Self-Care Supine Twist

This exercise releases fixations in these joints, which govern the pain and restriction around those joints. The multifidi and rotatores seem most directly connected to the sharp, fragile pain in the vertebrae.

How this works…

Vertebrae are joined to the vertebra above and below by 3 joints

  • in the front of the vertebra, the body of the vertebra connects to body of the adjoining vertebrae by the intervertebral disc. This structure creates a spongy multidirectional joint.
  • in the back of the vertebra, on both sides, an articular process extends up and down to connect to the vertebrae above and below. These are slippery, flat, facet joints that allow for multidirectional movement.

The nerve endings in the posterior facet joints that inform on position and movement, called proprioceptors, change muscle tension with trigger points that create pain, restrict contraction and restrict stretch.

Effective relief starts with an understanding of the anatomy.

About the coloring of the illustrations…

Multifidi and rotatores are interspinous muscles that manage tension and balance between vertebrae.

The Exercise

  • Lay on your back. This removes the muscle tension created by bearing weight on the vertebra, make movements gentler and easier.
    It is easier and more effective if you prepare the low back with a vapocoolant like IcyHot or stroking ice up and down the low-back along either side of the spine. This also releases stiff, trigger point laden muscle that restricts movement.
  • Cross one leg over the other.
  • Using the top leg, gently pull the knees toward the hip of the upper leg. Pull until there is tension through the hip and/or low-back. Don’t force this or pull it hard.
  • Hold it for about 2 seconds.
  • Return to the upright position.

    The foot that is on the table can be moved to target point the area You want to stretch. Moving the foot toward the hip targets the stretch higher, toward the mid-back. Moving the foot away from the hip targets the stretch lower, Toward the hip.

Do 4-6 repetitions if you are using ice-and-stretch or 12-15 if you are not. Do this lightly so that you can relax into each stretch.

Do this for both sides. Work with the more restricted side, then cross your legs in the other direction and work with the other side. If you get joints that release with a click, go back and work with the other side again.


This site is undergoing changes. Starting in early 2020, we began changing the format of the posts to include more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We’d love your feedback. We are adding posts and converting the old posts as quickly as time permits.


Weekly Featured Post

Can’t Reach the Pain
Under the Shoulder Blade

This pain and tension under the shoulder blade may be the most common pain pattern that I see. It isn’t always the primary complaint as people have gotten used to the constant ache.

It is usually combined with this pattern in the upper neck, which creates upper neck tension to go with the shoulder blade pain.

Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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