A Deeper Look at T-Spine Rotation

Scott Swanson
Sep 17
5 min read

When assessing athletes in-house, we see a lot of variance in the degree of T-Spine rotation they have available. Let’s dive into what we think through when looking at an athlete’s T-Spine in the assessment process.

So, let’s say we assess an athlete and see a lack of range of motion available. The next step is looking through the rest of the info we have available on the athlete to understand whether this is actually something we need to address in our programming. The first place to look would be past injury history. If an athlete has or had significant arm, low back, or neck pain, this raises some red flags for us to dive deeper. Even if no pain is present, we look at our athlete’s movement patterns on the mound and try to gain an understanding of what their movement deficiencies are that may be holding them back from throwing harder, having better command, and staying healthy.

When it comes to T-Spine rotation, we look at a couple of things in particular when assessing. We look at how the body sequences into flip-up. A common theme among those that lack T-Spine rotation towards their throwing arm side is that flip-up is compromised. This could rear its head as an elbow climb, working only within 90 degrees, or lacking the ability to get the torso lined up for a plane of rotation that matches their arm slot. When it comes to restrictions on the throwing arm side, the other thing we will look at is the sequence of how the arm goes into layback. Restrictions to the throwing side can potentially lead to shallow arm spirals and late layback, as the athlete may have a hard time delaying torso rotation.

Let’s say we have an athlete that presents with a restriction to their throwing side but has no issue into flip-up and is fully healthy. In those cases, we will likely forgo addressing it in programming. We will make a note on it, and if an athlete ever begins to experience pain or inconsistency, we will re-assess the need. Often, physical restrictions like this can help freeze an athlete’s movement options in the delivery and, as a result, may actually help them perform better by allowing less room for unwanted moves to occur.

For example, if we have a very loose mover fascially who creates big separation moves but presents lacking in T-Spine rotation, that may be their body’s way of keeping them from stretching past what they can coordinate as they go into rotation. Opening more room for them might sound great, but that extra room could lead to a number of resulting compensations and an inability to decelerate parts of the body on time for ball release.

Now, let’s look at the glove side. T-Spine rotation to the glove side could be a factor depending on when deceleration happens. For example, we’ve seen a lot of high-level throwers that present with a lack of room to that side. However, when you watch them throw, they pull out slack and decelerate the torso at the right time. In that case, assuming they are pain-free, there would be no reason to try and open up space. In other cases, we will see athletes that lack room to the glove side and also struggle to decelerate and create a late ball launch. In those cases, we may want to address that ROM depending on what else is seen throughout our assessment process.

As an example, let’s say that we have assessed an athlete and have determined that we want to open some ROM into T-Spine rotation. What are some ways we can go about it?

we need to look at the athlete’s starting posture. When we think of “T-Spine rotation” in the delivery, we need to understand how the ribcage drives rotation or lack thereof. For the T-Spine to rotate the ribcage, it has to change shape, meaning we need one side of the ribcage to expand while the other compresses. If the athlete has a ribcage stuck in an inhaled state (wide), our approach may include things like rolling activities that encourage compression and tight shape changes of the ribcage by using the ground as a constraint. On the flip side, if the athlete is stuck in an exhaled state (narrow), our goal would be to create expansion. For those athletes, we may more heavily program things like cable lift variations and side-bending exercises.

We can look at how the athlete presents fascially. The spiral line will likely work hand in hand with how the T-Spine rotates. Any time we turn our upper back, we are also tensioning fascial slings across the body. If there is a restriction in the line itself, we may identify it as a spine restriction when it’s really more of a compression of a spiral line. If this is the case, some things we can include in programming are fascially driven activities that get the spiral line to length. If one side is compressed excessively, something we will commonly do is program rotational volume to the opposite side. In most cases, this will end up being the athlete’s non-throwing side. For this, we could use med ball, waterbag, or PVC variations. The biggest thing is that the load is light and we are exposing the opposite side to high-speed rotation.

Some other things we may do to open ROM is loaded rotational work. Eccentric loading has been shown to be one of the most effective ways to open up ROM. In the case of the T-Spine, this could be things like rotational cable rows, rotational landmine variations, or even just loading up traditional T-Spine rotation drills.

Another consideration when programming for these athletes is being cognizant of bilateral loading and its potential effects in exacerbating some of the restrictions they already present with. This doesn’t mean we never bilaterally load these athletes, but we will likely skew towards unilateral variations for two reasons:

They likely promote some natural relative motion at the T-Spine.
The unilateral nature limits the amount of weight an athlete uses, which limits some of the compressive effects of the exercise.

Lastly, we may also use some of the more traditional T-Spine openers, but integration would be key there. Most low-threat exercises like that will create a short-term adaptation where more range is available. Blending that stimulus within a day of training is what’s most important in that case. For example, if we use it in a warmup, we also want to follow it up with another exercise that may give the body more context for that range—something like blending a kneeling T-Spine rotation with a WB drop-step decel.

The idea being this: open range and then move through range with proper sequence and speed. We may also blend it into lifts in this way. For example, we may feel a need to give an athlete a rotational power exercise on the landmine. We can use a T-Spine opener in the exercise block prior as a way to set the athlete up for success when they get to that particular block.

Overall: When looking at an athlete’s T-Spine, we must understand its context within the throw itself and within the athlete’s physical presentation to determine whether a lack of mobility is affecting their health or performance.