75, 1998. Nevertheless, even this young woman shows tendencies which, if left unchecked, could lead to troubles in later life. The iliacus is definitely and obviously a hip flexor, though there is some controversy over whether it is a medial or lateral rotator of the hip (see The Psoas Pseries3). Aside from the radial tendon, the distal end of the biceps sports the odd bicipital aponeurosis weaving itself into the flexor group, thus linking the DFAL with the SFAL (Fig.
This often leads to super-tight muscles and to extra fibrotic and stuck-down fascia along the back line of the body, tissue that aches and cries out to be worked on. The opposite occurs when the left leg goes forward and the right comes back. networks, see Appendix 1, pp. As you roll onto your left side, bring your knees and elbows together once again and you will find it easy to roll onto your back. Fig. If we follow this line from the midline just above the xiphoid process, around the middle slips of the serratus to the middle of the rhomboid and across to the splenius capitis, we end up on the skull on the opposite side (Fig. The short head of the biceps runs down from the coracoid to the radial tuberosity, thus affecting three joints: the gleno-humeral joint, the humero-ulnar joint, and the CHAPTER 7 The Arm Lines Fig. The right arm grips the bolt or spear with CHAPTER 10 Anatomy Trains in Movement Superficial Back Arm Line Deep Front Arm Line Superficial Front Arm Line 177 Superficial Back Arm Line Deep Front Arm Lines Front Functional Line Left Spiral Line Superficial Front Line Spiral Line Front Functional Line Superficial Front Line Back Functional Line Lateral Line Fig. Berkeley: North Atlantic Books; 2004. Finally, there is the real question as to whether both the Anatomy Trains system and the acupuncture map might not both arise from the same organismic responses to body development, movement, and protection. This work is especially called for in those whose pelvis is anteriorly shifted relative to their feet. Imagine that these two cylinders extend into the trunk. Conversely, the DFL on the left leg is lengthening, allowing the foot to stay on the ground until the last possible moment. The challenge for the researchers and practitioners of the coming decades is to integrate this thoroughly new vision of how our cells hold together and adjust, running seamlessly from the genetic material within the nucleus all the way out to the level of the whole organism.
J Physiol. foot to the skull.
Although the Boat pose (Fig. 48. We have described two ways in which the myofascial system can remodel in response to stress or the anticipation of stress: (1) the obvious speedy one muscle tissue can contract very quickly at the nervous systems whim within the fascial webbing to pre-stress an area or line of fascia; and (2) long-term stresses can be accommodated by the remodeling of the ECM around the stress patterns, adding matrix where more is demanded (see Fig. Continue working upward a few inches at a time until you reach the limit of that technique (www.anatomytrains.com video ref: Superficial Back Line, 31:0833:57).
A1.3 Small numbers of cells can hold themselves together and thus create tissue structure, through cell-to-cell adhesions. It represents a plea to expand consciousness from being solely the domain of the brain to include the accumulated wisdom of the rest of the nervous system, the chemical wisdom of the fluid system, and the spatial wisdom found in the semiconducting fluid crystal of the connective tissue web. For years I observed these bubbles between the skin and the fascia profundis and in other areolar tissue, but dismissed them as artifacts of either the dying process or being exposed to the air. Schultz L, Feitis R. The Endless Web. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Secondly, we have noted the frequent application of the double bag (a sphere turned in on itself ) in the bodys fasciae. 7). With your model lying on her back with the knees up, and you sitting at the head of the table, put your fingertips on the back edge of the SCM, in the triangle between the anterior edge of the trapezius and the posterior edge of the SCM. Make sure your client is rotating around the axis of the neck, not simply rolling her head away from you on the table. The ventral muscle lies in close proximity to the trachea and the esophagus ventral to it from the first rib to C4 to C7. Fascia Congress. Ho M. The Rainbow and the Worm. A2.2). 7.33). Fascial tensegrity implies evenness of tone with allowances for differences of muscle fiber type and density variations from superficial to deep along each line and among the lines (Video 1.2). Ball P. The Self-Made Tapestry; Pattern Formation in Nature. 10.2 Kouros. 2.6). Bagg M, McCauley J, Mosely GL, Benedict MW. Once these tissues were somewhat resilient, the leftright issues could be addressed, releasing the LL on the left from hip to ankle and the LL on the right from hip to ear. Oschman J. To address this pattern in the SPL, have your seated client bend forward a little (not so far that he can rest his elbows on his knees) to expose the area between the thoracic spine and the vertebral border of the scapula. As he turns this will bring his weight onto the left leg and foot, which will become the fulcrum for the remainder of the movement. Langevin HM, Huijing P. Communicating about fascia: history, pitfalls, and recommendations. Sultan J. Alberts B, Johnson A, Lewis J, etal. (Used with the kind permission of Dr Peter Dorsher.) This figure shows a familiar continuous compression model of the body the head resting on C7, the upper body resting on L5, and the entire body resting like a stack of bricks on the feet. This is a highly useful exercise, but hardly definitive, as it leaves out the effect the muscle could have on neighboring muscles and ligaments by tightening their fascia and pushing or pulling them. For best results, it is important that the clients feet not be hanging, but rather firmly planted. 3, the Superficial Back Line) lays out the terminology and concepts used throughout the rest of the chapters, and is thus worth reviewing first. The good news is that elasticity can be (re)trained in an enjoyable and safe manner.
