From an upcoming, much longer, post detailing my visit to Stanford University’s Clinical Anatomy Lab, where I worked with cadavers:
I, along with many others, talk about how certain parts of the spine respond to certain types of motion. Most prominently talked about is the lower back not responding well to rotation. I’ve seen research on this, read Stuart McGill’s work, yada yada.
What’s ironic here is many mention this fact, yet when it comes to application all you see is people talk about flexion and extension. We’ll come back to this.
My instructor helped me see how the spine prefers to move by looking closely at the facet joints.
The facet joints are how the vertebrae move in relation to one another.
The easiest way to visualize this is to use your hands. Put one on top of the other. For the cervical vertebrae the facets (hands) are slanted forward:
For the thoracic they are pretty much upright:
And for the lumbar they are upright. However, instead of being vertical they’re horizontal:
Remember, the facet joints move on one another. Can you see how the cervical spine is built more for rotation, the thoracic more for side to side (lateral) motion, and the lumbar more for up and down (flexion and extension)?
Cervical; lateral view:
Which is similar to someone rotating their head side to side:
Thoracic; lateral view:
The lateral thoracic view is tough to see. You can see things better by looking at a posterior view:
Lumbar; lateral view:
Similar to someone bending forward and back:
It makes sense then people with neck issues tend to fit into a too much extension pattern, those with thoracic into a too much flexion pattern, and those with lumbar into a too much rotation pattern. These spinal segments don’t like these motions.
You may see people with too much cervical flexion or thoracic extension, but this is really rare. The point is you don’t often see people with rotation issues at the neck or side bending issues at the thoracic spine. At least not to the point of causing cervical or thoracic pain. These spinal segments like these motions.
Going back to my earlier comment about focusing on lumbar extension and flexion: The lumbar spine is actually made for this type of movement! No, that doesn’t mean you want to deadlift with a rounded back. But, it does mean you should probably take your obsession with flexion and extension and concomitant focus on rotation, and flip that around.
Lastly, this is a dimmer switch. In regards to rotation, as you move down the spine the switch goes from bright (embracing rotation)-yet not blinding, to dark (disdaining rotation) -yet not blacked out. It’s not like all the cervical spine is great with rotation and horrible with flexion / extension. There is a transition as you move down the spine. What you takeaway from this is certain parts of the spine handle certain motions better.
Using these biomechanical observations with what everyday people tend to do: There’s really no reason to do anything resembling extension at the cervical spine, flexion at the thoracic spine, or twisting at the lumbar spine. You’re playing with fire.
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Serge
January 16, 2014
Good point! However does that mean we should avoid torso twisting stretches/mobility exercises? Thank you
reddyb
January 16, 2014
If by “torso” you mean “lower back,” yes.
Serge
January 26, 2014
Hey Brian, finally finished reading through your all articles, found tons of useful info as well as some things that are quite opposite to what I used to believe in but that only makes me think harder.
As for my last comment under torso rotation exercises I meant the one that I believe is called arm openers where you open one of the arms laterally laying sideways and holding something between your bent legs to prevent your pelvis from moving, same idea as with lumbar rotation stretch but starting from top of your body rather than twisting hips. I found this exercise is extremely helpful increasing thoracic spine mobility. Is the lumbar rotation avoided here at all?
Also, if we look at yoga which has proven to be the ultimate body discipline there are plenty of lumbar rotation type asanas. What do you think of that? Thank you
reddyb
January 27, 2014
Hi Serge,
I don’t like the Side Lying Windmill exercise.
1) You have to be sure you are rotating from the thoracic spine and not the lumbar spine. This is not easy.
2) Going with the theme of this post, rotation at the thoracic spine is not something it handles well. It handles it better than the lumbar spine, but not that much better. I just don’t see the point. When it comes to thoracic mobility, normally if anything is lacking, it’s extension. If you want to rotate the spine, it should be at the neck.
Regarding yoga, I think it’s a great way for people to make their spines hypermobile (cause them dysfunction) because of the movements you reference.
Sangeeta
November 24, 2014
Hi Brian,
I have a coccyx issue with the coccyx angulated forwards( anterior angulation and it stuck there for quite sometime and got calcified .I had no signs of pain/restricted feeling until the calcification started and only then did I find pain when I try sitting.I am going for sacro coccygeal joint releases and manipulation from a pelvic therapist.However the
de-calcification is happening slowly.Could you suggest me anything on de-calcification like diet,supplements etc…
Thanks a lot !!
reddyb
November 27, 2014
Hey Sangeeta,
I don’t believe anything diet or supplement oriented is going to be able to have that effect. I will say, especially with anything lower back oriented, the issue is just about always things are moving too much. Where manipulating things so there is more movement is usually not a good idea.
sangeeta
November 28, 2014
Hi Brian,
Thank you so much !! I agree with you completely.
However ,coccyx issues are tricky and I realize as I kept exploring more into coccyx patient stories including myself,there’s still a large scope for more research 🙂 .Most coccyx sufferers have to endure the manipulations to get out of the mess of pelvic pain,sitting pain,leg pains,lowerback aches….that a simple tailbone can cause.
Its the one shot – multiple effects/reliefs sort of.
reddyb
December 1, 2014
What’s made you so sure the coccyx is the root of those problems?