McKenzie-type Exercises Improve the Functional Abilities of a Patient with Recurrent Herniated Discs: A Case Report

Ramzi A. Al-horani1, *, Ahmad S. Batainah1, Nabil Shamroukh2, Mohammad F. Abumoh'd1
1 Department of Exercise Science, Yarmouk University, Irbid, Jordan
2 Department of Physical Education, Yarmouk University, Irbid, Jordan

© 2020 Al-horani et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Exercise Science, Yarmouk University, Irbid, Jordan; Tel: 0798284998; E-mail:


This case is unique in which the patient had two previous lumbar spinal surgeries, recurrent herniated discs, and new bulged and herniated discs were developed. We aimed to investigate whether implementing the McKenzie method would reduce the symptoms of a long history of Low Back Pain (LBP) with multiple surgeries. A 2-months of McKenzie-type exercise program was performed at a rate of 5 days/week. Disability index, pain intensity, lumbar Range of Motion (ROM), and lower limb strength were tested before and after the exercise treatment intervention. Disability and pain were also measured at 3-months follow-up. The Oswestry disability index and pain visual analogue scale score reduced immediately after the treatment intervention and remained reduced at 3-months follow-up from 44% to 22%, and from 8 to 4, respectively. Lumbar ROM improved about 1.5 cm during standing flexion and 3 cm during extension. Unilateral leg extension of the affected leg and bilateral leg press increased by 16.5 kg and 70 kg, respectively. The current protocol has shown that Mckenzie-type exercise treatment can improve the physical functions and reduce pain in a patient with a history of lumbar spine surgeries and prolonged LBP. In addition, despite no additional exercise, McKenzie method increased the lower limb strength, possibly through nerve root decompression.

Keywords: Low back pain, Herniated disc, McKenzie method, Rehabilitation, Lumbar spine, Unilateral leg extension.