Take a wad of loose cotton wool and gently pull on the ends to see the multidirectional fibers accommodate your stretch until suddenly the stretching comes to a stop as the lined up fibers bind. A4.3A,B).
If the muscles of the deep posterior compartment are over-shortened, they tend to create an inverted or supinated ankle, or a medially rotated forefoot. References Fig. J Bodyw Mov Ther. 1998;2(4): 231247. into the neck (Video 3.1). ( Bryan Whitney, reproduced with permission.) anatomy 2002;10:362365.
, Lending
Fascia: The Tensional Network of the Human Body. Feldenkrais M. Awareness Through Movement. The right Lateral Line, the right Front Functional Line, and the left Spiral Line are all commonly shortened in flute playing. Other connections among the lines are made by the arms on a minute-by-minute basis to accommodate the varying movements and strains placed on the shoulderarm complex carrying a tray full of dishes, wielding a shovel, or attempting to put the hands together behind the back. Bordoni B, Marelli F, Morabito B, Castagna R. A new concept of biotensegrity incorporating liquid tissues: blood and lymph. Apply sudden external pressure to this model to see why so many impact injuries result in ligament rather than muscle damage. The Lateral Line (LL abductors, ITT, and lateral compartment of the lower leg) provide stability that prevents the hip falling inward into adduction, while the adductor group and the other tissues of the DFL assist the flexion/ extension motions and provide stability from the inner arch up the inside of the leg to the medial side of the hip joint, guiding it and preventing excess rotation of the hip. 9.9). 2. Trail Guide to the Body. 3.9). New research from a number of different angles confirms that fascia is a very interesting and communicative whole-body 6 CHAPTER 1 Laying the Railbed Fig. Chronic flexion of the hips is often occasioned by the failure of the hips to fully extend as the child grows; this lack of extension will require indicative, readable compensation in the SBL. B, Courtesy Dr Neil Thiese. Komi P, ed. The old saying goes: If your hand is a hammer, everything looks like a nail. Whatever tool we are using to intervene, we do well to remember all three of these holistic communicating systems, and their relative dominance within each person. Alexander RM. Keep your hands on the floor and try to turn your elbows around so they look like knees to feel the impossibility of having your arms approach a parallel position to the legs. 2009;85(9):e42. Relationship of acupuncture points and meridians to connective tissue planes. In: Leipsch D, ed. To look at one common example that leads to much misunderstanding, what do we mean by anterior tilt of the pelvis (sometimes termed in physiotherapy an anterior rotation of the pelvis, but for consistency will be an anterior tilt here)? Fascia We have referred to this body-wide complex throughout as the fascia, or the fascial net. Muscles attach to other muscles by their sides, muscles are in series with ligaments, and muscles attach to nearby neurovascular bundles these attachments get little consideration in modern anatomy, but the research referenced here shows the importance of each and all of them in our assessment of efficient biomechanics.5,6,164 Muscles and ligaments are almost universally studied as isolated units, as in Figure A1.75. 3.12, p. 34).
Bibliography Tomasek J, Gabbiani G, Hinz B, etal. 3. Edinburgh: Elsevier; 2007. In daily activities, the body employs a spectrum of structural models from tensegrity to more compression-based modeling.185 Filling in the range from the pure compression of a stack of blocks to the self-contained tensegrity of Figure A1.86, a sailboat provides one of several middle ground structures (Fig. 4 The Superficial Front Line OVERVIEW The Superficial Front Line (SFL) (Fig. A1.5). 2002;30:106110. A Abdomen horizontal bands across, 323324 SFL and, 60, 63f Abdominal muscles, LL, 79 palpation, 84 Abduction Line (FAbL), 352 Abductor muscles, 76f, 79 Abductor pollicis longus, 120 Achilles tendon, 34, 35f, 152f Acromion, SBAL, 127f Acupressure, 203204 Acupuncture meridians, 339 Adduction Line (FAdL), 353 Adductor(s), hip DFL and, 161162 palpation/manipulation, 156 Adductor brevis, 78f, 154f Adductor group, 150f Adductor hiatus, 153f Adductor longus, 78f, 139, 154f Aphrodite de Melos, 179 biceps femoris short head and, 30f DFL and, 158, 162 FFL and, 140141 FFL at, 139 track of, 158f training and, 180 Adductor magnus, 78f, 104f, 153f155f, 157f DFL and, 153 SPL and, 102 Adductor minimus, 154f Adhesome, 313315, 314f Aikido roll, 125, 204206 Alar fascia, 168f Albinus, Bernhard Siegfried, 18f ALL. anatomy myofascial trains movement myers thomas chains train tom training meridians anatomytrains body edition reads must posters human clemens holly Standing and activity be as free of structural pain as possible. 2006;20:811827. An astonishingly wide variety of natural systems, including carbon atoms, water molecules, proteins, viruses, cells, tissues, and even humans and other living creatures, are constructed using tensegrity.167 All structures are compromises between stability and mobility, with savings banks and forts strongly at the stability end while kites and octopi occupy the mobility end (Video 6.11). The resting tensegrity structure is a balance of opposing forces, not equilibrium. In: Schleip R, Findley TW, Chaitow L, etal, eds. Movement Function Aside from hip adduction and the breath wave in the diaphragm, there is no movement that is strictly the province of the DFL, yet neither is any movement outside its influence.
