McKenzie Side Glide Test (Mechanical Diagnosis and Therapy – MDT)
- Fysiobasen
- Oct 4
- 3 min read
Mechanical Diagnosis and Therapy (MDT), commonly known as the McKenzie Method, is a classification-based system developed to group patients into homogeneous subgroups for more targeted treatment¹.
Research by Long, Donelson, and Fung has shown that a mechanical assessment can identify a large subgroup of patients with acute, subacute, and chronic low back pain who demonstrate a directional preference – an immediate and lasting reduction of symptoms with repeated or sustained movements or positions in the sagittal plane (flexion or extension) or the frontal plane (lateral shift or rotation)².
The McKenzie Side Glide Test is used to assess frontal plane movement restrictions and can also serve as a provocation test to classify the patient’s condition.
Purpose of the Test
The primary aim of the Side Glide Test is to:
Evaluate whether the patient has restricted movement in the frontal plane.
Determine whether the maneuver reproduces or modifies pain symptoms.
Identify the presence of a lateral component contributing to the patient’s condition³.
This assessment is crucial for classification within MDT and helps guide treatment strategies.
Test Procedure
Patient position
The patient stands with feet shoulder-width apart.
They are instructed to keep shoulders level while sliding the hips sideways, avoiding knee flexion or side-bending.
Examiner’s role
The therapist may:
Stabilize the shoulders to minimize compensatory trunk movements.
Assist the patient in moving the hips sideways.
Repeat the test to both directions and note any range of motion asymmetry or symptom reproduction.
Additional pressure
The examiner can apply overpressure at end range to confirm maximal movement or to provoke symptoms.
Interpretation
Positive test: Significant motion loss to one side, or pain is reproduced/centralized.
Negative test: Symmetrical movement without pain provocation.
A lateral component is suspected when there is a clear asymmetry or symptom change during the test.
Treatment Application
If a lateral shift is present, side glide exercises can be prescribed as part of treatment.
Example: Lateral Shift Correction Exercise
Patient stands in a doorway with one shoulder against the door frame.
The hips are actively pushed toward the door frame.
The patient retreats slightly from end range but does not return fully to neutral.
Repeated movements are performed until symptoms improve.
Clinical note:A lateral shift is defined by shoulder displacement relative to the hips. For example, if the shoulders are shifted to the right and the hips to the left, this is classified as a right lateral shift.
Scientific Evidence
According to McKenzie, a lateral shift is clinically relevant when:
Postural observation shows a visible shift.
Side glide testing alters pain location or intensity⁴.
Evidence highlights:
Lateral components are common in patients with disc derangements.
The Side Glide Test can be both diagnostic and therapeutic, especially when pain centralizes with repeated side glides.
Evidence supports its inclusion in MDT assessment for low back pain patients¹²³⁴.
Clinical Relevance
The McKenzie Side Glide Test is an important tool for classifying mechanical low back pain.
Identifies whether lateral forces are necessary for treatment progression.
Should be combined with sagittal plane testing (flexion/extension) for full MDT evaluation.
Conclusion
The McKenzie Side Glide Test is a reliable assessment for identifying lateral components in patients with low back pain. By detecting motion loss or symptom reproduction in the frontal plane, it guides clinicians in classification and targeted MDT treatment. While not diagnostic on its own, it provides essential information when used alongside other MDT assessment strategies.
References
Lam OT, Strenger DM, Chan-Fee M, Pham PT, Preuss RA, Robbins SM. Effectiveness of the McKenzie Method of Mechanical Diagnosis and Therapy for Treating Low Back Pain: Literature Review With Meta-analysis. Journal of Orthopaedic & Sports Physical Therapy. 2018;48(6):476-490.
Long A, Delson R, Fung T. Does it matter which exercise? A randomized control trial of exercise for low back pain. Spine 2002;27(24):2529-2602.
Santolin SM. McKenzie diagnosis and therapy in the evaluation and management of a lumbar disc derangement syndrome: A case study. J Chiropr Med, 2013;2(2): 60-65.
Donahue MS, Riddle DL, Sullivan MS. Intertester reliability of a modified version of McKenzie's lateral shift assessments obtained on patients with low back pain. Phys Ther. 2009; 76(7): 706-16.
Joel Laing. McKenzie Method: Extension in Lying with Lateral Modification. Available from: https://www.youtube.com/watch?v=K7EmCJR9aYk [last accessed 23/02/2020]
