This blog post will cover the best exercises and stretches to fix a Twisted Spine.

What Is A Twisted Spine?

A Twisted Spine is where the torso is rotated towards one side.

It involves rotation of the Lumbar and/or Thoracic spine.

In This Blog Post:

• Causes
• Muscles Involved
• Potential Issues
• How To Determine Rotation Direction
• Exercises To Fix A Twisted Spine

Causes

In my opinion – the main cause of having a twisted spine is the habitual positioning of the torso in a rotated position.

Over time, certain muscles become locked in a shortened position (and others in a relatively lengthened position) which can result in the spine adopting a twisted position.

Other Causes:

• In response to having pain on one side of the spine
• As a compensation for an injury on one side of the body (Eg. Limping due to foot pain)
• When participating in a sport that requires rotating towards one side. (Eg. Tennis, Rowing)
• Improper technique with exercise

Muscles Involved

The following muscles tend to get tight/shortened for a spine that is rotated towards the RIGHT.

Tight muscles on the RIGHT side:

Tight Muscles on the LEFT side:

(Note: For a spine that is twisted towards the LEFT, the tight muscles will be on the opposite side mentioned.)

Potential Issues

Although having rotation in the spine is not inherently dangerous, it may predispose one to developing the following issues:

How To Determine The Direction (And Level) Of Twist In The Spine

(Keep in mind: If you are not confident in conducting these tests on your self, make sure to get a thorough assessment with your healthcare professional.)

Rotation At Lumbar Spine

Instructions:

• Stand with your feet shoulder-width apart and level with each other.
• Make sure that your pelvis is in a neutral position.
• Look down at your belly button.
• Question: Which direction does it point towards?

(Note: Asymmetrical tension in the abdominal region, past abdominal surgeries etc. can affect the position of the belly button.)

Rotation At Thoracolumbar Region

Instructions:

• Stand with your feet shoulder-width apart and level with each other.
• Make sure that your pelvis is in a neutral position.
• Place your finger on the same points of the lower ribs. (see above)
  • (Aim for Rib 6 if you know how to locate your ribs accurately.)
• Question: Is one side more forwards or behind?

Rotation At Middle Thoracic Spine

Instructions:

• Stand with your feet shoulder-width apart and level with each other.
• Make sure that your pelvis is in a neutral position.
• Place your finger tips on the same points at the front of the chest region.
  • (Aim for Ribs 2-4 if you know how to locate your ribs accurately.)
• Look downwards.
• Question: Is one side more forwards or behind?

Rotation At Upper Thoracic Spine

Instructions:

• Stand with your feet shoulder-width apart and level with each other.
• Make sure that your pelvis is in a neutral position.
• Place your finger tips on the sternal ends of the clavicles. (see above)
• Question: Is one side more forwards or behind?

Shoulders

Instructions:

• Stand with your feet shoulder-width apart and level with each other.
• Make sure that your pelvis is in a neutral position.
• Look down at the front of your shoulders
• Question: Is one shoulder more forward as compared to the other?

(Note: The results can be skewed if you have Rounded Shoulders or Uneven Shoulders.)

Overall Rotation In Spine

Instructions:

• Stand with your feet shoulder-width apart and level with each other.
• Make sure that your pelvis is in a neutral position.
• Take a photo from the above head position.
• Find the line of your pelvis. (Red line)
• Find the line of your torso. (Orange line)
• If these 2 lines are not parallel, then you have a rotated torso relative to the position of the pelvis.

(Note: Uneven muscular bulk can give the illusion of a rotation.)

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Now that you know the DIRECTION and LEVEL of the spinal rotation, you can start to perform the suggested exercises on this blog post.

Apply the techniques and exercises to the muscles in the specific region where the rotation is originating from.