8.10) and the same for The cricket bowler uses the Front Functional Line to add impetus to the power of the arm. Line is more contracted, locating the head on the torso, and the right SL is more stretched. 3.2 Superficial Back Line tracks and stations. 6th ed. Sultan J Lines of transmission. Shiatsu, Acupressure, or Thumb Work The practice of shiatsu, acupressure, and some other forms of pressure-point work such as finding and eradicating trigger points involve placing significant pressure through the thumbs. Scapula (Sc), the spinous process of T1, and the longus colli muscles (LC). All of this pattern is explained by a shortening in one SL more than the other. Each of the nets has ambassadors to the other nets to alter their state and to keep the systems inter-informed and regulated.
7).
7). For more specific work, a knuckle may be used as an applicator, and a seeing elbow is also good for opening heavier fascial sheets and ropes. APPENDIX 1 A Fascial Reader 267 This hydrophilic quality means they are very versatile in handling forces within the body, and come up for more discussion under Fascial properties and Fascial responses to intervention, below. Complete acupuncture. CHAPTER 10 Anatomy Trains in Movement 205 Spiral Line Superficial Back Line Spiral Line Superficial Back Line Front Functional Front Functional Line Line Superficial Front Line Superficial Front Line B A Deep Back Arm Line Back Functional Line Back Functional Line Deep Front Line Fig. without any differentiation. In spite of its gel-like nature, its viscous tendency to deform under slow pressure, and elastically bounce with rapid short pressure, the collagenous net is a highly efficient transmitter of tensional force.38,6266 Exerting little force until the fiber net lengthens out to the lock position, any fascia is capable of handling considerable force, as you felt in our finger-onthe-forearm experiment above.67 Force transmission and distribution is the principal job of the myofascia and the surrounding fascia profundis holding it in. DISCUSSION 7.1 Scapular Position and Postural Balance The mobility of the scapula (as compared with the more fixed hip bone) is crucial to the many services that our arms and hands provide. This changed when an imaging system was developed that could examine connective tissue in vivo where a regularly irregular network of channels could be clearly seen running between the capillaries and lymph channels and the cells they served.
Earlier in our phylogenetic history, the serratus was primarily responsible for creating a sling to support the rib cage within the uprights of the scapulae (see Ch. As implied in our first paragraph, the SFAL controls the positioning of the arm in its wide range of motions in front CHAPTER 7 The Arm Lines 121 Medial intermuscular septum Pectoralis major 1 Teres major 2 Latissimus dorsi 7 3 6 4 5 Fig. The helical routes around the body are not by any means limited to the Spiral Line described here. A1.60 The bilaminar membrane of the cell forms the original pattern for the double-bag image, which is repeated over and over again in macro-anatomy. J Morphol. Philadelphia: FA Davis; 1992. Boulder, CO: Discovery Books; 2005. (B, Adapted with permission from Gtz-Neumann K. Gehen Verstehen: Ganganalyse in der Physiotherapie. Watch the hip. Enter the email address you signed up with and we'll email you a reset link. An actual tensegrity structure is difficult to describe we offer several pictures here, though building and handling one gives an immediate felt sense of the properties and differences from traditional views of structure but the principles are simple. They are good dancers, ride bikes, and are otherwise quite coordinated, but I cannot teach them to hop from one leg to the other. It sounds as if they are missing a stage of creeping, mused Feldenkrais. 2nd ed. Earls J. New York: Dover; 1957. For this reason, the photographs herein are devoid of such outside reference except of course the line of gravity as represented in the orientation of the picture. The fasciacytes: a new cell devoted to fascial gliding regulation. Reproduced from Abrahams, etal. Part of the solution, besides easing pulls from the Superficial and Deep Front Lines and correcting faulty breathing, is to release these extra fascial attachments at the back of the scalp to allow the head to rise. These bands surround and connect into the proximal part of the medial intermuscular septum, a fascial wall between the flexor and extensor group in the upper arm, which carries us down to the next bony station, the medial humeral epicondyle (Fig.
