The Spine Rotation test assesses how far a client can rotate the trunk or spine to the left and right. It may be performed in standing, sitting, side-lying or lumbar-locked positions using observation, tape measure, goniometer, inclinometer, smartphone inclinometer or digital movement tools. The result may provide useful information about spinal mobility, left-right differences, symptom response, movement confidence and change over time. It does not diagnose the cause of spinal pain, stiffness, disc injury, nerve symptoms or readiness for sport or work on its own.
Spine rotation is used in daily life, training, work and sport.
It contributes to tasks such as:
turning to look behind
reaching across the body
walking and running
throwing
swimming
golf
tennis
cricket
baseball and softball
combat sports
dance and gymnastics
lifting or carrying with trunk rotation
The Spine Rotation test assesses active spinal or trunk rotation to the left and right. Depending on the setup, it may reflect thoracic rotation, lumbar rotation, thoracolumbar rotation, total trunk rotation or a combined movement that includes the pelvis and hips.
This test should be interpreted carefully because rotation range can be influenced by:
thoracic mobility
lumbar mobility
hip and pelvic movement
shoulder position
rib cage movement
pain
guarding
fear or confidence
sport history
warm-up
testing position
measurement method
A large lumbar spine range-of-motion database measured lumbar ROM in standing across sagittal, coronal and horizontal planes and reported that normative values were age-related and sex-specific. For axial rotation, the same database summary reported lumbar rotation of about 7 degrees each direction, or about 14 degrees total, across the adult age range, which highlights that isolated lumbar rotation is much smaller than total trunk rotation.
The Spine Rotation test measures active rotation of the spine or trunk.
It may be performed as:
standing trunk rotation
seated trunk rotation
lumbar-locked thoracic rotation
side-lying thoracolumbar rotation
quadruped rotation
lumbar-only rotation, if isolated with an appropriate method
thoracic-only rotation, where the setup attempts to limit lumbar and pelvic contribution
total trunk rotation
smartphone or inclinometer measurement
goniometer measurement
tape-measure measurement
video or digital movement assessment
The exact version matters.
A seated trunk rotation test is practical and reduces lower-limb contribution more than standing rotation. A lumbar-locked position may be used when the goal is to bias thoracic rotation. Standing rotation is more functional for sport and daily movement, but it allows more pelvis and hip contribution.
The existing MAT page describes the Spine Rotation Test as a left and right trunk rotation measure that can be assessed in seated, standing or lumbar-locked positions with tools such as an inclinometer, smartphone, goniometer, tape measure or observation.
Spine rotation testing may be used to:
establish a baseline mobility profile
compare left and right rotation
monitor change over time
assess symptom response to rotation
observe movement confidence and guarding
identify side-specific movement limitations
guide exercise selection and progression
support communication between professionals
record spinal mobility in a structured assessment workflow
It may be especially useful when the client reports symptoms or limitations during:
turning
reaching
throwing
swinging
kicking
swimming
running
lifting while rotating
changing direction
sport tasks involving repeated trunk rotation
The test should support assessment reasoning. It should not be used as a stand-alone diagnostic test.
The Spine Rotation test may measure:
active trunk rotation range
left and right spinal rotation
thoracic rotation, depending on setup
lumbar rotation, if isolated with a valid method
thoracolumbar movement
movement quality
pain response
symptom location
confidence during rotation
repeated-test change over time
It may be recorded in:
degrees
centimetres
tape-measure distance
goniometer values
inclinometer readings
smartphone readings
digital movement values
qualitative notes
It does not directly measure:
disc pathology
nerve compression
spinal instability
rib injury
vertebral fracture
tissue healing
spinal strength
spinal endurance
throwing capacity
lifting capacity
readiness to return to sport
readiness to return to work
the cause of pain or stiffness
The Spine Rotation test may be useful for:
exercise professionals
allied health support teams
strength and conditioning coaches
movement assessment professionals
sport and performance staff
workplace health professionals
students learning assessment skills
professionals using Measurz or MAT for structured assessment tracking
It may be relevant for clients with:
low back stiffness
thoracic stiffness
rotation-related symptoms
asymmetry during sport skills
reduced confidence turning
recurrent back symptoms
occupational rotation demands
golf, tennis, cricket, swimming or throwing goals
baseline mobility monitoring needs
Equipment may include:
tape measure
goniometer
inclinometer
dual inclinometer
smartphone inclinometer
chair or stool for seated testing
wall or plinth for safety
floor marker
pain rating scale
body chart
camera or video if movement quality is being reviewed
Measurz or other assessment recording workflow
For general use, an inclinometer, smartphone inclinometer or goniometer can be more objective than visual estimation. Tape-measure methods can be useful, but they should be interpreted with method-specific limitations.
