Clinical Conversations

Medical Advisory: Choose Your Physical Therapist Wisely

Medical Advisory: Choose Your Physical Therapist Wisely


Nick Rinard MPT Cert MDT Owner of MDT Physical TherapyNick Rinard

The purpose of this essay is to inform you that not all Physical Therapy is the same. Some are more effective than others. If you had Physical Therapy, did it work? If you are going to Physical Therapy now, is it helping? If yes, you should continue until you are better. However, if you are not getting better, or if you need Physical Therapy in the future, then you should read on.

First choice for treating spinal pain

Mechanical Diagnosis and Therapy (MDT) has been shown in numerous scientific studies to be the most effective type of Physical Therapy available today. In a poll of Physical Therapists nationwide, MDT was the first choice for treating spinal pain (APTA publication 2002). This is a good thing, since it shows that the profession of Physical Therapy is gaining more and more scientific evidence to support its use. However, you should know just what MDT is so you can be sure you are actually receiving it.

Development of MDT

MDT was developed in New Zealand by a physiotherapist named Robin McKenzie. Mr. McKenzie noticed that his patients got better faster, and could control their pain themselves, compared to patients being treated traditionally. He founded the McKenzie Institute and has been training therapists since 1980. You should choose a therapist that is a certified MDT therapist, designated by Cert MDT.

What – no gadgets?

The MDT method does not rely on technological gadgets such as ultrasound or electrical stimulation commonly used in traditional Physical Therapy. There is little evidence to show that these machines actually help in recovery. Instead, Mechanical Diagnosis and Therapy, as its name suggests, uses mechanical forces to centralize referred pain, and to correct the physical problem. Exercises designed specifically for each patient, affect pain immediately, and can be performed by the patient whenever pain arises. Over a short time, these exercises heal the injury and allow full recovery. In our clinic, Nick Rinard Physical Therapy, the average number of visits is only six and a half!

Your Time is Valuable

A very important part of the MDT method is the evaluation on the first day. A qualified Cert MDT therapist should be able to identify if you will respond or not. This way, if the problem is not mechanical, valuable time in your recovery is not wasted, since you would not go through several weeks of rehabilitation to discover at the end that it did not help. Doctors who have the best interests of their patient in mind prefer MDT for this very reason. If your doctor is not aware of the MDT method, then you can choose an MDT therapist yourself. It is considered standard practice and has been accepted by the medical community.

Medical Advisory: MDT is a Superior Form of Physical Therapy

If you sustained your injuries in a motor vehicle accident, or work-related injury, then your chances of getting better are improved if you choose an MDT therapist. There is a financial advantage also since the total cost of your therapy will be less, based on the fewer number of visits MDT uses. Your PIP money will go further, and you will not have to sacrifice a large amount of money out of your settlement just to pay high physical therapy bills. If you are a worker, your case will be less likely to be denied if you are getting better faster, than if your recovery drags on. Believe me, insurance adjusters are less likely to keep your case open if you are not improving in physical therapy.

MDT compared to Chiropractic

So you can see that MDT is a superior form of physical therapy. What about MDT compared to Chiropractic care? I tell my patients that Chiropractic treatment is indeed mechanical, but there are two distinct reasons it is not superior to MDT. The first reason has to do with the evaluation, and the second reason has to do with the treatment. A chiropractor first must take an X-ray to make the diagnosis. Unfortunately, there is little evidence to suggest a chiropractic diagnosis is reliable, and therefore, treatment based on an unreliable diagnosis is a guess at best. Secondly, chiropractic treatment is performed to the patient, not by the patient. Any improvement in the patient’s condition, therefore, is dependent on them going back for more visits! As mentioned, MDT treatments consist primarily of exercises that the patient performs so you can treat yourself when not in the clinic. This obviously results in less pain, a speedier recovery, less visits, and money saved!

MDT Treatment is more effective and takes less time

By reading this essay, you are now equipped with knowledge to seek out the best care possible for your injuries. Don’t waste time going to traditional physical therapy, or chiropractic for many visits. It is better to get an MDT evaluation to determine if your condition will respond mechanically or not, and if it is mechanical, then the treatment is more effective and takes less time!

Better in only 6.5 visits

In closing, I would like to mention how MDT compared to traditional physical therapy in an objective study conducted by a third party. The average improvement in traditional physical was only 78 percent, and it took an average of 11 visits to achieve this. By contrast, MDT got patients 93 percent better in only 6.5 visits! The data speak for themselves. Don’t settle for less effective treatment for your injury – find a Cert MDT therapist who is using the MDT method properly, and get better faster!

Nick Rinard is president of, and a therapist at, Nick Rinard Physical Therapy, a private physical therapy clinic.