Sci Am. A1.15). 1.6 & 1.13). A1.21). Myers T. Extensor coxae brevis. Be sure to take a little skin with you and keep your fingers moving out against the hamstring tendons to avoid pressuring the endangerment site in the middle of the popliteal space. In all, this unique exploration of the role of fascial in healthy movement and postural distortion is an essential read for physical therapists, massage therapists, craniosacral therapists, yoga instructors, osteopathologists, manual therapists, athletic and personal trainers, dance instructors, chiropractors, acupuncturists, and any professional working in the field of movement. Wilke J, Krause F, Vogt L, etal. There is plenty that science has yet to learn about how we sense the body in motion, and how our clients make sense of our work in themselves. 3rd ed. The SCM can participate in pure neck flexion in the supine position, as in a sit-up, when it is lifting the head against the force of gravity. Munich: Bergman Verlag; 1938. From here it runs into the intercostal muscles underneath the scapula, into the splenius muscle ending also at the mastoid process of the temporal bone.
When doing a functional assessment of a client or student such as FMS (Functional Movement Screen) or SFMA (Selective Functional Movement Assessment), it is obviously useful to observe and assess which specific structures might be involved in an action or in its restriction.26 The examples in this chapter will perhaps have convinced the reader of the value in also doing a more global myofascial meridian assessment as part of this process. The sharp edges of the retinacula seen in anatomy atlases are not often palpable, as it fades off into the crural fascia the sharp edges are created with a scalpel. Med Hypotheses. If you draw a mental line between the lateral malleolus and just in front of the fibular head, the septum will lie close to this line. Collapsing in the upper part of the DFAL is a reliable way to ensure subsequent hand, elbow, shoulder, or neck problems. J Acquir Immune Defic Syndr. 2nd ed. 4.18 The rectus abdominis is the most superficial muscle of the abdomen all the way from the chest to the pubic bone. New York: Thieme; 2006. Any movement that requires dorsiflexion and toe hyperextension will stretch the plantar-calf section of the SBL around the heel. deeper locals, which are too often ignored because they are out of sight, out of mind. Genu varus involves a lateral shift (and is probably accompanied by a rotation as well) of the knees. The fibers and ground substance, as we shall see, actually form a continuous spectrum of building materials, but the distinction between the two (non-water-soluble collagen fiber and hydrophilic proteoglycans) is commonly used.
In assessing The short and simple movement exercise in the next section (Rolling over) is inspired by the work of Dr Moshe Feldenkrais,25 who devised hundreds of movement explorations he termed Awareness Through Movement (ATM) lessons.
The cells are connected to, and active within, a responsive and actively changing matrix, a matrix that is communicating meaningfully to the cell, via many connections (see Figs A1.95B and A1.96). They talk insistently: if one wants to avoid bites, kicks and scratches and survive while performing treatments, seek pain-free approaches. This form of pre-stress a middle ground between the immediate contraction of voluntary muscle and the fiber-creating remodeling shown by the pure fibroblast can prepare the body for greater loads or facilitate transfer of loads from one fascia to another. Taking the medial to lateral differences first: a common pattern is that the rhomboids are locked long (overstretched, eccentrically loaded) with the serrati locked short (concentrically loaded), pulling the scapula away from the spine. A1.60, p. 295 for more detail.) From the station at the occipital ridge, the epicranial fascia, or galea aponeurotica, runs up over the occipital bone (containing, in most people, slips of the occipitalis muscle), over the top of the head and down the forehead (enveloping the frontalis muscle) to attach to its final station, the brow ridge (see Fig. As long as the knee is bent, these two myofascial units go their own ways, neighboring but loosely connected (Fig. 2007;68:7480. The relative hydration of our tissues, and 312 APPENDIX 1 312 A Fascial Reader especially the interstitial ground substance, is determined by the balance between these centripetal and centrifugal forces. This myofascial line clearly continues from this station with the infrahyoid muscles the sternohyoid express covering the sternothyroid, thyrocricoid, and cricohyoid locals up to the suspended hyoid bone itself (Fig. 7.32 or for a more detailed explanation: www.anatomytrains.com video ref: Shoulders and Arm Lines, 06:2212:59). Edinburgh: Churchill Livingstone; 2012:165170. A3.13 Session 8 is an opportunity to put the head on. Schleip R. Fascial plasticity.
To free the front sheet and the muscle, have your client lie supine with his knees up, feet on the table. The Superficial Back Arm Line with the trapezius and 128 CHAPTER 7 128 The Arm Lines Deep Front Arm Line Deep Back Arm Line Superficial Back Arm Line A Superficial Front Arm Line B Fig. The Root of Thought: Unlocking Glia. 1998;(August):6169. 48 CHAPTER 3 48 The Superficial Back Line Again, the Awareness Through Movement lessons of Moshe Feldenkrais, which separate eye movements from neck and body movements, are unequaled in their ability to clarify and differentiate these muscles and this area.6 Palpation Guide for the SBL Beginning again from the distal end of the SBL, the first station is at the underside of the tips of the toes, which we cannot feel very well through the pads, but we can find the tendons of the short toe flexors under the thinner-skinned proximal part of the toes. 6.6).
