Twisted Grip - Don't get it Twisted!

Hands up if you avoid any form of twisted grip like the plague?? Does your body not like it? Does your pole instructor refuse to teach it? Or have you just not heard good things about it?

Well whether it's from a negative personal experience or hearing stories from others, there certainly are a lot of pole dancers out there who stay well and truly clear of the twisted grip.

But why? In today's blog, we answer the question: Is twisted grip actually more dangerous than other pole grips?

We write this blog with a mixture of satisfaction, irritation and fascination all at the same time, an interesting combination I assure you.

The source of our fascination lies in how far pole dance and pole fitness has journeyed over the past 10 years; it has progressed in leaps and bounds in so many areas.

However the source of our irritation also lies in that the progress is still not enough. There is a lack of researched evidence focused on pole specific injuries in the medical world, so instead we ‘borrow’ evidence researched on other sports like rock-climbing and gymnastics which don’t require the same musculoskeletal demands as pole dancing. Therefore this research doesn’t quite hit the nail on the head in the schemes of understanding pole mechanics and injury prevention.

And the source of satisfaction? Filling in this knowledge gap by providing you, the everyday pole dancer (and/or instructor), with the knowledge required to prevent injuries for yourself and hopefully other dancers at your studio. So with that in mind, we present to you all the information (research and clinical) currently known on the twisted grip in a very in-depth blog.

It’s a bit of information to take on board, so make sure you take it at a slow pace to absorb all of the twisted grip goodness. We can promise you it’s worth it! Let’s start at the beginning…

Fig 1: Shoulder Flexion

What is twisted grip?

Twisted grip; it is one of many different pole grips that can be utilised to Handspring and Ayesha. It can also be used in shoulder mounts (also known as a princess grip) and for for many beautiful spins such as ballerina.

To understand twisted grip, we need to understand basic should anatomy & biomechanics. Twisted grip can be broken down into three main components:

  • Shoulder flexion (varying degrees dependent on the trick)

  • Full internal rotation of the arm

  • Good active overhead shoulder stability

Spoiler alert: It’s the internal rotation or the arm that makes it feel twisted!

Fig 2: Shoulder Internal Rotation at 0, 90 & 180 degrees

Why does twisted grip have such a bad rap in the pole community?

Well that’s a good question! To be honest, certain instructors have chosen not to teach twisted grip because of their individual experiences with it, with some instructors being quite outspoken about this grip in the past.

Some of these polers have experienced injury as a result of twisted grip and/or their body simply just doesn't like feel good in this grip. And others actually just have no idea why they don't teach it in their curriculum, it's just the way things are done at their studio.

Firstly it's important to know that some polers bodies' will naturally love twisted grip and other's just simply won't. Whatever your body prefers, that's ok. Our bodies are not designed to love every trick or grip out there. And it is also important to note that shoulder injuries can occur in any pole grip.

So why is it that twisted grip continually gets demonised?

The short answer is that twisted grip can be a less forgiving position for the shoulder than most. We will cover this in a lot of detail later in our Anatomy 101 section.

But twisted grip shouldn't be unnecessarily feared, especially if we approach it and its use in the right way. If we're strong enough to handle the demands of twisted grip and don't overload it, then we are far less likely to have any issues !

Epidemiology of shoulder injuries in pole dance

Considering pole dance is a primarily upper body dominant activity, it is only natural that we would expect to see a greater number of shoulder injuries. In fact, the shoulder is the most commonly injured area amongst all types of aerialists and gymnasts, followed by hamstring injuries from split style movements (Nicholas, 2019).

Ground breaking epidemiological pole research led by Dr Joanna Nicholas was undertaken at The University of Western Australia in 2019, looking specifically at the anatomical location of pole related injuries and their causes. 103 injuries were included in this study and assessed and diagnosed/characterised by local physiotherapists.

Of the 103 pole related injuries included in this study, 21 were injuries of the shoulder (20.4% of the total injuries). And out of these 21 injuries, 6 of them were directly related to twisted grip. That equates to a 6% of total pole related injuries and 29% of all shoulder injuries being directly related to twisted grip.