Read This:

• As the spine can rotate and counter-rotate at multiple levels, it would be impossible for me to cover all of these different combinations.
• Which specific muscles you need to target is really dependent on which level of the spine is your rotation coming from.
• Focus on the muscles that are relevant to you.
• Although I have listed all of the main muscles that are responsible for twisting the spine, you do not need to address them all!
• You will need to do a bit of experimentation on yourself and see what works for you.
• The exercises mentioned on this blog post are best used in conjunction with a healthcare professional.

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Exercises To Fix A Twisted Spine

STEP 1: Address Pelvis Rotation
STEP 2: Releases
STEP 3: Stretches
STEP 4: Joint Mobilization
STEP 5: Strengthening Exercises
STEP 6: Posture Reset
STEP 7: Bad Habits
STEP 8: Neutral Spine
STEP 9: Side Bending Of Spine
STEP 10: Counter Rotation

1. Address Pelvis Rotation

Since the torso is directly connected to the pelvis, any rotation in the pelvis will likely influence the position of the spine.

(Note: In some people – fixing the position of the pelvis will automatically improve the twisted orientation of the spine.)

How to tell if your pelvis is rotated:

Perform the following 3 tests to determine if you have a rotated pelvis.

(Keep in mind – These are very general ways to determining the position of the pelvis.)

ASIS Method

Instructions:

• Stand with your feet shoulder-width apart and level with each other.
• Locate the Anterior Superior Iliac Spine (ASIS).
  • These are the pointy bones that are located at the front of both of your hips. (see above)
  • (Use Google if you are not sure where they are.)
• Place a finger at the front of each of these bony land marks.
• Question: “Is one side more in front of the other?”

Buttock Position

Instructions:

• Stand with your feet shoulder-width apart and level with each other.
• Take a downwards facing shot of the back of your hips.
• Question: “Is one butt cheek more forward?”

(Note: Having uneven glute muscle size may give inaccurate results.)

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How to Fix a Rotated Pelvis

For a complete guide on the best exercises to fix a rotated pelvis:

See Post: Rotated Pelvis

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Note: The following exercises address a twisted spine that is rotated towards the RIGHT side.

(If you have a spine that is rotated to the left, do the same exercises but to the opposite mentioned.)

If you are not sure which direction your spine is rotating towards, make sure to have a look at this section of the blog post: How To Determine The Direction (And Level) Of Twist In The Spine.

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2. Releases

The next step is to release the tight muscles that are holding your spine in a rotated position.

Muscles to release on the RIGHT side

Longissimus/Iliocostalis

Instructions:

• Lie down on the floor.
• Place a massage ball on the muscles which are located on the side of the spine.
• Apply an appropriate amount of bodyweight on top of the massage ball.
• Make sure to cover the length of the muscle that is involved with the spinal rotation.
• Continue for 2 minutes.

Latissimus Dorsi

Instructions:

• Lie down on your right side.
• Place a foam roller underneath the muscle on the back/side of your rib cage.
• Apply an appropriate amount of body weight on top of the foam roller.
• Make sure to cover the entire length of the Latissimus Dorsi muscle.
• Continue for 2 minutes.

Internal Oblique

Instructions:

• Lie down on the floor.
• Place a massage ball underneath the RIGHT side of the abdominal region.
• Apply an appropriate amount of weight on top of the massage ball.
• As the Internal Oblique muscle wraps around the the side of the back, make sure to cover that area too.
• Continue for 2 minutes.

Intercostals

(For Rotation in the Thoracic Spine)

Instructions:

• Lie down on your back.
• Place a small massage ball in the area between the ribs where your rotation is occurring.
• DO NOT place the massage ball directly on top of any bony region.
• Gently lean your body weight on top of the ball.
• Take relaxed breaths in and out.
• You will need to move the massage ball multiple times to cover all of the areas involved.
• Continue for 30 seconds per area.

Muscles to release on the LEFT side

External Obliques

Instructions:

• Lie down on the floor.
• Place a massage ball underneath the LEFT side of the abdominal region.
• Apply an appropriate amount of weight on top of the massage ball.
• As the External Oblique muscle wraps around the the side of the back, make sure to cover that area too.
• Continue for 2 minutes.

