The McKenzie Side Glide Test assesses how lumbar symptoms respond to repeated or sustained side-gliding movement. It is commonly used when a person has low back pain, referred leg symptoms, a visible lateral shift, or suspected directional preference. A positive test may involve centralisation, symptom reduction, improved movement, or a clear mechanical response to side glide. A negative test means there is no meaningful symptom or movement change. The test does not diagnose disc pathology, nerve compression or a specific spinal condition on its own.
The McKenzie Side Glide Test is used in Mechanical Diagnosis and Therapy, also known as MDT, to assess whether lateral lumbar loading changes symptoms or movement.
It is most often associated with:
low back pain
referred buttock or leg symptoms
visible lumbar lateral shift
suspected directional preference
centralisation or peripheralisation assessment
mechanical response testing
The test is not mainly about “finding a structure”. It is about observing response.
The most useful question is:
Does side gliding change pain location, pain intensity, movement range, confidence or symptoms?
Centralisation and directional preference are broader MDT concepts. An updated systematic review reported centralisation and directional preference as positive prognostic factors in low back pain, but also noted limited evidence for some reliability and treatment-effect-modifier questions.
Test name: McKenzie Side Glide Test
Also known as: Side Glide Test, lateral shift correction test
Body region: Lumbar spine and pelvis
Purpose: Assess response to lateral lumbar loading
Positive finding: Meaningful symptom or movement response during side glide
Negative finding: No meaningful change in symptoms or movement
Best used with: History, repeated movement testing, neurological screen, Slump Test, Straight Leg Raise and lumbar ROM
Main limitation: It does not diagnose a specific pathology on its own
The McKenzie Side Glide Test is a standing lumbar assessment where the professional guides the client’s pelvis sideways while the trunk is stabilised. It can also be performed as an active wall side glide, where the client uses their body position against a wall to create repeated lateral movement.
During the test, the professional observes whether symptoms:
reduce
increase
centralise
peripheralise
move location
become easier to reproduce
become harder to reproduce
remain unchanged
The current Measurz article also frames the test as an assessment of whether lateral movement changes pain location, intensity or range, rather than as a test that confirms a disc lesion.
The test is used to assess whether a client has a meaningful response to frontal-plane lumbar loading.
It may help professionals:
assess directional response
explore a suspected lateral component
document centralisation or peripheralisation
compare left and right side-glide response
decide whether further lumbar movement testing is needed
monitor symptom response over time
support client education with clear movement-response language
It should not be used to diagnose a disc herniation, nerve compression or spinal lesion on its own.
The test assesses:
lumbar side-glide movement response
symptom behaviour during lateral loading
presence or relevance of a lateral shift
movement obstruction or asymmetry
centralisation or peripheralisation
client confidence with side movement
response to repeated or sustained lateral movement
It does not directly assess:
disc structure
nerve root compression
imaging findings
spinal instability
tissue healing
return-to-sport readiness
work capacity
This test may be useful for:
exercise professionals
movement assessment professionals
strength and conditioning coaches
allied health support teams
students learning lumbar assessment
professionals using Measurz or MAT for structured assessment education
It may be relevant when a client reports:
low back pain with a sideways shift
one-sided lumbar pain
buttock or leg symptoms
pain that changes with repeated movement
difficulty standing upright
symptoms affected by side bending or walking
Consider this test when:
a lateral shift is visible
symptoms appear mechanically influenced
sagittal-plane repeated movement testing is unclear
side gliding changes symptoms during warm-up or observation
lumbar flexion/extension testing does not explain the response
the client can stand safely
It is more meaningful when paired with:
symptom history
repeated flexion and extension testing
neurological screen when relevant
Slump Test or Straight Leg Raise when leg symptoms are present
functional movement assessment
Use caution or avoid the test when there is:
recent significant trauma
suspected fracture
progressive neurological symptoms
severe or worsening leg symptoms
unexplained systemic symptoms
inability to stand safely
high irritability where small movement worsens symptoms
dizziness or poor balance
post-surgical precautions
client fear or distress
Stop the test if symptoms escalate, travel further down the leg, neurological symptoms worsen, or the client cannot return to standing comfortably.
Usually no equipment is required.
Helpful options include:
wall for active side glides
plinth nearby for safety
pain rating scale
body chart
Measurz assessment record
camera or posture grid if documenting lateral shift visually
Explain the test clearly:
“We are going to check whether a sideways movement of your lower back changes your symptoms. This does not diagnose a condition by itself. Tell me if your symptoms reduce, increase, move, spread or become more familiar.”