In the pelvis and legs, the cylinders appear to be turned in, making the back appear wider than the corresponding area in front. It would be all one network, connected from top to toe, skin to bone, dense in some spots and gossamer in others, but showing both the external and internal shape of the entire body minus the hair. 10.47 A Lateral Line stretch, and a Lateral Line strengthening exercise. This gives a fuller discussion of the terminological issues. broadly, such as a right side tilt of the torso relative to gravity, or very specifically, such as an anterior tilt of the left scapula relative to the right or a posterior tilt of the right innominate bone relative to the sacrum or a medial tilt of the navicular relative to the talus. Online. As in Client 2, the left SL is shorter than the right in the upper body, with the lower anterior SL shorter on the right, and the lower posterior SL shorter on the left.
Those with more weight and substance in the legs and pelvis versus the ribs and shoulders tend toward the 240 CHAPTER 1 1 240 A BodyReading Structural Analysis B Fig. Tarrytown, NY: Station Hill Press; 1987. The section represents numerous structures of the Deep Ventral Line. ( iStockphoto.com, reproduced with permission. 8. The brachioradialis arises from the lateral intermuscular septum and goes to the radius, thus making another connection from the SBAL to the DFAL (Fig. (Photo courtesy of the author. The rhomboids carry us along the same line of pull over to the medial border of the scapula, thus connecting the left side of the skull to the right scapula and vice versa (Fig. A low but strong lumbar curvature might parse out on investigation as: the lumbars have a strong posterior bend from L5S1 to about L3, but have an anterior bend from L3T12. In the spine, the essential difference between a tilt and a bend is whether the deviation from normal is a singlesegment or multi-segment event and it is usually the latter. Thus, when either the lower lumbar vertebrae or the thoracolumbar junction (TLJ) are being pulled down and forward toward the front of the pelvis, any or all three of these pathways could be involved, and all three should be investigated in dealing with a lower lumbar lordosis, compressed lumbars, an anteriorly tilted or even a posteriorly tilted pelvis. Functional Lines Equivalents of the Functional Lines (FL; Fig. Thus, while in extreme cases the biceps might have a role in chronic humeral adduction or elbow flexion, the therapist is far more likely to get results from addressing the underlying locals than from work on the superficial biceps. Only if you push the wall sideways will the underlying tensional forces be evident. Step 3 Bringing all these observations into a coherent story would require weaving them in with a full history, but in general, we can say that most of this womans pattern is built on: 1. Osteopathy Research and Practice. Current Diagnosis and Treatment in Orthopedics. It could be compared to a clock or a compass, but since we are mired in train images for this book, we will call it a roundhouse (Fig. Water has a viscosity of its own (jump off the Golden Gate bridge to have an impactful experience with waters viscosity). Clients who create repetitive strain in the plantar fascia are likely to create plantar fasciitis anywhere along the plantar surface where it tears and inflames. and minor on the other side as part of the same fabric (see Figs. I went over to the window to see, and called my students over to witness a simple but telling phenomenon. A1.82). 1.26 The German anatomist Hoepke detailed some myofascial meridians in his 1936 book, which translates into English as muscle-play. Of course these two halves are not symmetrical to begin with, but we can still observe the balance between the two.
Granulation tissue as a contractile organ, a study of structure and function. 17.
The cranium is interlocked to itself, the thoracic curve is maintained by the ribs and sternum complex, the sacrococcygeal curve by the hip bones and pelvic ligaments, and the heel by the shape of the foot bones (Fig.
This often leads to super-tight muscles and to extra fibrotic and stuck-down fascia along the back line of the body, tissue that aches and cries out to be worked on. The opposite occurs when the left leg goes forward and the right comes back. networks, see Appendix 1, pp. As you roll onto your left side, bring your knees and elbows together once again and you will find it easy to roll onto your back. Fig. If we follow this line from the midline just above the xiphoid process, around the middle slips of the serratus to the middle of the rhomboid and across to the splenius capitis, we end up on the skull on the opposite side (Fig. The short head of the biceps runs down from the coracoid to the radial tuberosity, thus affecting three joints: the gleno-humeral joint, the humero-ulnar joint, and the CHAPTER 7 The Arm Lines Fig. The right arm grips the bolt or spear with CHAPTER 10 Anatomy Trains in Movement Superficial Back Arm Line Deep Front Arm Line Superficial Front Arm Line 177 Superficial Back Arm Line Deep Front Arm Lines Front Functional Line Left Spiral Line Superficial Front Line Spiral Line Front Functional Line Superficial Front Line Back Functional Line Lateral Line Fig. Berkeley: North Atlantic Books; 2004. Finally, there is the real question as to whether both the Anatomy Trains system and the acupuncture map might not both arise from the same organismic responses to body development, movement, and protection. This work is especially called for in those whose pelvis is anteriorly shifted relative to their feet. Imagine that these two cylinders extend into the trunk. Conversely, the DFL on the left leg is lengthening, allowing the foot to stay on the ground until the last possible moment. The challenge for the researchers and practitioners of the coming decades is to integrate this thoroughly new vision of how our cells hold together and adjust, running seamlessly from the genetic material within the nucleus all the way out to the level of the whole organism.
