A search term on my blog today was “soap note for hip lateral shift mckenzie.” That was written by a physical therapist. That is really specific and it uses therapist speak. I didn’t realize how much I loved and missed this stuff until recently when I started being immersed in it again because of my chart review job and realizing that I will most likely never do it again.
A lateral shift means your low back hurts. Or maybe your hip hurts. When a lateral shift is present, your upper body is shifted to either the right or left because (probably because) an intervertebral disc in your low back is displaced (bulging) out to the side preventing your spine from being straight up and down like a good spine should. Your upper body is “leaning away from the pain.” It looks like this.
The shift is always named by the superior segment so in the picture that would be called a left lateral shift. So how do you fix it? Well…….if your shoulders are shifted to the left and you have low back pain, I’ll bet you a million dollars that your pain is on the right side of your low back. Or in your right hip. Or you have pain going down your right leg.
To eliminate the pain, first you want to see that pain ‘centralize’ meaning moving the pain to the middle of your low back and not just to one side. So first you have to address the shift. There are ways to try this yourself but you might need a PT’s help the first few times. Here’s the exercise to try on your own. This is for a left lateral shift which means your shoulders are shifted to the left relative to your hips and your low back pain is on the right. If the exercises don’t work, here is what a therapist would do.
Then this kind of thing would typically be followed by some by some extension exercises. These extension exercises would be progressed as much as need be and you would be lectured to about having good posture and then you would be tested bending forward to make sure that doesn’t bring the pain back and if it doesn’t you would be discharged never to be seen in PT again unless you have a stroke.
DISCLAIMER: I had a stroke, so don’t you dare listen to my advice.