Rotatores

Instructions:

• Lie down on the floor.
• Place a massage ball on the muscles which are located on the LEFT side of the spine.
• Apply an appropriate amount of bodyweight on top of the massage ball.
• Make sure to cover the length of the muscle that is involved with the spinal rotation.
• Continue for 2 minutes.

3. Stretches

After performing the releases, the next step is to stretch the tight muscles that are associated with the spinal rotation.

Muscles to stretch on the RIGHT side:

Iliocostalis/Longissimus

Instructions:

• Sit down on a chair.
• Hunch forwards as much as possible.
• Place your left hand at the back of your head.
• Place your right hand on the outside of the left knee.
• Pull your head down in the direction of the left knee.
• Whilst maintaining this pressure, start to bend your torso towards the left knee.
• Aim to feel a stretch on the right side of your middle to upper back.
• Hold for 30 seconds.

Latissimus Dorsi

Instructions:

• Assume the position above.
• Hold onto a door frame with your right hand.
• Whilst anchoring your legs as shown, aim to bend your mid section as much as possible.
  • Use your body weight to sink into the stretch
• Twist your pelvis away.
• Aim to feel a stretch on the right side of your torso.
• Hold for 30 seconds.

Internal Obliques (Front)

(For Lumbar+ Lower Thoracic spine.)

Instructions:

• Lie down on your stomach.
• Prop yourself up onto your hands (or elbows) and arch backwards.
• Keep your pelvis connected to the floor.
• Push your belly button into the floor.
• Turn your torso towards the left.
• Aim to feel a stretch in the Right side of the abdominal region.
• Hold for 30 seconds.

Internal Obliques (Back)

(For Lumbar+ Lower Thoracic spine.)

Instructions:

• Whilst standing, lean all the way over to your left side.
• Twist your torso towards the left by placing your hands on your left knee.
• Allow your right leg to lift and dangle.
  • Keep it relaxed!
• Allow gravity to pull your right leg down.
• Rotate your pelvis towards the right.
• Aim to feel a stretch in the right side of the lower back region.
• Hold for 30 seconds.

Intercostal

Instructions:

• Place your right hand on top of a table.
• Lock your elbow straight.
• Lean some of your weight into the right hand.
• Glide your torso towards the right.
• Aim to feel a stretch on the right side of your rib cage.
• Hold for 30 seconds.

Muscles to stretch on the LEFT side:

Psoas

(For Lumbar spine rotation)

Instructions:

• Assume the lunge position with your right leg in front.
• Perform a posterior pelvic tilt
  • “Tuck your tail bone underneath you” 
  • Keep your glutes contracted.
• Make sure that your pelvis is facing forwards.
• Lean your torso away from the side you are stretching.
• Turn your torso towards the left.
• Aim to feel a pulling sensation at the front of your left hip.
• Hold for 30 seconds.

External Obliques (Front)

(For Lumbar+ Lower Thoracic spine.)

Instructions:

• Stand with a wide stance.
• Bend your torso towards the right.
• Reach your left arm backwards as you twist your torso towards the left.
• Aim to feel a stretch in the LEFT side of the abdominal region.
• Hold for 30 seconds

External Obliques (Back)

(For Lumbar+ Lower Thoracic spine.)

Instructions:

• Lie down on your back with your arms spread out on the floor.
• Cross the left leg across the body
• Aim to feel a stretch in the LEFT side of the lower back.
• Hold for 30 seconds.

4. Joint mobilization

If the joints in the spine are stiff, it can be more difficult to fix the rotation in the spine.

Here are some exercises to help loosen up the joints.