J Physiol. foot to the skull.
Although the Boat pose (Fig. 48. We have described two ways in which the myofascial system can remodel in response to stress or the anticipation of stress: (1) the obvious speedy one muscle tissue can contract very quickly at the nervous systems whim within the fascial webbing to pre-stress an area or line of fascia; and (2) long-term stresses can be accommodated by the remodeling of the ECM around the stress patterns, adding matrix where more is demanded (see Fig. Continue working upward a few inches at a time until you reach the limit of that technique (www.anatomytrains.com video ref: Superficial Back Line, 31:0833:57).
A1.3 Small numbers of cells can hold themselves together and thus create tissue structure, through cell-to-cell adhesions. It represents a plea to expand consciousness from being solely the domain of the brain to include the accumulated wisdom of the rest of the nervous system, the chemical wisdom of the fluid system, and the spatial wisdom found in the semiconducting fluid crystal of the connective tissue web. For years I observed these bubbles between the skin and the fascia profundis and in other areolar tissue, but dismissed them as artifacts of either the dying process or being exposed to the air. Schultz L, Feitis R. The Endless Web. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Secondly, we have noted the frequent application of the double bag (a sphere turned in on itself ) in the bodys fasciae. 7). With your model lying on her back with the knees up, and you sitting at the head of the table, put your fingertips on the back edge of the SCM, in the triangle between the anterior edge of the trapezius and the posterior edge of the SCM. Make sure your client is rotating around the axis of the neck, not simply rolling her head away from you on the table. The ventral muscle lies in close proximity to the trachea and the esophagus ventral to it from the first rib to C4 to C7. Fascia Congress. Ho M. The Rainbow and the Worm. A2.2). 7.33). Fascial tensegrity implies evenness of tone with allowances for differences of muscle fiber type and density variations from superficial to deep along each line and among the lines (Video 1.2). Ball P. The Self-Made Tapestry; Pattern Formation in Nature. 10.2 Kouros. 2.6). Bagg M, McCauley J, Mosely GL, Benedict MW. Once these tissues were somewhat resilient, the leftright issues could be addressed, releasing the LL on the left from hip to ankle and the LL on the right from hip to ear. Oschman J. To address this pattern in the SPL, have your seated client bend forward a little (not so far that he can rest his elbows on his knees) to expose the area between the thoracic spine and the vertebral border of the scapula. As he turns this will bring his weight onto the left leg and foot, which will become the fulcrum for the remainder of the movement. Langevin HM, Huijing P. Communicating about fascia: history, pitfalls, and recommendations. Sultan J. Alberts B, Johnson A, Lewis J, etal. (Used with the kind permission of Dr Peter Dorsher.) This figure shows a familiar continuous compression model of the body the head resting on C7, the upper body resting on L5, and the entire body resting like a stack of bricks on the feet. This is a highly useful exercise, but hardly definitive, as it leaves out the effect the muscle could have on neighboring muscles and ligaments by tightening their fascia and pushing or pulling them. For best results, it is important that the clients feet not be hanging, but rather firmly planted. 3, the Superficial Back Line) lays out the terminology and concepts used throughout the rest of the chapters, and is thus worth reviewing first. The good news is that elasticity can be (re)trained in an enjoyable and safe manner.
Take a wad of loose cotton wool and gently pull on the ends to see the multidirectional fibers accommodate your stretch until suddenly the stretching comes to a stop as the lined up fibers bind. A4.3A,B).
If the muscles of the deep posterior compartment are over-shortened, they tend to create an inverted or supinated ankle, or a medially rotated forefoot. References Fig. J Bodyw Mov Ther. 1998;2(4): 231247. into the neck (Video 3.1). ( Bryan Whitney, reproduced with permission.) anatomy 2002;10:362365.
