Twisting is one of the seven key movement patterns that were necessary for our early ancestors' survival. If you could not bend, push, pull, squat, lunge, twist, or walk, jog or run quickly and efficiently, you probably would not have lasted long in a primitive society. I call these Primal Pattern(R) movements (Chek P. Movement That Matters. A C.H.E.K Institute publication, 1999). Even though our Westernized lives are different nowadays, our bodies have not changed from a musculoskeletal perspective; we still need to perform all seven movements to decrease the risk of injury during our daily life, work or sports activities.
Twisting may well be the most important movement pattern for anyone to master and perform, as it
is integral to almost every movement done in a functional environment. For example, twisting is a key component in any throwing motion or racquet sport. Sadly, the most common source of back injury is from movement that combines bending and twisting, such as picking up a suitcase (Waddell G. The Back Pain Revolution. New York: Churchill Livingstone, 1998).
If you can't twist correctly, you must learn to do so before injury happens. Yet, exercises that involve twisting are generally rare in body-conditioning programmes and are sometimes considered 'contraindic-ated' exercises. This is a problem because the human body runs by the maxim 'Use it or lose it', which means that if you don't condition the twist, you will be more likely to have a deficit of skill in this movement. Lack of neuromuscular 'knowledge' of how to twist can lead to injury when the body has to recover from an off-balance or emergency situation: your reaction is instinctive; you absolutely must twist, yet the body has no built-in twist pattern (or 'motor engram') to rely on (Chek P. Primal Pattern(R) Movements: A Neurodevelopmental Approach to Conditioning. DVD correspondence course. C.H.E.K Institute, 2001).
The twist is a coupled movement, which means that it generally occurs with other patterns. For example, throwing a ball is a combination of a lunge, twist and push. Some situations do require a pure twist pattern-think of the repetitive movements made by a supermarket checkout person. A golf swing has a large twist component. This is also a good example of a movement where a lack of rotation or ability to twist in one area of the body will be compensated for by over-rotation in another.
The body can rotate or twist in many different ways: think of your head rotating on your neck while the body remains still, or your trunk twisting from the waist up with a fixed pelvis. In a golf swing, if you have a limited capacity to rotate in one segment of the body such as the thoracic spine, then, to achieve a full backswing and follow-through, you must have more rotation in a different part of the body-in this case, the lumbar spine (Chek P. The Golf Biomechanic's Manual. A C.H.E.K Institute publication, 1999). The ability of different segments of the body to twist or rotate can also lead to injury, as attested to by the high incidence of low back pain in golfers.
Optimal twisting and rotation
1. Good static and dynamic posture. Static posture is the position from which movement begins and ends. Dynamic posture is what occurs in between the beginning and ending of a movement or, more technically, the ability to maintain an optimal instantaneous axis of rotation of any and all working joints in any space-time relationship, regardless of body position or speed of movement. A detailed analysis of this definition is beyond the scope of this article, but suffice it to say that the better your posture before, during and after a movement, the better you will be able to rotate or twist with less stress on the joints and ligaments, with a reduced risk of injury (Grakovestky S. The Spinal Engine. New York: Springer-Verlag Wien, 1988).
So, it is essential to correct any postural deficits before loading the body in a twist pattern. Try this experiment: sit on a stool or bench without a back rest. Cross your arms across your chest and, if you have one, hold a wooden rod horizontally at shoulder height. Now slouch into a poor seated posture and see how far you can rotate your trunk around to each side using the rod as a pointer. Remember where you end up facing (Fig. 1, upper). Return to the start position, and sit up straight and tall. Repeat the twisting to each side and compare how far you went when you were slouching vs sitting up straight (Fig. 1, lower). You should have achieved a much greater range of motion with good posture compared with slumping.
2. Adequate levels of flexibility and joint mobility. In the example of the golf swing mentioned above, a lack of mobility in the thoracic spine resulted in excess rotation in the lumbar spine. Similarly, a lack of extension in the same upper back area can lead to overuse of the shoulder in athletes who throw (rotation-dominant), such as base-ball pitchers and tennis players. Assessment of flexibility and joint ranges of motion, followed by correction of any restricted areas or imbalances between left and right, is important for optimal rotation.
