Updated: 5 days ago
November 21st, 2020
So in our last blog we ventured into the realm of the twisted grip and learnt a few key things:
Shoulder injuries are common in pole and occur in all grip positions, although twisted grip does appear to increase the risk of injury by placing muscles in a lengthened state
And despite this, twisted grip is not bad for you! In fact, being able to correctly perform twisted grip is a sign of strong and robust shoulders
Before you continue to reading today’s blog, make sure you catch up on all of last week’s goodness right here.
Otherwise, if you’re all caught up, then let’s pick up where we left off… So you can probably tell by now I’m a fan of the twisted grip, but I’m also here to tell you that just because you can push yourself to do something, doesn’t always mean you're ready for it at that point in time.
Am I more likely to injure myself in twisted grip compared to other grips?
Well, the research evidence is still out on this. But what we can say from clinical evidence is that yes twisted grip can be a more challenging position for some people because of the anatomical position required, BUT you are unlikely to injure yourself in twisted grip if you’re strong in your rotator cuff muscles and able to engage them in a twisted position. I repeat from the first blog: twisted grip is not bad!
If you don’t feel comfortable doing a twisted grip then don’t push that position just yet. It likely feels uncomfortable because your body hasn’t been conditioned for that particular movement yet and like anything you need to strengthen!
If your body doesn’t have the capacity to handle the load of a twisted grip then yes you can injure yourself. This is similar to you trying to iguana or dragon’s tail before you have the strength and pole smarts to: not the best idea and may end in injury.
Your body MUST be able to tolerate the DEMANDS of the exercise and have the CAPACITY to tolerate its LOAD. My point being that if your body is not ready to handle the demands of a twisted grip, then you will be placing yourself at risk of shoulder injury.
What's the best way to learn twisted grip?
Well, we feel very strongly here that the best way to learn twisted grip is to feel strong and comfortable in your true grip/straight first. All the time we see polers being taught their Ayesha/static V in a twisted grip first. This trick is often the first time a poler is inverted with their entire body weight through their shoulders, so it just makes sense to use a grip that is more natural and comfortable for the shoulder to perform in. Once you're feeling good in this grip then you can change it up to a twisted grip or even cup grip.
Another issue we see is a progression of tricks too quickly. A huge issue in our eyes is studios teaching polers how to handspring before the even know how to Ayesha. Just stop this! You're trying to get a poler to kick upside down but they don't know how to engage their shoulders correctly or hold the position when they are there! This is a disaster waiting to happen. And not just for the shoulder. The number of injuries we have treated that have occurred to a wrist and elbow when learning a handspring far too early are astronomical. Strong shoulders are key to reducing your risk of injury. So learn your true grip ayesha first. Followed by your twisted grip. And only once you are owning that trick should you think about working on a straight and twisted grip handspring.
Is there a way we can know whether someone is ready to train their twisted grip shoulder mount or Ayesha? Yes there is. And we refer to it in the physio world as screening.
Screening is the best way to know if your body is able to tolerate the demands of the trick position. Again, there is no injury prevention research on this in the pole world but common sense dictates that if you break down the demands of the movement into anatomical joint positions and muscle actions then you are able to determine the pre-requisites for a twisted grip trick (or any trick for that matter).
So what movements and actions do we require for our twisted grip?
1. Full shoulder flexion (180 degrees)
The amount of shoulder flexion required is actually determined by the trick you’re attempting, however if you do not have full shoulder flexion then you’re not far from ready to attempt these tricks and need to go and work on your active and passive mobility first before proceeding.
(Please note this movement accounts for 60 degrees of upward rotation and elevation of the scapula)
2. Full shoulder internal rotation (90 degrees)
This is also a non-negotiable. To be in a twisted position you ideally require 90 degrees of active shoulder internal rotation in an overhead position. Too frequently this is a movement that people lack prior to commencing twisted grip tricks and ultimately contributes to their shoulder injury. It would also be recommended that you have 80+ degrees of internal rotation as shown with the arms in abduction in figure 4.
3. Strong shoulder external rotators (at mid to end of range shoulder flexion)
Our external rotators produce a great deal of force and stability for the shoulder joint in all of our pole tricks. And without these muscles we wouldn’t be able to actively hang off the pole because we would forever be dislocating our shoulder! Eeep!
When our shoulder is placed in an internally rotated position, such as a twisted grip, our external rotators are consequently placed on stretch. Similar to when you bend your knee, you shorten your hamstrings and lengthen your quads. As once muscle contracts, the other stretches.
And when a muscle is placed on stretch it is significantly harder for that muscle to produce force. This places it under considerable levels of strain which can lead to a soft tissue injury. So a twisted grip position makes it slightly easier for the internal rotators of the shoulder to engage and significantly harder for our external rotators to stabilise the joint. This holds true particularly for baby polers who have not undergone the muscular adaptations required (strength and stability) to hold such a challenging position.