Client stands upright.
Feet are about hip-width apart.
Knees relaxed.
Arms relaxed unless using a wall method.
Baseline symptoms are recorded before testing.
Record:
pain score
symptom location
side of symptoms
visible shift direction if present
ability to stand upright
For a manual side glide:
stand to the side of the client
stabilise the client’s upper trunk with your shoulder or hands
place both hands around the pelvis
guide the pelvis laterally beneath the trunk
For an active wall glide:
client stands side-on to the wall
shoulder or upper body remains near the wall
pelvis glides toward the wall
client repeats the movement as instructed
Manual method:
one or both hands control the pelvis
trunk is blocked or stabilised
avoid gripping painful areas
movement should be controlled, not forced
Stabilise:
upper trunk
pelvis
foot position
balance
Avoid:
trunk rotation
forward bending
backward leaning
knee bending
forcing through sharp pain
moving too quickly
The pelvis is moved sideways under the trunk.
Test both directions when appropriate:
pelvis glides left
pelvis glides right
The key is symptom response, not how far the person moves.
Use consistent instructions:
“Tell me if your symptoms change.”
“Tell me if pain moves up, down, in or out.”
“Tell me if the movement feels blocked.”
“Tell me if symptoms become sharper, spread or reduce.”
“Keep breathing.”
A positive test may include:
symptoms centralise
symptoms reduce
movement improves
a lateral shift becomes easier to correct
symptoms peripheralise or worsen in one direction
one side glide clearly changes symptom location or intensity
A negative test means:
no meaningful symptom change
no clear movement change
no directional response
no centralisation or peripheralisation
side glide does not add useful information
Stop if:
pain sharply increases
symptoms travel further down the leg
numbness or weakness worsens
the client becomes distressed
balance is unsafe
the client asks to stop
symptoms do not settle after returning to neutral
Do not force the side glide. Use gentle, progressive pressure and monitor symptoms continuously.
A positive McKenzie Side Glide Test may suggest that the client’s symptoms are mechanically influenced by lateral lumbar loading.
A positive response is more meaningful when it matches:
history
symptom location
movement behaviour
lateral shift observation
repeated movement testing
neurological screen where relevant
functional task response
A positive test may increase suspicion that a lateral component or directional preference is relevant. It does not confirm disc pathology, nerve compression or a specific spinal condition.
A negative test may suggest that lateral loading is not a meaningful direction for that client at that time.
However, a negative result does not exclude:
lumbar-related symptoms
referred pain
nerve involvement
discogenic pain
movement sensitivity
Further assessment may still be needed if symptoms, history or functional limitation remain concerning.
At the time of writing, high-quality peer-reviewed diagnostic accuracy evidence reporting sensitivity, specificity or likelihood ratios for the McKenzie Side Glide Test itself appears limited.
That means the test should be used as:
a movement-response assessment
a directional preference exploration
an education tool
part of a broader assessment cluster
It should not be used as a stand-alone diagnostic test.
Evidence is stronger for broader MDT concepts such as centralisation and directional preference than for the Side Glide Test alone. A 2025 paper reported that directional preference had not previously been assessed against controlled lumbar discography and investigated its concurrent validity in persistent low back pain, showing that diagnostic interpretation of MDT response patterns remains an evolving area.
Plain-language interpretation:
Higher sensitivity would make a negative result more useful for decreasing suspicion, but this has not been clearly established for this exact test.
Higher specificity would make a positive result more useful for increasing suspicion, but this has not been clearly established for this exact test.
Without strong likelihood ratio data, the result should be interpreted cautiously and combined with other findings.
Reliability evidence for related MDT classification systems is stronger than evidence for the Side Glide Test alone.
A 2018 systematic review on MDT reliability reported that trained clinicians had acceptable reliability for classifying patients with lumbar pain, but evidence was not equally strong across all spinal regions or procedures.
A study on lumbar lateral shift detection noted that reliability problems may relate to rater training, biological variation and test reactivity. This matters because visual lateral shift observation alone may be less dependable than recording a clear symptom response during side glide testing.