3. A functional core. This is essential for twisting and rotation, as the core musculature is critical for optimal stabilization of the spine, and also provides a strong foundation from which to work the shoulder, arms, pelvis and legs. What is a 'functional' core? That depends on the person and the task or sport in question, as what is 'functional' for a new mother would not be for firemen or professional football players. The inner unit must provide adequate stabilization for the task at hand and also integrate with the outer unit, which are the muscles and sling systems responsible for gross movements. (To find out more about the core, and ways to condition both the inner and outer units, see WDDTY vol 19 no 11, pages 16-7.)
Conditioning the twist pattern
It is useful to learn the twist move-ment in an isolation exercise, where the twist is the predominant pattern, before moving on to more neuro-logically demanding exercises that integrate two or more patterns.
Swiss Ball Russian Twist (Fig. 2)
This pure rotation exercise is great for the beginner exerciser, and can also be progressed to develop speed and power in the well-conditioned athlete.
- Lie face up on a Swiss ball, with your upper back and shoulders resting on top of the ball, and your head just behind the apex. Lift your hips up into a table-top position, keeping the body parallel with the floor. You may need to change the size of the ball to do this. Point your arms straight up at the ceiling, palms together, and position your tongue on the roof
of your month just behind the front teeth.
- Keeping your face towards the ceiling, rotate your body on top of the ball as far as possible to point your arms to the side. Let the ball roll underneath you, keeping your head in the same plane as your body-do not lift it up. Rotate back to the centre and repeat on the other side. Move at a moderate tempo and maintain a smooth rhythm from side to side.
- To make this more challenging, increase the tempo or speed of movement, and hold a dumbbell or medicine ball in your hands.
The Woodchop (Fig. 3)
This cable exercise is an isolation exercise that can be progressed to include a weight shift for more lower-extremity involvement.
- Stand sideways to the cable, which should be positioned just above head height, and take a stable, wide stance.
- Moving your arm across your body, take hold of the cable handle with the hand farthest away from the cable. Place your other hand on top of the the first hand and take the load of the weight off the rest of the stack. You may need to reposition yourself farther from the weights.
- Draw your belly button gently in towards your spine.
- Initiate the movement by rotating with the trunk rather than pulling with your arms. 'Chop' the movement diagonally downwards, crossing the body and ending with your hands on the outside of your hips. Keep your arms straight throughout, and keep your feet, legs and hips still, with your trunk as upright as possible.
- Slowly return your arms to the start position and repeat 8 to 12 times.
- Turn around and repeat the exercise on the other side.
To integrate the lower body into the exercise, include a weight shift:
- Set up the exercise as above, this time starting with 70 per cent of your weight on the leg closest to the cable weight stack.
- As you perform the woodchop, shift your weight until you end up with 70 per cent of your weight on the outside leg.
- Again, take care not to lean forward with your trunk.
The Reverse Woodchop
This movement is similar to the Woodchop except that the exercise starts from a low cable position and ends in a high diagonal. Imagine throwing a bucket of water over your shoulder. Again, this can be done as an isolation exercise with no weight shift, or with a full weight shift.
The importance of twisting
The twist is one of the key movement patterns, or Primal Pattern(R) move-ments, that everyone should be able to perform with a level of skill appropriate for their everyday work or sports requirements. Many common movements include some degree of rotation or twisting, yet exercise programmes are generally lacking this movement. However, it is important to include exercises with a twisting component into your regular conditioning workout, including variations of the exercises described above.
Paul Chek is founder of the C.H.E.K Institute in Encinitas, CA, and an internationally recognized lecturer and educator in the fields of orthopaedic rehabilitation, and corrective and performance exercise. For more information, call 0208-874-6942 (UK) or visit his website at www.chekinstitute.com.
Vol. 20 04 July 2009