As a result, we need to make sure both our external and internal rotators of the shoulder are super strong before trying this position. Particularly our external rotators. If we aren’t able to stop ourselves from ‘hanging’ out of the joint (i.e collapsing into shoulder internal rotation +/- elevation/depression), our passive structures become overloaded in an attempt to maintain shoulder stability. It's this overload that in turn may cause an inflammatory pain response or a structural injury to the surrounding structures.
So how can you test your overhead rotator cuff strength to determine whether you are ready to proceed with training for your twisted grip with your pole instructor?
If you’re not seeing a physio then a simple test is this ‘overhead rotation’ or ‘break the bar’ test. Can you rotate against the band’s resistance to a position of shoulder external rotation without any shoulder discomfort? If yes, then can you comfortably repeat this test x 10 times?
If the answer is no, see if the discomfort changes when you elevate your shoulder slightly? If this elevation improves your discomfort then you need to see a physio to strengthen your upward rotators and elevators first before attempting the twisted grip.
If your discomfort does not improve then you are definitely not ready to try this grip and need to seek guidance of a (pole/aerial) physio first. There is a key factor missing for you and an aerial physio’s input is key. A physio can also test your shoulder strength using a handheld dynamometer to get an accurate strength reading of your rotator cuff.
Please note – this test is not fool proof. It is not an accurate representation of testing your whole body mass in an eccentric position for your shoulder external rotators. However it is meant to be an intermediate test as very few positions are able to effectively re-create that load.
Here’s my little flow chart summary of whether you’re ready to train twisty grips with your pole instructor:
Please Note: This is a quick medical screening of whether you’re able to physically perform a twisted grip position. This does not give you clearance to start working on a specific trick such as a shoulder mount, Ayesha or handspring. You may still not be ready for these tricks. Please consult with your instructor so they can provide you with tailored advice.
Are you already a ‘Victim of the Twisty?’
If you are a victim of the twisted grip (i.e past or current injury) and haven’t returned back to this grip out of fear or pain, then take a moment to ask yourself why you haven’t rehabbed your shoulder fully? Or why rehab hasn’t worked for you in the past?
Did you simply rest expecting the pain to resolve but didn't notice an improvement once you returned back to that trick? Or is it that your rehab didn't actually mirror the demands of pole dancing?
Rehab for a pole dancer must involve heavy strengthening of the shoulder through all ranges of motion, so it really does benefit to see a physiotherapist that understands the demands and position of your body in your sport.
And these shoulder injuries are serious injuries that should not be neglected by avoiding that movement. You need to strengthen your shoulder back to normal otherwise it will place you at an even bigger risk of injury down the track in other non-twisted grips. Yes, in non-twisted grips! With the correct TLC and guidance, shoulder injuries can fully rehabilitate.
Which means you can return to all pole movements you love, including twisted grip!
Engage – don’t hang!
One of the main reasons people injure their shoulder in twisted grip is because they lack external rotation strength and hang out of their shoulder as described earlier.
And at risk of sounding silly, you won’t need to rehab an injury if you don’t injure it in the first place. This is why I enjoy injury risk reduction (prevention) strategies so much – it’s easier to treat an injury when you’re not actually injured, and in the process these techniques just make you a stronger and more capable pole dancer.
So this is a reminder to anyone doing pole, you need to engage your shoulders/blades in all grips, but particularly in twisty grip due to the eccentric load of the external rotators.
To engage your shoulder:
Elevate your shoulder blade by letting it lift up as you reach. Do not, I repeat do not, pull your shoulder blade back and down. Check out this handy video to help you train your shoulder elevation (shrug).
Allow your shoulder blades to rotate away from your body like wings. Your shoulder blades need to upwardly rotate. Locking your shoulder blades down will increase your risk of shoulder injuries.
Instead of pulling down with your shoulder blade to lift your body up the pole, think to pull through your bicep/elbow or think about bringing the pole to you. This changes the narrative for the shoulder blades and stops you from unnecessarily depressing them when they are meant to be elevated overhead.
How to build up to a twisted grip Just like if you wanted to spatchcock on the pole you would make sure you nailed it first off the pole, the same concept applies. If you want to do twisted grip then you need to strengthen into twisted grip off the pole and build the strength required by meeting the demands of the movement.
Keep an eye out for the online shoulder workshop that we run, as they will give you the edge and information you need to strengthen for twisted grip along with tips and tricks to reduce your risk of shoulder injury in all grips.
Shoulder injured or wanting tailored guidance and rehabilitation for your twisted grip related injury?
Online telehealth appointments can be booked with the Pole Physio via our ‘Book Online’ page that can be found here. Assessment and tailored rehabilitation are provided in accordance with best practice and evidence-based treatment to help you unleash your 'poletential'.
Until next time, train safe.
The Pole Physio
Disclaimer: This information is not tailored to you as an individual and do not constitute as medical advice. If you have medical or injury concerns, then please individually consult with a medical professional.
Nicholas, J.C. (2019). The psychological, physiological, and injury-related characteristics of recreational pole dancing. (Unpublished). URL: https://research-repository.uwa.edu.au/en/publications/the-psychological-physiological-and-injury-related-characteristic