The remaining 15 shoulder injuries were caused by mechanisms including inversions, increase in volume/overuse, handstands, direct impact and loaded external rotation.

So why is it that we get so hung up and fixated on the twisted grip injuries when more injuries were caused in a non-twisted position?

Because for a number of pole dancers out there, they continually hurt themselves in this grip. And for many others they would say they have never fully recovered from their injury.

Why? The answer here lies in a lack of understanding in the pole world about shoulder anatomy and biomechanics, particularly about the demands of this trick. And there is a lack of understanding by healthcare professionals to when it comes to rehabbing the shoulder to get back to twisted grip. So yes, twisted grip can be really challenging for some shoulders, but instead of fearing it, let's try to understand it (and rehab our shoulders fully!)

Don’t get it twisted

There are many nay-sayers in the pole community out there on twisted grip. It actually blows my mind a little. And the fear mongering that I’ve seen from studios and instructors alike is actually quite concerning. So here it is, straight from the Physio’s mouth:

Twisted grip is not bad for you! **

What’s interesting is that the unease about twisted grips is similar to the unease of the non-pole muggles when I talk to them about doing squats or deadlifts. These are simple movements for us active folk, but for them these movements freak them out because they worry about hurting their knees or backs etc. But in reality, when done well these movements make our bodies more robust.

You must be thinking by now, ‘but Simone, if twisted grip isn’t bad for you then why is it linked to a high number of pole related injuries in Dr Nicholas’ study?’

Well, the answer is quite simple and this is where the ** lies.

Just like every other pole trick out there, twisted grip is not bad for you when:

  1. You are ready to handle it's demands

  2. You don't overload it and perform it well

Just like I wouldn’t want you to perform an invert with less than ideal technique for risk of an injury, I also wouldn’t want you to perform twisted grip incorrectly. Compared to a true grip, a twisted grip biomechanically speaking is much harder on our shoulders and has less room for error.

However, when done correctly twisted grip is a wonderfully powerful grip that teaches your body how to correctly engage muscles of the rotator cuff. In fact, I would argue that if you cannot perform twisted grips your shoulder strength is not robust enough and you are placing yourself at risk of further shoulder injury with other advanced level tricks... But that conversation is for another day.

Let’s now geek out on the anatomy behind why twisted grip places our shoulder at a higher risk of injury.

Anatomy 101 of the Twisted Grip

Our shoulder is an inherently unstable joint. It relies on the muscles and ligaments around it to prevent joint dislocation. In twisted grip two major things occur around the shoulder joint:

  1. Full internal rotation movement of the shoulder reduces the active space available in the shoulder joint. Twisted grip places the shoulder in a closed pack position which can increase load on the joint and the structures within this space when in an overhead position if our muscles are unable to stabilise the joint.

  2. Additionally, full internal rotation places the external rotators of the shoulder in a lengthened state and under considerable load. This is a challenging position for our rotator cuff muscles to contract in and produce force. Particularly when we are already attempting to support our body weight through the shoulder.

Now, please note there is nothing wrong with reducing shoulder space and placing your muscles and tendons in a compressive and lengthened position. We do that all the time as pole dancers. I mean – we do it to our hamstrings every time we do the splits!

But if the muscles around the shoulder aren’t strong enough to handle these demands, then you’re likely 'hanging' off the passive structures of the shoulder such as ligaments and joints. Increased passive load through the shoulder joint, does increase risk of rotator cuff related shoulder pain (previously referred to as impingement). This particularly rings true for ‘unconditioned novices who lack the strength and stability required to hold such extreme postures’ (Nicholas, 2019, p.180).

Rotator Cuff related Shoulder Pain (explained in a hot minute)

Now I’ve seen other practitioners try to simplify twisted grip shoulder injuries and unfortunately it’s just not that simple. Our shoulder is full of different structures and everyone’s body can move differently. The shoulder complex is, well, just that… complex.

And today’s blog is not the time to delve into the many different drivers of shoulder pain. But just know this:

If your shoulder is not providing adequate strength to stabilise your humeral head (shoulder) in the joint, then the surrounding structures of the joint (bursa, ligaments, labrum, tendons etc) may become overloaded, which in turn can lead to pain. There may even be increased movement that occurs in the jo