A surgical instrument may comprise a shaft; a wrist structure coupled to the shaft; an end effector coupled to the wrist structure; and an actuation element extending through the shaft and the wrist and coupled to the end effector. The wrist structure may be articulatable in multiple degrees of freedom relative to the shaft, and the actuation element may follow a twisted path along at least a portion of a length of the wrist structure, the twisted path having an angular extent of less than 360 degrees over the length of the wrist.