Explain the test before starting.
Example wording:
“We are going to measure how far your spine or trunk rotates to the left and right. This is a mobility test, not a diagnosis. Tell me where you feel any symptoms, whether they are familiar, and whether the movement feels safe.”
Select and record the method:
visual observation
seated trunk rotation with goniometer
standing trunk rotation with goniometer or inclinometer
lumbar-locked thoracic rotation
side-lying thoracolumbar rotation
tape measure
single inclinometer
dual inclinometer
smartphone inclinometer
digital movement system
video-supported movement review
Do not compare scores from different methods as if they are the same.
Common options include:
Seated rotation: useful for reducing lower-limb contribution.
Standing rotation: more functional but allows more pelvis and hip contribution.
Lumbar-locked rotation: often used to bias thoracic rotation.
Side-lying thoracolumbar rotation: can be useful when standing or seated control is difficult.
Quadruped rotation: practical for exercise-based assessment but more dependent on shoulder and hip position.
Record the position because results are not interchangeable.
A practical seated setup:
client sits tall on a chair or stool
hips and knees around 90 degrees
feet flat on the floor
pelvis kept level
arms crossed over chest or hands on opposite shoulders
head follows the trunk unless testing trunk-only with head fixed
client rotates left and right as far as comfortable
This setup helps reduce lower-limb and pelvic contribution, but it does not fully isolate one spinal region.
A practical standing setup:
feet hip-width apart
knees straight but not locked
weight even between both feet
pelvis starts facing forward
arms crossed over chest or held consistently
client rotates left and right as far as comfortable
Standing rotation is useful for sport and work contexts, but pelvic and hip contribution should be observed and recorded.
A lumbar-locked setup may involve:
quadruped or kneeling position
hips flexed back toward heels
hands placed behind head or across chest
client rotates the upper trunk left and right
pelvis and lumbar spine kept as still as possible
This position is often used to bias thoracic rotation. However, it is still a clinical approximation and should not be treated as a perfect isolation test.
Smartphone, bubble inclinometer and goniometer methods have been studied for thoracic mobility assessments, including lumbar-locked trunk rotation and seated trunk rotation. One study noted that quantifying thoracic spine mobility is challenging and evaluated the reliability and validity of these practical tools.
Ask the client to:
rotate left as far as comfortable
keep the movement smooth
avoid forcing end range
keep the pelvis controlled if required by the method
report pain, stiffness, pressure, stretch or symptoms
return to the start position under control
Example instruction:
“Turn your trunk to the left as far as you comfortably can. Keep the movement smooth and tell me if any symptoms appear.”
Ask the client to:
rotate right as far as comfortable
avoid forcing end range
keep the movement smooth
keep the pelvis controlled if required
report symptoms
return to the start position under control
Example instruction:
“Now turn your trunk to the right as far as you comfortably can. Try to keep the same posture and tell me what you feel.”
If using a goniometer:
define the axis and reference lines
record whether the trunk, shoulders or pelvis are used as landmarks
measure left and right rotation
repeat the same setup at retest
If using an inclinometer or smartphone:
place the device consistently
zero it in the start position
measure end-range rotation
record the device placement and app/tool used
repeat the same method at retest
If using a tape measure:
define the start and end landmarks
record the distance reached
use the same landmarks at retest
A practical protocol:
1–2 familiarisation movements each side
2–3 recorded trials if measurement precision matters
record best, average or most representative trial
use the same method at retest
If symptoms are irritable, one controlled trial may be enough.
Ask:
“Where do you feel that?”
“Is that your familiar symptom?”
“Is it pain, stretch, stiffness, pressure, numbness or tingling?”
“Does it stay in the back, or does it move into the ribs, hip or leg?”
“Rate it from 0 to 10.”
“Does the movement feel safe?”
“Do you feel limited by stiffness, pain, fear, tightness or balance?”
