Book Review: 'Treat Your Own Back'

Brian Estell  ·  Aug 24, 2017

Treat Your Own Back by Robin McKenzie is based on an idea that seems too good to be true. An exercise as simple as lying on your stomach and pushing up onto your elbows can cure back pain. 

Recently, I was bending over to put on my shoes and a familiar, debilitating pain struck. My back “went out.” It was so bad I had to resort to crawling on all fours.

I managed to make it into the office on Monday. My supervisor noticed my stooped over posture and handed me a copy of Treat Your Own Back. I was intrigued because I had done some back exercises years ago, and they had seemed to help.

Still, I wondered: Could simple exercises really cure severe back conditions? Was there good science to back up these claims? 

I’m happy to report that I received relief the first day I tried the exercises, and the more consistently I practice them, the better I feel. Plus, the book convinced me that there is good evidence the exercises will benefit almost everyone. I only wish I had started the McKenzie Method earlier in my life.

Robin McKenzie, a physical therapist who began practicing in New Zealand in the 1950s, often told the story of how he stumbled upon the method by accident. The end of an exam table was left in a raised position, and a patient lay on it face down, causing his spine to be bent slightly backwards. When McKenzie entered the room he was horrified to discover his patient in that position because it was considered harmful at the time.

The patient had been receiving treatments and manipulations for weeks to no avail, but he remarked how being in the prone position for a few minutes had given him relief. It was the lightbulb moment for McKenzie. The lower back does have a slightly backwards curve to it when we stand with good posture. It ought to be obvious that we should try to restore, maintain, and strengthen that posture.

McKenzie began experimenting with a variety of exercises that would eventually develop into the world famous therapy that goes by his name. He died in 2013 but his legacy lives on. Treat Your Own Back has sold more than 4 million copies in the U.S. and there are now more than 4,000 clinicians certified in the McKenzie Method of Mechanical Diagnosis and Therapy.

The method is based on the idea that the lower back, the lumbar, is the key to the most common back pain. It is the centerpiece of our skeleton, bearing the weight of the upper body and transmitting it to the pelvis and lower body. 

The most basic problems we have are “mechanical.” That is, a joint somehow gets into a position where surrounding ligaments and tissues are overstretched. The vertebrae and discs in the lower back are the prime example.

Nearly everyone will deal with some degree of back pain, and there are many causes. Poor posture or improper lifting will do it. Lack of movement and exercise is another big problem. Technology and prosperity have made it possible for more and more of us to live sedentary lifestyles, in offices and in front of computer screens. And, if you haven’t experienced lower back pain yet, just give it time. We live in a fallen world and we’re all getting older. Gravity and aging will eventually get you.

McKenzie distinguished between degrees of back problems. 

“Postural syndrome” is something almost everyone deals with, and “derangement syndrome” means the problem is more serious. Derangement means that movement in the joints and tissues is restricted, the pain is greater, and the pain is radiating to other parts of the body.

According to McKenzie, 80 percent of patients suffering from back pain can be treated with exercises, and only 10 percent of those actually need any form of clinician-applied manipulative therapy to be restored. Of course, he also recognized that more serious problems such as severe injuries or autoimmune diseases like arthritis were a different category entirely, and would call for other kinds of treatment.

The exercises are quick and simple but they do require you to be precise and consistent. You must follow the diagrams closely and be willing to do them frequently, up to 10 times a day if that is what is takes to get better.

McKenzie was famous for preaching that back pain is a personal responsibility. I must confess that once the acute pain is gone, it is easy to forget about your back and the exercises you ought to be doing.

None of the exercises are complex or require specialized equipment. Some involve using a chair or doorway to get yourself into position. The book shows clear photos and diagrams of how to do them properly.

McKenzie taught his patients to recognize progress by the principle of centralization. Basically, pain radiating out from the lower back should move back toward the center and diminish if the exercises are working. Range of movement is gradually restored.

Centralization has been studied by the McKenzie Institute and others, and there is now an extensive body of medical literature on it. A secondary concept that emerged from the McKenzie Method is “mechanically determined directional preference.” Once the problem area is identified, it involves stretching in a certain direction to correct the problem.

As you exercise and strengthen your back, you should experience the healing process of centralization. Pain radiating out from the lower back should gradually diminish and move back to the center.

Direction is a very important concept in the McKenzie method. The exercises themselves go in one of two basic directions: Extension increases the angle between two body parts and flexion decreases the angle.

McKenzie was also one of the first to popularize the use of simple lumbar roll cushions. He urged people not to underestimate the power of this simple tool, for maintaining proper posture and support of the lower back. Again, just like the exercises, he preached that consistent use was the key. McKenzie recommended getting one that has a belt to keep it in place, and also a designed version that can be worn when sleeping.

The McKenzie Institute also publishes companion books, Treat Your Own Shoulder and Treat Your Own Neck. I appreciate the easy-to-read format with illustrations and step-by-step instructions.  I hope you’ll check out Treat Your Own Back. It could change the way you think about posture and back pain. It could even save you from unnecessary surgery.

If you would like to find a McKenzie-certified clinician near you, visit 

This article is for educational purposes and not meant as medical advice.