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.

Introduction

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.  

Quick Summary

• 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

What Is the McKenzie Side Glide Test?

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.  

Why It Is Used

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.

What It Assesses

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

Who It Is Useful For

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

When to Use This Test

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

When Not to Use or When to Be Cautious

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.

Equipment Required

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

Step-by-Step Protocol / Practice

Setup

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 Position

• 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

Examiner / Professional Position

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

Hand Placement

Manual method:

• one or both hands control the pelvis
• trunk is blocked or stabilised
• avoid gripping painful areas
• movement should be controlled, not forced

Stabilisation

Stabilise:

• upper trunk
• pelvis
• foot position
• balance

Avoid:

• trunk rotation
• forward bending
• backward leaning
• knee bending
• forcing through sharp pain
• moving too quickly

Movement or Force Direction

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.

Instructions

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.”

Positive Finding

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

Negative Finding

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

Stopping Criteria

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

Safety Notes

Do not force the side glide. Use gentle, progressive pressure and monitor symptoms continuously.

Positive and Negative Test Interpretation

Positive Test

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.

Negative Test

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.

Sensitivity, Specificity and Diagnostic Accuracy

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 and Validity

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 and Limitations

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

Practical Applications

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

How to Record This in Measurz

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.

Related Tests / Internal Links

• Spine Flexion Extension
• Spine Lateral Flexion
• Spine Rotation
• Slump Test
• Straight Leg Raise Test
• Standing Flexion Test
• Stork Test
• Oswestry Disability Questionnaire

FAQs

What does the McKenzie Side Glide Test assess?

It assesses whether side-gliding movement changes lumbar, buttock or leg symptoms. It is mainly a symptom-response test.

What is a positive McKenzie Side Glide Test?

A positive test is a meaningful symptom or movement response, such as centralisation, symptom reduction, peripheralisation, worsening or improved movement after side gliding.

Does the test diagnose a disc herniation?

No. It may support assessment reasoning when symptoms change with lateral loading, but it does not confirm disc pathology.

What is centralisation?

Centralisation means symptoms move from a more distal area, such as the leg, toward the spine or reduce distally during repeated movement or positioning.

What is peripheralisation?

Peripheralisation means symptoms move further away from the spine, such as from the back into the leg, or spread distally during testing.

Should the test be painful?

The test may reproduce symptoms, but it should not be forced into sharp, escalating or unsafe pain.

Can this test clear someone for sport or work?

No. It can support movement-response monitoring, but readiness decisions need symptoms, strength, function, workload, confidence and professional judgement.

Key Takeaways

• 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.

References

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