Record or repeat the trial if:
feet move
pelvis rotates when it should be controlled
trunk side-bends instead of rotating
client leans backward or forward
arms change position
balance is lost
measurement landmarks shift
device is not zeroed
movement is stopped because of symptoms
client misunderstands the task
Stop or modify the test if the client reports:
sharp or escalating pain
neurological symptoms
dizziness
loss of balance
symptoms travelling strongly into the leg
recent trauma concerns
rib or flank pain that feels concerning
inability to return from the position safely
fear or distress during movement
Use extra caution with:
acute back pain
suspected fracture
recent surgery
osteoporosis risk
neurological signs
inflammatory or systemic symptoms
significant balance concerns
Spine rotation may be recorded as:
degrees of rotation
centimetres of reach or tape-measure distance
left and right comparison
positive, limited, painful or unable
symptom response
movement quality notes
comparison to baseline
Record both sides separately.
A useful recording format may include:
left rotation score
right rotation score
difference between sides
symptom response on each side
movement quality on each side
whether the client used pelvis, hips or side-bending to compensate
A higher range may suggest:
greater available rotation in that test position
improved confidence rotating
improved mobility compared with baseline
less guarding if symptoms are stable or improved
However, more range is not always better. Some clients need control, strength, tolerance, timing or confidence more than extra motion.
A lower range may suggest:
reduced available movement
pain-limited motion
stiffness
guarding
fear or low confidence
pelvis or hip restriction
balance limitation
fatigue
test unfamiliarity
A lower score does not explain the cause of the limitation on its own.
Left-right differences may be useful for monitoring, especially when the client has one-sided symptoms or a rotation-dominant sport.
Interpret asymmetry with:
pain response
symptom familiarity
sport or work demands
baseline values
hip and pelvic movement
trunk side-bending
repeated-test consistency
related spine ROM findings
Asymmetry does not automatically mean injury or dysfunction.
Record:
pain score
symptom location
symptom type
whether symptoms are familiar
whether symptoms travel or change
whether one side is more provocative
confidence during movement
stopping reason
Pain during rotation does not confirm a specific diagnosis. It can support assessment reasoning when interpreted with history, neurological screening where relevant, strength testing, functional tasks and professional judgement.
The score does not prove:
diagnosis
disc injury
nerve compression
spinal instability
rib injury
tissue damage
pain source
readiness to lift
readiness to throw
readiness to run
readiness to return to sport
readiness for work duties
effectiveness of one intervention by itself
Spine rotation norms exist, but they vary by spinal region, method, age, sex and population.
A lumbar spine normative database measured standing lumbar ROM in all three planes in 405 asymptomatic adults aged 16–90. For lumbar axial rotation, one summary reported that no age-related decline was observed and that lumbar axial rotation remained approximately 7 degrees each direction, or 14 degrees total, across the age range. This is useful for isolated lumbar rotation context, but it should not be treated as a total trunk rotation norm.
Thoracic rotation values are different from lumbar values and depend strongly on test position. A reliability study of non-radiologic thoracic rotation measures reported thoracic rotation in the lumbar-locked position of about 47 degrees across several devices, with intra-rater reliability estimates from 0.738 to 0.906 and inter-rater estimates from 0.736 to 0.853. Those values apply to that protocol and should not be used as universal cut-offs.
For this exact Measurz spine rotation setup, broad universal norms should not be used unless the protocol, region and population match the reference source.
Use practical comparison guidance:
compare left and right sides
compare with the client’s baseline
compare repeated tests using the same method
record symptom response
interpret with hip and pelvic control
consider sport or work demands
use age-, sex- and protocol-matched norms only where available
avoid universal pass/fail thresholds
Best classification for this article:
Level 2: closest available benchmark guidance. Published lumbar and thoracic rotation reference values exist, but they are method-specific and may not match every field-based spine rotation protocol.
Reliability describes how consistent a measure is when repeated.
Validity describes whether the test measures what it is intended to measure.
SEM estimates measurement error around a score.
MDC estimates how much change may be needed to exceed measurement error.
Spine rotation reliability depends on:
measurement method
landmarks
device
tester training
client effort
pain level
warm-up
movement speed
pelvis control
trunk side-bending control
whether the same method is used at retest
Thoracic spine mobility measurement can be challenging because the thoracic spine is complex and many tools measure combined trunk movement rather than pure segmental thoracic motion. A study evaluating smartphone, bubble inclinometer and universal goniometer tools for thoracic spine mobility included lumbar-locked trunk rotation and seated trunk rotation, highlighting the need for repeatable tool placement and protocol standardisation.
A study on side-lying thoracolumbar rotation measurement reported that thoracic rotation is difficult to isolate clinically, so global trunk or thoracolumbar rotation measures may be more feasible in practice. This supports recording the region and method tested rather than assuming the result represents one spinal segment.
A 2023 double-inclinometer study investigated reliability for thoracolumbar ROM and joint position sense in people with recent low back pain, supporting the use of standardised inclinometer protocols while reinforcing that method details matter.
