Back & Neck Pain Living With How to Develop Normal Spinal Rotation By Anne Asher, CPT Anne Asher, CPT Facebook LinkedIn Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert. Learn about our editorial process Updated on November 27, 2020 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Laura Campedelli, PT, DPT Medically reviewed by Laura Campedelli, PT, DPT LinkedIn Laura Campedelli, PT, DPT, is a physical therapist currently working in New York at Morgan Stanley Children’s Hospital, an affiliate of New York Presbyterian. Learn about our Medical Expert Board Print Healthy spine rotation is an important aspect of preventing injury. And rotated vertebrae or "twisted spine" can result from spine, nerve, or muscle disease—or from harmful movements. Understanding the causes and prevention of rotated vertebrae can help you protect your spine from damaging vertebrae rotation. Milkos / Getty Images The Twisting Capability of a Normal Spine Your spine can move in several ways, including twisting. Tilting sideways is powered by some of the same muscles that twist the spine. Other spine movements include bending or rounding forward, and extending or arching backward. The spine is made of 26 interconnected bones, called vertebrae. When you move your spine, each individual vertebrae affects the direction of the entire spinal column. Although your spine can move in many directions, there are limits to how far you should go. This is especially true with twisting. Rotated or twisted vertebrae, especially when bending forward—as when lifting heavy objects—is associated with a risk of back injuries like strain and herniated disc. How Spinal Rotation Works Rotation is a basic spinal movement in which you turn the spinal column. When you twist your spine, it also bends to the side. The internal oblique abdominals and the external oblique abdominals, which don't directly attach to the spine, are the muscles primarily responsible for powering spinal rotation in the lower back. Intrinsic muscles such as the multifidus and longissimus contribute to this twisting movement as well. The multifidus helps control the movement, and the longissimus provides it with a bit of extension. The multifidus helps the spine twist when one side is contracted (activated) and it extends the lumbar spine when both sides contract. The Link Between Age and Spinal Rotation Most people, especially as they age, accumulate tension and/or weakness in the oblique abdominal muscles and other trunk muscles. These changes are largely attributable to sedentary behavior. Chronically tight back and abdominal muscles impair the range of motion of the trunk, as well as the ability to twist the spine. Being sedentary may lead to weakened muscles, which, in turn, may decrease support for any spinal movement, including twisting. Muscle weakness can also diminish overall trunk stability. Spinal Rotation and Scoliosis In scoliosis, which is a lateral curve of the spine, some of the vertebrae appear to be displaced to the side. Often, abnormal vertebral rotation underlies this displacement. Treatment for scoliosis is often focused on controlling vertebral rotation with medical guidance and physical therapy. Scoliosis Causes and Treatment The Dangers of Over-Rotating Your Spine Many people over-rotate their spines with manual work, which can increase the risk of back injuries. Over-rotation can happen with activities like digging a garden or shoveling snow. There are safe ways to do these types of activities, and it is a good investment of time to learn how to perform physical tasks safely, such as shoveling. When shoveling, rotating your spine to dump a shovelful of snow or garden dirt behind you may seem easier while you’re in the throes of your project, but overall, this is much riskier for your back than taking a few steps around to where you want to dump the dirt or snow, and then flipping the shovel down instead. In a 1997 review of studies, the Centers for Disease Control concluded that lifting heavy objects with your back twisted, as well as other awkward work postures, is indeed a risk factor for a work-related injury. How to Develop Your Spinal Rotation A good way to achieve optimal rotation of your spine is with daily back exercises. An effective back exercise program will consist of movements in every direction the spine moves, including rotation. Yoga is great for this because it places emphasis on developing flexibility and strength in all directions. Pilates does the same. But rotation may worsen some back problems, such as a herniated disc. If you have a spine condition, talk to your healthcare provider or physical therapist about how you can safely exercise your spine. A good injury prevention exercise program will also work your hip and pelvic muscles, too. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 7 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Shan X, Ning X, Chen Z, Ding M, Shi W, Yang S. Low back pain development response to sustained trunk axial twisting. Eur Spine J. 2013;22(9):1972-8. doi:10.1007/s00586-013-2784-7 Hebert JJ, Koppenhaver SL, Teyhen DS, Walker BF, Fritz JM. The evaluation of lumbar multifidus muscle function via palpation: reliability and validity of a new clinical test. Spine J. 2015;15(6):1196–1202. doi:10.1016/j.spinee.2013.08.056 Realini CE, Vénien A, Gou P, et al. Characterization of Longissimus thoracis, Semitendinosus and Masseter muscles and relationships with technological quality in pigs. Microscopic analysis of muscles. Meat Sci. 2013;94(3):408-16. doi:10.1016/j.meatsci.2013.03.009 Waongenngarm P, Rajaratnam BS, Janwantanakul P. Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers. Saf Health Work. 2016;7(1):49-54. doi:10.1016/j.shaw.2015.08.001 Horne JP, Flannery R, Usman S. Adolescent idiopathic scoliosis: diagnosis and management. Am Fam Physician. 2014;89(3):193-8. Low Back Pain Fact Sheet. National Institutes of Health. Breaking Down The Exercises That Break Down Your Spine. National Spine Health Foundation. Additional Reading Bernard, B., P., MD, MPH. Musculoskeletal Disorders and Workplace Factors: A Critical Review of Epidemiologic Evidence for Work-Related Musculoskeletal Disorders of the Neck, Upper Extremity, and Low Back. U.S. Department of Health and Human Services. Public Health Service. Centers for Disease Control and Prevention. National Institute for Occupational Safety and Health. July 1997.