Twisted Spine — What are your Back's Limits?

The phrase "twisted spine" may conjure up all sorts of unsavory things in your imagination: Hunchbacks, broken bones, injury risks or an urgent need to see your chiropractor. But let's unpack this term just a bit, to allay your fears and help you address your pain in an appropriate-for-you kind of way. 

The spine can do several movements, of which twisting is one. The others include bending or rounding forward, tilting sideways, which is often powered by the same muscles that twist the spine, and extending or arching backwards.

And the spine is made of 26 interconnected bones, called vertebrae. When you perform the above-mentioned movements, set the direction for the entire column is set by each individual vertebrae. You might think of the vertebra as underpinnings or structure for spinal motion.

Although the well-being of your back relies to a great extent on your ability to perform all the movements which are, again, bending, tilting, twisting and arching, limits exist as to how far you should go. This is especially true with twisting. Rotated or twisted vertebrae, especially in conjunction with forward bending — as when lifting heavy objects without minding the rules of good body mechanics —  is associated with a higher risk for back injuries like strain and herniated disc.

Rotation is a basic spinal movement in which you turn the spinal column around itself (called turning around the axis, with the axis being the spine.) When you twist your spine, it also bends to the side as a secondary part of that action. This is due to the way the vertebra fit together. The internal oblique abdominals and the external oblique abdominals are the muscles primarily responsible for powering spinal rotation in the lower back, with intrinsic muscles such as the multifidus and longissimus contributing as well. The multifidus helps control the movement and the longissimus, provides it with a bit of extension.

Most people, especially as they age, accumulate tension in the oblique abdominal muscles and other trunk muscles. This type of tension is largely attributable to sedentary behavior. The problem is, because chronically tight back and ab muscles reduce trunk range of motion,  the ability to twist the spine is also diminished.

And being sedentary may lead to weak muscles, which, in turn, may decrease support for any spinal movement, including twisting. Muscle weakness is another thing that may decrease overall trunk stability.

Scoliosis is often called a lateral curve of the spine, suggesting displacement off to the side of some of the vertebra. While this may seem true upon visual inspection, a more careful examination may reveal that an abnormal vertebral rotation underlies this side-to-side displacement. Treatment for scoliosis is often focused on decreasing the degree of the vertebral rotation. As far as curative activities for scoliosis is concerned, the best thing to do is consult with your doctor and/or physical therapist for guidance.

Many people over-rotate their spines during the manual work-intensive winter and summer months. Unfortunately, they often pay for it with a back injury.

Generally speaking, people who over-rotate while digging a garden or shoveling snow have either not learned how to safely shovel (or perform similar tasks) or  they aren't willing to make the extra effort to step around before letting go of the shovel's contents. In other words, rotating your spine in order 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 simply 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 work-related injury.

Perhaps the best way to achieve optimal rotation of your spine is to do your back exercises daily.

A good 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 irritate some back problems, such as herniated disc. If you have a condition, talk to your doctor or physical therapist about how you can safely rotate your spine or move in any of the other directions as you exercise.

A good injury prevention exercise program will also work your hip and pelvic muscles, too.