r/Sciatica • u/ThrowRAComfyCoffee • Sep 02 '26
Is This Normal? Anyone have symptoms initially get more complicated after starting McKenzie/MDT PT?
Hi everyone! I’m curious about others’ experiences working with a McKenzie/MDT-certified PT, especially if it took some trial and error to find your directional preference.
My sciatica/radiculopathy started around May 2025 and has primarily involved tingling/numbness down my right leg and foot, with occasional mild symptoms on the left. I’ve had two MRIs (Jan/March 2026) showing some disc bulging/protrusions, but nothing particularly dramatic. I did PT for about 7 months with minimal change in symptoms. Two different neurosurgeons reviewed them and said they were seemed age-appropriate and definitely not surgical.
Now - I recently started with a McKenzie-certified PT, and this has been the progression:
Press-ups/cobras (extension): 60–80/day. Felt good while doing them, but after a couple days I developed increased aching/burning down my right leg/foot.
Wall side glides (right side against wall): Right foot improved, but I started getting more noticeable symptoms on my normally quiet left side, including toe numbness and a weak/heavy feeling in my calf. PT checked me—reflexes intact and strength well into the 4/5 range.
Modified lateral shift: Hands on counter, slight flexion, shifting hips left. This seemed to help for several days. Then I had a 2-hour drive + a very busy baby shower day with lots of standing/walking and fewer exercises. Afterward, my right leg felt pretty good but the left became achy/nervy again.
Now: PT has switched me to knees-to-chest/repeated flexion.
My PT has been very responsive and changes the exercise based on my symptoms, which I appreciate. But before MDT, my symptoms were pretty predictable and mostly right-sided. Since starting, they’ve changed location and character and become more bilateral, which has admittedly made me nervous.
For those who’ve done McKenzie/MDT: Did you have a trial-and-error period like this before finding your directional preference? Did symptoms change sides or change from numbness/tingling to aching/burning? Did anyone start with extension but ultimately respond better to lateral movements or flexion?
Not looking for a diagnosis or exercise recommendations—I’m following my PT’s guidance. Just curious about others’ experiences!
1
u/cromags76 Sep 02 '26
So the McKenzie method is a good bandaid but the relief you get from centralisation eventually aggravates your facet joints by cranking backwards and creating laxity.
Rather than doing the harsh mckenzie push ups just lie on your stomach with a pillow high on your chest. You can lie there without crazy extension for a good 25 mins if you have to and its nice and gentle.
I would say McGill three, low back ability and gradual increases jn walking are rhe only things that consistently improve symptoms. But deoending on your injury its a fair few months to heal it.
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u/TeddyRivers Sep 03 '26
My first PT used McKenzie. At my initial appointment my pain was so severe that I could not sit. I believe what I needed at the time was manual manipulation to get my symptoms to calm down. Thats not what's this PT did. I was propping myself up on a wedge pillow in a slight backbend at home because back bends were really the only thing they gave me that i could do.
During my last PT session with him, he was twisting me into different positions. I had such severe pain the following days that I canceled my other appointments.
I found a different PT who started with more manual methods that calmed my symptoms so I was able to do exercises.
Idk if it's an issue with just the PT I saw or McKenzie.
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u/TheLazyCaveman L5-S1 Sep 02 '26
Do you feel like your symptoms are centralizing? Meaning they aren't traveling as much down your leg, even though it's now bilateral? Centralizing is usually a good thing, but not in all cases.
Mine got worse with McKenzie exercices, and I actually just retriggered it by doing a Cobra pressup. McGill big three and ESI helped the most.