Side Gliding With Untrained External Assistance and Preexisting Hip Internal Rotation Weakness Preceding Acute Lateral Hip Pain: A Mechanical Diagnosis and Therapy (MDT) Case Report.

A patient complained of left-sided low back pain that radiated to her left ankle and, upon examination, was found to have right hip internal rotation weakness. She was classified by this author as having a directional preference for lumbar rotation in flexion per the McKenzie Method of Mechanical Diagnosis and Therapy (MDT, or the McKenzie Method). At the patient's eighth visit, she reported that she had been performing approximately 160 repetitions of left lumbar side gliding against a wall per day and, of her own volition, having an untrained family member give this movement a push. At this visit, manual correction of a lateral lumbar shift, also known as a shift correction, slightly improved her lumbar active range of motion (AROM). The clinician then asked the patient to perform left lumbar side gliding against a wall in the clinic during which a "pop" was heard, and the patient reported intense right hip pain as well as displayed an antalgic gait. Despite numerous limitations including inadequate documentation of subjective and objective baselines, such as numeric pain rating scale, strength, and AROM immediately after this critical event as well as multiple confounding factors, it is possible that future clinicians may wish to utilize the shift correction manual technique, instead of additional repetitions of lumbar side gliding, to more accurately determine directional preference.