A 2022 study compared common clinical thoracic rotation tests with MRI-derived thoracic rotation and noted that although reliability of thoracic rotation measurements had been reported in prior studies, whether measured clinical angles accurately reflect true thoracic rotation needed investigation. This supports caution when interpreting clinical rotation tests as exact anatomical measures.
For the exact spine rotation protocol used in a local workflow, high-quality evidence reporting SEM, MDC or typical error may not be available unless the method matches a published protocol.
A change is more meaningful when:
the same method is used
the same landmarks are used
symptoms are recorded
movement quality is similar or improved
pelvis and hip contribution are controlled
the change is repeated across sessions
it exceeds known measurement error for a matching protocol
it aligns with function, confidence or goal progress
Small changes should be interpreted cautiously because they may reflect normal measurement variation rather than true mobility change.
Sensitivity and specificity are usually not applicable for this test because spine rotation ROM testing is not a stand-alone diagnostic test.
It measures movement range, symptom response and movement behaviour.
It does not diagnose:
disc injury
nerve compression
spinal stenosis
facet pain
rib injury
fracture
instability
inflammatory disease
Diagnostic accuracy values should only be discussed when using a validated diagnostic test for a specific condition with a defined reference standard. That is not the usual role of a general spine rotation ROM assessment.
Common errors include:
not defining whether the test is thoracic, lumbar, thoracolumbar or total trunk rotation
allowing pelvis rotation during a test intended to control the pelvis
allowing trunk side-bending instead of rotation
changing arm position between trials
changing seated, standing or lumbar-locked position at retest
using visual estimation only when precise tracking is needed
comparing values with norms from a different protocol
not recording pain or symptoms
treating more motion as automatically better
using ROM alone to make return-to-sport or work decisions
Limitations include:
spine rotation is difficult to isolate by region
hips and pelvis can strongly influence standing rotation
shoulder position can affect trunk rotation measures
pain can reduce range
fear and confidence can change movement
balance can affect standing tests
norms are method-specific
measurement error can be meaningful
ROM does not explain the cause of symptoms
The Spine Rotation test may help with:
baseline spinal mobility assessment
monitoring left and right rotation tolerance
comparing movement before and after a training block
tracking confidence after symptoms
identifying side-specific movement limitations
supporting client education
guiding exercise modification
documenting functional movement changes
It is most useful when combined with:
pain and symptom history
neurological screening where appropriate
spine flexion and extension ROM
spine lateral flexion ROM
hip range of motion
thoracic mobility assessment
trunk strength or endurance testing
movement control assessment
sport-specific rotation tasks
client goals
workload and training history
It measures active rotation of the spine or trunk. Depending on the method, it may reflect thoracic, lumbar, thoracolumbar or total trunk rotation.
No. Seated trunk rotation can reduce lower-limb contribution, but it still may include movement from multiple spinal regions. A lumbar-locked position may bias thoracic rotation more, but it still does not perfectly isolate the thoracic spine.
A goniometer, inclinometer, smartphone inclinometer or digital tool can be more objective than visual estimation. The best option is the one that can be repeated consistently with clear landmarks and instructions.
Reduced rotation may suggest limited movement in that direction, but it does not explain why. Pain, stiffness, guarding, hip or pelvic control, balance, confidence and test method can all affect the result.
Painful rotation means the movement reproduced symptoms. It does not identify the exact tissue or diagnosis on its own. It should be interpreted with history, symptoms, neurological findings where relevant and related movement tests.
Published reference values exist, especially for lumbar axial rotation and thoracic rotation protocols, but they vary by age, sex, region and method. Use only protocol-matched reference values where possible.
No. It can support mobility and symptom monitoring, but return-to-sport or work decisions should also consider strength, endurance, task tolerance, pain response, confidence, workload and professional judgement.
The Spine Rotation test assesses left and right trunk or spinal rotation.
The test may measure thoracic, lumbar, thoracolumbar or total trunk motion depending on the setup.
Measurement method must be recorded because results are not interchangeable across methods.
Seated, standing and lumbar-locked rotation tests measure different movement behaviours.
Reduced range does not explain the cause of symptoms on its own.
Pain during movement should be recorded by location, intensity and familiarity.
Norms exist but are region-, age-, sex- and protocol-specific.
Reliability improves when landmarks, instructions, device placement and scoring are standardised.
The test supports assessment reasoning and progress tracking, not diagnosis or clearance by itself.
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