Gait Loading Progression for Lumbar Lateral Shift | Modern Manual Therapy Blog

Gait Loading Progression for Lumbar Lateral Shift


The patient in the video had several level spinal fusion from T7-S1. He had several years of being able to golf and return to function and running. However, he noticed continued lumbar lateral shift to the right. His lumbar spine and left LE is still Sx free, however it has atrophied significantly and in the past year, he has found it difficult to load. His balance is affected and he now needs a cane to walk. He is a PT and is also going to several PTs for gait and general strengthening/conditioning.

The video series I show 4 videos
  1. Unsupported gait 
  2. gait with cane
  3. gait with kettlebell on L - involved side
  4. gait with cane and kettlebell
Manual therapy was also performed to his L hip, L ankle and great toe, all of which had mobility issues. After all of this, he felt much steadier and enjoyed the kettlebell farmer's carries. He was able to walk faster as well with increased ability to accept load on his left.

Gait Loading Progression

Initially, we also attempted carrying the kettlebell on his right (activating L lateral chain was the thought), but this made him much more unsteady/shifted to the right.

What else do you notice about his gait?

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