clients to make them a daily habit. -
Get Professional Guidance:
If you’re unsure about how or when to incorporate McKenzie extensions, consult with a therapist who specializes in MDT.
Success Stories: Real-Life Applications
As an athletic trainer, I’ve used McKenzie extensions with a range of clients—from office workers battling chronic back pain to athletes recovering from lumbar strain. One memorable case involved a long-distance runner who struggled with sciatica symptoms. After just two weeks of daily McKenzie extensions, they reported significant relief and were able to resume training with confidence. Stories like these highlight how simple yet effective this exercise can be when used appropriately.
Disclaimer
This blog is for informational purposes only and should not be taken as medical advice. Always consult with a qualified healthcare provider before starting any new exercise program, especially if you have an existing medical condition or are experiencing pain. The McKenzie Method should be applied under the guidance of a trained professional.
Final Thoughts
McKenzie extensions are a powerful tool in the world of rehabilitation and recovery. They’re easy to perform, highly effective, and provide clients with a sense of empowerment over their own healing process. However, as with any exercise, they must be used wisely and with proper precautions.
By sharing this knowledge with your clients, you’re not just helping them alleviate pain—you’re equipping them with a lifelong skill to protect their spinal health. So go ahead, give McKenzie extensions a try, and experience the benefits for yourself. Your back will thank you!

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