Upper Back Stretch

Instructions:

• Sit down on a chair.
• Nod your chin down towards the upper chest.
• Interlock your fingers behind the back of your head.
• Whilst keep in the chin in the nodded position, gently pull your head downwards.
• Allow the upper back to bend forwards as much as possible.
• Aim to feel a stretch in your upper back area.
• Take a deep breath in to increase the stretch sensation.
• Hold for 30 seconds.

Lower Back Stretch

Instructions:

• Sit on the edge of a chair.
• Have your knees facing outwards.
• Fold your torso between your legs.
• Make sure that you torso is completely relaxed in this position.
  • “Dangle” your torso.
• Aim to feel a stretch in the lower back.
• Hold for 30 seconds.

Rib Cage Stretch

Instructions:

• Sit on your side whilst leaning on your elbow or hand.
• Bow your torso towards the floor.
• Aim to feel a stretch at the side of your torso.
• To increase the stretch, take deep breaths into the area of stretch.
• Hold for 30 seconds.
• Repeat on the other side.

Rotation

Instructions:

• Sit down on a chair.
• Place your hand on the outer side of the opposite knee
• With the other hand, grab onto the back of the chair.
• Rotate your spine. (Look behind you.)
• Use your hands to help push you further into range.
• Oscillate in this position for 30 repetitions.
• Repeat on the other side.

Spinal Segmentation

Instructions:

• Stand up right.
• Wrap your arms around an exercise ball as much as you can.
  • Try to get your fingers tips to touch.
• Starting from the neck: Proceed to SLOWLY round your spine down one vertebra at a time all the way to the pelvis.
  • Think about: “Creating a wave in your spine”
• From here, reverse your movements back to the beginning.
• Remember to go slow!
• Repeat 20 times.

If you would like more exercises to help get your spine moving:

See Post: Thoracic Spine Stretches

5. Strengthening exercises 

Aim to move at the levels where the spinal rotation is originating from (i.e. Upper vs Middle vs Lower torso).

Wall Twists

(For Middle to Upper Thoracic rotation.)

Instructions:

• Assume a wall plank position.
• Keep your pelvis and belly button facing forwards at all times.
• Twist your upper torso towards the left.
• Repeat 30 times.
• (Keep in mind – There shouldn’t be too much movements with this exercise.)

Rotation

(For Middle to Lower Thoracic rotation)

Instructions:

• Assume the 4 point kneel position.
• Do not move the pelvis.
• Using your left hand, reach over and behind you.
• Aim to rotate in the area where your rotation is originating from.
• Aim to feel the muscles in the left side of your back.
• Repeat 20 times.

Rotation(4 pt. kneel)

(For Middle to Lower Thoracic rotation)

Instructions:

• Assume the 4 point kneel position.
• Do not move the pelvis.
• Using your right hand, reach under and towards the left.
• Aim to rotate in the area where your rotation is originating from.
• Aim to feel the muscles in the right side of abdominal region.
• Repeat 20 times.

Seated Rotation

Instructions:

• Sit up right on a chair.
• Keep your pelvis level:
  • Maintain equal weight distribution between each hip.
  • The knees should be level.
• Cross your hands over your stomach.
• Proceed to rotate your torso towards the LEFT.
  • Do not initiate this movement with your left shoulder blade.
  • (Do not let the hands/arm slide over your belly.)
• Aim to rotate in the area where your rotation is originating from.
• Hold for 5 seconds.
• Repeat 20 times.
• Perform 3 sets

Seated Rotation (With Resistance)

Instructions:

• Sit up right on a chair.
• Keep your pelvis level:
  • Maintain equal weight distribution between each side.
  • The knees should be level.
• Using both hands, hold onto a thick resistance band that is anchored to your right side. (see above)
• Proceed to rotate your torso towards the LEFT.
  • Do not initiate this movement with your arms.
  • Your arms should stay in line with the center of your body at all times.
• Aim to rotate in the area where your rotation is originating from.
• Hold for 5 seconds.
• Repeat 20 times.
• Perform 3 sets

Pallov Press Hold

Instructions:

