This model explains the effectiveness of various procedures based on the assumption that flow, or displacement of fluid, nucleus or sequestrum can  occur within the intact annulus of the intervertebral disc as a result of prolonged or repetitive loading.  Sisplacement most commonly, but not exclusively, occurs with flexion loading, To treat such displacements we must apply well-defined  compressive forces, in order to reverse the direction of flow or displacement.  This model is supported substantially by Kramer (1981).

To achieve an alteration in the distribution or location of displacement, either static loading or repetitive motion can be effective.  An exercise becomes a mobilisation when performed with a certain frequency and in such a way that a rhythmical passive stretch is created.  In a similar manner the same exercise with the addition of overpressure can become a manipulation.  The suggestion put forth is that mobilisation and manipulation are nothing more then extended exercises, and an exercise can become a mobilisation or manipulation.  In this way patients can be taught to practise mobilisation and manipulation of their own spine.

McKenzie model ends with prevention.  It has now been demonstrated that several different patient populations have been taught to manage and treat their own back problems using self-applied movement described here and elsewhere (Di Maggio and Mooney, 1987a, b; Donelson et al., 1986; Kopp et al., 1986; McKenzie et al., 1988; Nwuga and Nwuga, 1985; Ponte et all, 1984).  If there is the slightest chance that a patient can be educated in any method that enables him to reduce his own pain and disability using his own understanding and resources, he should receive that education.  Every patient is entitled to the information, and every therapist should be obliged to provide it.