Audience Q&A: Lumbar Lateral Shift | Modern Manual Therapy Blog - Manual Therapy, Videos, Neurodynamics, Podcasts, Research Reviews

Audience Q&A: Lumbar Lateral Shift

There has been something I have been meaning to throw out there to generate some discussion. I know what I (and other MDT trained clinicians) do for a lumbar lateral shift in terms of evaluation, treatment, and patient education.
My question for all of you out there is, for those of you who are not formally MDT trained, or have no exposure to it, what do you do?

From my education at the University of St. Augustine, I was taught positional distraction and given relevant scan study info showing that that position has maximal gapping unilaterally. However, there was no real progression or patient education, other than the typical avoidance.

I'm asking this because it's not often a very difficult lateral shift comes walking crookedly into your clinic. I'm currently seeing one who was seen in the clinic 1.5 years ago. Back then, he was fully corrected, the derangement was stable, and he returned to function after 8-9 visits.

This time around, after 6 visits, he returns back after each session either no better, or worse. On the last visit, he told me he can't take care of his daughter, who is 1 month older than my youngest. He said, "I can't be left alone with her." That hit me so hard, I spend 90 minutes with him trying various shift correction strategies. He left walking slightly more upright, with centralization of R LE complaints, but still had 5/10 pain.

So my question to you guys is more out of curiosity and less for advice, but that's always appreciated!

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