, Lending
Fascia: The Tensional Network of the Human Body. Feldenkrais M. Awareness Through Movement. The right Lateral Line, the right Front Functional Line, and the left Spiral Line are all commonly shortened in flute playing. Other connections among the lines are made by the arms on a minute-by-minute basis to accommodate the varying movements and strains placed on the shoulderarm complex carrying a tray full of dishes, wielding a shovel, or attempting to put the hands together behind the back. Bordoni B, Marelli F, Morabito B, Castagna R. A new concept of biotensegrity incorporating liquid tissues: blood and lymph. Apply sudden external pressure to this model to see why so many impact injuries result in ligament rather than muscle damage. The Lateral Line (LL abductors, ITT, and lateral compartment of the lower leg) provide stability that prevents the hip falling inward into adduction, while the adductor group and the other tissues of the DFL assist the flexion/ extension motions and provide stability from the inner arch up the inside of the leg to the medial side of the hip joint, guiding it and preventing excess rotation of the hip. 9.9). 2. Trail Guide to the Body. 3.9). New research from a number of different angles confirms that fascia is a very interesting and communicative whole-body 6 CHAPTER 1 Laying the Railbed Fig. Chronic flexion of the hips is often occasioned by the failure of the hips to fully extend as the child grows; this lack of extension will require indicative, readable compensation in the SBL. B, Courtesy Dr Neil Thiese. Komi P, ed. The old saying goes: If your hand is a hammer, everything looks like a nail. Whatever tool we are using to intervene, we do well to remember all three of these holistic communicating systems, and their relative dominance within each person. Alexander RM. Keep your hands on the floor and try to turn your elbows around so they look like knees to feel the impossibility of having your arms approach a parallel position to the legs. 2009;85(9):e42. Relationship of acupuncture points and meridians to connective tissue planes. In: Leipsch D, ed. To look at one common example that leads to much misunderstanding, what do we mean by anterior tilt of the pelvis (sometimes termed in physiotherapy an anterior rotation of the pelvis, but for consistency will be an anterior tilt here)? Fascia We have referred to this body-wide complex throughout as the fascia, or the fascial net. Muscles attach to other muscles by their sides, muscles are in series with ligaments, and muscles attach to nearby neurovascular bundles these attachments get little consideration in modern anatomy, but the research referenced here shows the importance of each and all of them in our assessment of efficient biomechanics.5,6,164 Muscles and ligaments are almost universally studied as isolated units, as in Figure A1.75. 3.12, p. 34).
Bibliography Tomasek J, Gabbiani G, Hinz B, etal. 3. Edinburgh: Elsevier; 2007. In daily activities, the body employs a spectrum of structural models from tensegrity to more compression-based modeling.185 Filling in the range from the pure compression of a stack of blocks to the self-contained tensegrity of Figure A1.86, a sailboat provides one of several middle ground structures (Fig. 4 The Superficial Front Line OVERVIEW The Superficial Front Line (SFL) (Fig. A1.5). 2002;30:106110. A Abdomen horizontal bands across, 323324 SFL and, 60, 63f Abdominal muscles, LL, 79 palpation, 84 Abduction Line (FAbL), 352 Abductor muscles, 76f, 79 Abductor pollicis longus, 120 Achilles tendon, 34, 35f, 152f Acromion, SBAL, 127f Acupressure, 203204 Acupuncture meridians, 339 Adduction Line (FAdL), 353 Adductor(s), hip DFL and, 161162 palpation/manipulation, 156 Adductor brevis, 78f, 154f Adductor group, 150f Adductor hiatus, 153f Adductor longus, 78f, 139, 154f Aphrodite de Melos, 179 biceps femoris short head and, 30f DFL and, 158, 162 FFL and, 140141 FFL at, 139 track of, 158f training and, 180 Adductor magnus, 78f, 104f, 153f155f, 157f DFL and, 153 SPL and, 102 Adductor minimus, 154f Adhesome, 313315, 314f Aikido roll, 125, 204206 Alar fascia, 168f Albinus, Bernhard Siegfried, 18f ALL. anatomy myofascial trains movement myers thomas chains train tom training meridians anatomytrains body edition reads must posters human clemens holly Standing and activity be as free of structural pain as possible. 2006;20:811827. An astonishingly wide variety of natural systems, including carbon atoms, water molecules, proteins, viruses, cells, tissues, and even humans and other living creatures, are constructed using tensegrity.167 All structures are compromises between stability and mobility, with savings banks and forts strongly at the stability end while kites and octopi occupy the mobility end (Video 6.11). The resting tensegrity structure is a balance of opposing forces, not equilibrium. In: Schleip R, Findley TW, Chaitow L, etal, eds. Movement Function Aside from hip adduction and the breath wave in the diaphragm, there is no movement that is strictly the province of the DFL, yet neither is any movement outside its influence.
8.10) and the same for The cricket bowler uses the Front Functional Line to add impetus to the power of the arm. Line is more contracted, locating the head on the torso, and the right SL is more stretched. 3.2 Superficial Back Line tracks and stations. 6th ed. Sultan J Lines of transmission. Shiatsu, Acupressure, or Thumb Work The practice of shiatsu, acupressure, and some other forms of pressure-point work such as finding and eradicating trigger points involve placing significant pressure through the thumbs. Scapula (Sc), the spinous process of T1, and the longus colli muscles (LC). All of this pattern is explained by a shortening in one SL more than the other. Each of the nets has ambassadors to the other nets to alter their state and to keep the systems inter-informed and regulated.
7).
