Mechanical Diagnosis & Therapy



'Mechanical Diagnosis and Therapy® (MDT) is an internationally acclaimed method of assessment and treatment for spinal and extremity pain developed by New Zealand Physiotherapist Robin McKenzie. It has been widely used all over the world for more than 30 years.

MDT clinicians are trained to assess and diagnose all areas of the musculoskeletal system. That means that if a problem exists in or around the spine, joint or muscle, an MDT evaluation may be appropriate.

MDT is a philosophy of active patient involvement and education that is trusted and used by clinicians and patients all over the world for back, neck and extremity problems. This approach continues to be one of the most researched physical therapy based methods available.

A key feature is an initial assessment - a safe and reliable way to reach an accurate diagnosis and only then make the appropriate treatment plan. Expensive tests such as MRI’s are often unnecessary.  Certified MDT clinicians are able to rapidly determine whether the method will be effective for each patient.

In its truest sense, MDT is a comprehensive approach based on sound principles and fundamentals that, when fully understood and followed, is very successful.'


  • 'Are there periods in the day when you have no pain? Even 10 minutes?

  • Is the pain confined to areas above the knee or above your elbow?

  • Have you had more than one episode of low back pain or neck pain over the past few months or years?

  • Do you feel worse during or immediately after prolonged bending or stooping; as in making beds, vacuuming, gardening, concreting, etc?

  • Do you feel worse when sitting for prolonged periods or on rising from the sitting position
    eg. after watching TV or working on the computer?

  • Do you associate your pain with any one particular activity but are generally pain-free when not engaged in this activity?

  • Do you feel worse when inactive and better when on the move?

  • Does your low back feel better when lying face down? (You may feel worse for a minute before the pain subsides, in that case, the answer to this question is yes).

  • Does your low back pain feel better when you are walking?


If you have answered yes to more than 4 questions, your chances of gaining benefit from MDT® is very good.

If you answered yes to 3 or fewer questions you may require specialized assessment and treatment and you should contact a clinician trained in MDT®'


If you have any of the following:


  • Sciatica

  • Arthritic pain in hips or buttocks, shoulders or upper arms

  • Difficulty bending due to stiffness or pain in your lower back

  • Pain that starts in the back or neck and seems to spread to the buttocks or shoulders

  • Intermittent pins and needles or numbness in the feet or hands

  • Aching pain into the elbows or knees that hasn't been assisted by treatment to these areas

Then you may be assisted by a trained MDT clinician. They are trained to assess and diagnose all areas of the musculoskeletal system. MDT clinicians are trained to assess your problem and help you understand how you may be able to help yourself to improve your pain, stiffness or ability to do your work or daily activities.'



'MDT begins with the clinician taking a detailed history of your symptoms and how they behave. You will be asked to perform certain movements and rest in certain positions. The main difference to most other assessments is the use of repeated movements rather than a single movement. How your symptoms and range of movement changes with these repeated movements provides the clinician with information that they can use to categorize your problem.'


'Each syndrome is addressed according to its unique nature, with specific mechanical procedures, including repeated movements and sustained postures. MDT is a comprehensive classification system and includes a smaller group of patients that cannot be classified into one of the three Syndromes but are into the ‘Other’ Subgroup which includes serious pathologies, non-mechanical causes, true chronic pain, etc.'

'Using the information from the assessment, the clinician will prescribe specific exercises and advice regarding postures to adopt and postures to temporarily avoid. If your problem has a more difficult mechanical presentation, a qualified MDT clinician may need to add hands-on techniques until you can self-manage. The aim is to be as effective as possible in the least number of sessions. Treatment that you can perform five or six times a day is more likely to be effective in a shorter period of time than treatment administered by the clinician once or twice per week. The emphasis is on you, the patient, being actively involved. This can minimize the number of visits to the clinic. Ultimately, most patients can successfully treat themselves when provided with the necessary knowledge and tools.'

'By learning how to self-treat the current problem, you gain knowledge on how to minimize the risk of recurrence. You can also rapidly deal with symptoms if they recur, putting you in control of your treatment safely and effectively. Persisting problems are more likely to be prevented through self-maintenance than by passive care.'