• Sit up right on a chair.
• Keep your pelvis level.
  • Keep equal weight distribution between each side.
  • The knees should be level.
• Using both hands, hold onto a thick resistance band that is anchored towards your right side. (See above)
• Center your torso:
  • Belly button facing forwards
  • Rib cage equal on both sides
  • Sternal ends of collar bone equal
• Extend your arms directly in front of you.
• Do not let the resistance band rotate you to the right side.
• Hold for 30 seconds.
• Perform 3 sets.
• Progression: Increase the resistance

6. Posture Reset

The goal of this exercise is to have the left and right side of your back EQUALLY in contact with the ground.

Relax as much as possible into this position.

Instructions:

• Lie down on the floor.
• Support your legs in the 90/90 position.
• If required – place a thin pillow under your head.
• Rest your arms in the “Y” position. (See above)
• Aim to have your ENTIRE back completely FLAT on the floor.
• Relax in this position for 15-20 minutes.

7. Avoid bad habits

There is absolutely no point in performing all of these exercises if you continue to place your body in the position which has lead to your twisted spine in the first place!

Here are some suggestions:

Workstation Set Up

Place your computer screen and keyboard directly in front of you.

Avoid twisting your body to look at a screen.

Sleeping Position

I generally encourage people to sleep on their back.

The reason being – it promotes the most symmetry of the body.

Sports

If you are involved with a sport which requires you to mostly rotate to one side (e.g. Tennis, Rowing etc.), it is a good idea to balance out the other side with the recommended exercises on this blog post!

Driving

Be aware that reaching out to hold onto the steering wheel with one hand as this can lead to a twisted spine.

8. Maintain neutral spine

Pay more attention to the position of your torso.

Here is a quick way to check if your torso is in a neutral position:

Keep in mind: I don’t want you to think about the position of your spine ALL of the time.

(This is an easy way to get overwhelmed!)

… Just be more aware of when you could make a small adjustment to your posture.

Keep in mind – the exercises mentioned on this blog post will help keep your spine in a more centered position naturally over time.

9. Side Bending Of Spine

Along side having a twisted spine, it is common to have side bends in your spine as well.

If you also have side bends in your spine, please check out the following blog post:

See Post: Scoliosis Exercises

10. counter-rotation

With a twisted spine – it is common for counter-rotation to occur at certain parts of the body.

This is the body’s automatic attempt to: de-rotate the spine to keep the head in a more centered position.

The areas that compensate for the rotation in the spine are generally where people will experience their pain.

Main areas of Counter-Rotation:

Neck

The neck can attempt to compensate for a twisted spine.

For Example:

As a result – pain can develop in the following muscles:

Left Side:

• Semispinalis
• Posterior Scalene
• Levator Scapula
• Sub-Occipital

Right Side:

• Sternocleidomastoid
• Upper trapezius
• Anterior Scalene

Shoulder Blade

The shoulder blade can attempt to compensate for the twisted spine.

For Example:

As a result – pain can develop in the:

• Muscles between the shoulder blade
• Rotator cuff

Spinal Segment Above The Rotation

This is where a particular section of the spine has attempted to partially/fully/over counter-rotate the twist in the spine.

For Example:

As a result – pain can develop in the muscles that rotate the torso towards the left:

Left Side:

• Erector Spinae
• Latissimus Dorsi

Right Side:

• External Obliques

What does this means for you?

If your symptoms predominantly occur on one side of the body, addressing your twisted spine may help completely eliminate your symptoms!

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Conclusion

A Twisted Spine is where the spine is rotated towards one side.

It is also common to see counter-rotations occurring within the spine.

This posture may lead to issues such as one shoulder being more forwards than the other, symptoms on one side of the body and asymmetrical strength/development of muscles.

Follow the steps mentioned in this blog post to help fix a Twisted Spine.

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Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. Seek guidance from a healthcare professional before starting any exercise and/or implementing any recommendation. For more information: Medical Disclaimer.