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Update — February 2004

In 1981 a young physical therapist, Robin McKenzie, from Auckland, New Zealand, published a monograph on using extension of the low back (bending backwards) as a method of reducing derangement of the spine.

Prior to this time everything was flexion (bending forward) to stretch and relieve low back pain. Over the past 20 years, studies have proven the extension method to be exceptional in relieving many types of low back pain.

Strengthening the low back however, was not part of the protocol; emphasis was placed on positioning and lumbar lordosis. Until recently, neither equipment nor a good low back strengthening protocol was available.

Medx engineered a low back machine in the 1980's, which proved to strengthen low back musculature, but the machine was very expensive, and thus not widely available to physical therapists. In 2002 they came out with the Medx EXL, a smaller, less expensive low back unit which isolates the multifidus muscle in the low back.

The SuperSlow^® exercise protocol, developed in the 1990's by Ken Hutchins, has proven to be a very safe–if not the safest–in dealing with low back problems. By going very slow through the range of motion and approaching the end points cautiously, there is little chance of causing injury. Additionally, you quickly build strength in the muscle groups being exercised by going to complete exhaustion (failure) of the muscles.

In my January 2004, Update, I posed the question: "Why have I been so successful in treating low back pain with only strengthening, not emphasizing McKenzie low back extension positioning?" Well, here's my explanation:

The reason for the success of my low back program can be attributed to the combination of

isolated low back extension (positioning) attained on the Medx EXL unit, specifically strengthening the mutifidus muscle in the lumbar spine
using the SuperSlow protocol for proper alignment, form and speed of motion

It is my belief that future writing of case studies and research will show low back extension and muscle isolation with the Medx EXL, coupled with the SuperSlow protocol to be a very important combination for reduction of low back pain and improved function.