Reliability improves when professionals record:
starting symptoms
shift direction
side-glide direction
number of repetitions
symptom response
pain location
centralisation or peripheralisation
stopping reason
retest response
Common errors include:
treating the test as diagnostic
not recording symptom location before testing
forcing the side glide
testing only one direction
confusing side bending with side gliding
not monitoring peripheralisation
relying only on visible lateral shift
failing to retest symptoms after movement
not recording whether symptoms centralised or peripheralised
Limitations:
diagnostic accuracy evidence for the exact test is limited
response may vary with irritability
results depend on examiner skill
client fear or guarding can change movement
lateral shift observation may be unreliable
positive response does not confirm a structure
negative response does not exclude spinal involvement
The McKenzie Side Glide Test can help professionals:
document lateral movement response
identify whether side glide changes symptoms
monitor centralisation or peripheralisation
decide whether more MDT-style movement testing is useful
educate clients about symptom behaviour
compare baseline and retest response
guide referral or further assessment when symptoms are concerning
It is most useful when combined with:
lumbar flexion and extension testing
spine lateral flexion
spine rotation
neurological screen
Slump Test
Straight Leg Raise
functional movement assessment
pain and symptom history
Record:
Test name: McKenzie Side Glide Test
Side/direction tested: pelvis glide left, pelvis glide right
Result: positive, negative, unclear or unable to test
Pain score: before, during and after
Symptom location: back, buttock, thigh, leg, foot
Symptom quality: pain, ache, numbness, tingling, pressure, tightness
Response: centralised, peripheralised, reduced, worsened, unchanged
Position used: standing manual side glide or wall side glide
Shift direction: left, right or none observed
Movement quality: blocked, smooth, guarded, painful
Comparison side: response left versus right
Confidence in result: high, moderate or low
Irritability: low, moderate or high
Compensations: rotation, side bending, knee bend, trunk lean
Reason for stopping: pain, peripheralisation, fatigue, fear, balance, no issue
Related findings: lumbar flexion/extension, Slump, SLR, neurological screen, gait
Interpretation note: “Side glide response may support assessment reasoning but does not diagnose a condition.”
Retest date: if monitoring change
Recording these details improves repeatability, communication, client education, assessment reasoning, monitoring over time, team consistency and reporting quality.
It assesses whether side-gliding movement changes lumbar, buttock or leg symptoms. It is mainly a symptom-response test.
A positive test is a meaningful symptom or movement response, such as centralisation, symptom reduction, peripheralisation, worsening or improved movement after side gliding.
No. It may support assessment reasoning when symptoms change with lateral loading, but it does not confirm disc pathology.
Centralisation means symptoms move from a more distal area, such as the leg, toward the spine or reduce distally during repeated movement or positioning.
Peripheralisation means symptoms move further away from the spine, such as from the back into the leg, or spread distally during testing.
The test may reproduce symptoms, but it should not be forced into sharp, escalating or unsafe pain.
No. It can support movement-response monitoring, but readiness decisions need symptoms, strength, function, workload, confidence and professional judgement.
The McKenzie Side Glide Test assesses response to lateral lumbar loading.
The most important finding is symptom response, not movement distance.
A positive test may suggest a meaningful directional response.
A negative test does not exclude lumbar involvement.
Diagnostic accuracy evidence for the exact test is limited.
Record centralisation, peripheralisation, pain score and side-glide direction.
Use the test as part of a broader assessment, not as a stand-alone diagnostic tool.
Deneuville, J.-P., & colleagues. (2025). Concurrent validity of the directional preference phenomenon compared to controlled lumbar discography: A supplementary analysis of a diagnostic accuracy study. Musculoskeletal Science and Practice. https://doi.org/10.1016/j.msksp.2025.103161
Garcia, A. N., Menezes Costa, L. C., Hancock, M. J., Souza, F. S., Gomes, G. V. F. O., Almeida, M. O., & Costa, L. O. P. (2018). Reliability of the Mechanical Diagnosis and Therapy system in patients with spinal pain: A systematic review. Journal of Orthopaedic & Sports Physical Therapy, 48(12), 923–933. https://doi.org/10.2519/jospt.2018.7876
Lam, O. T., Strenger, D. M., Chan-Fee, M., Pham, P. T., Preuss, R. A., & Robbins, S. M. (2018). 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, 48(6), 476–490. https://doi.org/10.2519/jospt.2018.7562
May, S., Runge, N., & Aina, A. (2018). Centralization and directional preference: An updated systematic review with synthesis of previous evidence. Musculoskeletal Science and Practice, 38, 53–62. https://doi.org/10.1016/j.msksp.2018.09.006
Moffett, J. K., & colleagues. (2003). Reliability of detection of lumbar lateral shift. Journal of Manipulative and Physiological Therapeutics, 26(8), 476–480. https://doi.org/10.1016/S0161-4754(03)00104-0