7). For more specific work, a knuckle may be used as an applicator, and a seeing elbow is also good for opening heavier fascial sheets and ropes. APPENDIX 1 A Fascial Reader 267 This hydrophilic quality means they are very versatile in handling forces within the body, and come up for more discussion under Fascial properties and Fascial responses to intervention, below. Complete acupuncture. CHAPTER 10 Anatomy Trains in Movement 205 Spiral Line Superficial Back Line Spiral Line Superficial Back Line Front Functional Front Functional Line Line Superficial Front Line Superficial Front Line B A Deep Back Arm Line Back Functional Line Back Functional Line Deep Front Line Fig. without any differentiation. In spite of its gel-like nature, its viscous tendency to deform under slow pressure, and elastically bounce with rapid short pressure, the collagenous net is a highly efficient transmitter of tensional force.38,6266 Exerting little force until the fiber net lengthens out to the lock position, any fascia is capable of handling considerable force, as you felt in our finger-onthe-forearm experiment above.67 Force transmission and distribution is the principal job of the myofascia and the surrounding fascia profundis holding it in. DISCUSSION 7.1 Scapular Position and Postural Balance The mobility of the scapula (as compared with the more fixed hip bone) is crucial to the many services that our arms and hands provide. This changed when an imaging system was developed that could examine connective tissue in vivo where a regularly irregular network of channels could be clearly seen running between the capillaries and lymph channels and the cells they served.
Earlier in our phylogenetic history, the serratus was primarily responsible for creating a sling to support the rib cage within the uprights of the scapulae (see Ch. As implied in our first paragraph, the SFAL controls the positioning of the arm in its wide range of motions in front CHAPTER 7 The Arm Lines 121 Medial intermuscular septum Pectoralis major 1 Teres major 2 Latissimus dorsi 7 3 6 4 5 Fig. The helical routes around the body are not by any means limited to the Spiral Line described here. A1.60 The bilaminar membrane of the cell forms the original pattern for the double-bag image, which is repeated over and over again in macro-anatomy. J Morphol. Philadelphia: FA Davis; 1992. Boulder, CO: Discovery Books; 2005. (B, Adapted with permission from Gtz-Neumann K. Gehen Verstehen: Ganganalyse in der Physiotherapie. Watch the hip. Enter the email address you signed up with and we'll email you a reset link. An actual tensegrity structure is difficult to describe we offer several pictures here, though building and handling one gives an immediate felt sense of the properties and differences from traditional views of structure but the principles are simple. They are good dancers, ride bikes, and are otherwise quite coordinated, but I cannot teach them to hop from one leg to the other. It sounds as if they are missing a stage of creeping, mused Feldenkrais. 2nd ed. Earls J. New York: Dover; 1957. For this reason, the photographs herein are devoid of such outside reference except of course the line of gravity as represented in the orientation of the picture. The fasciacytes: a new cell devoted to fascial gliding regulation. Reproduced from Abrahams, etal. Part of the solution, besides easing pulls from the Superficial and Deep Front Lines and correcting faulty breathing, is to release these extra fascial attachments at the back of the scalp to allow the head to rise. These bands surround and connect into the proximal part of the medial intermuscular septum, a fascial wall between the flexor and extensor group in the upper arm, which carries us down to the next bony station, the medial humeral epicondyle (Fig.
Sci Am. A1.15). 1.6 & 1.13). A1.21). Myers T. Extensor coxae brevis. Be sure to take a little skin with you and keep your fingers moving out against the hamstring tendons to avoid pressuring the endangerment site in the middle of the popliteal space. In all, this unique exploration of the role of fascial in healthy movement and postural distortion is an essential read for physical therapists, massage therapists, craniosacral therapists, yoga instructors, osteopathologists, manual therapists, athletic and personal trainers, dance instructors, chiropractors, acupuncturists, and any professional working in the field of movement. Wilke J, Krause F, Vogt L, etal. There is plenty that science has yet to learn about how we sense the body in motion, and how our clients make sense of our work in themselves. 3rd ed. The SCM can participate in pure neck flexion in the supine position, as in a sit-up, when it is lifting the head against the force of gravity. Munich: Bergman Verlag; 1938. From here it runs into the intercostal muscles underneath the scapula, into the splenius muscle ending also at the mastoid process of the temporal bone.
When doing a functional assessment of a client or student such as FMS (Functional Movement Screen) or SFMA (Selective Functional Movement Assessment), it is obviously useful to observe and assess which specific structures might be involved in an action or in its restriction.26 The examples in this chapter will perhaps have convinced the reader of the value in also doing a more global myofascial meridian assessment as part of this process. The sharp edges of the retinacula seen in anatomy atlases are not often palpable, as it fades off into the crural fascia the sharp edges are created with a scalpel. Med Hypotheses. If you draw a mental line between the lateral malleolus and just in front of the fibular head, the septum will lie close to this line. Collapsing in the upper part of the DFAL is a reliable way to ensure subsequent hand, elbow, shoulder, or neck problems. J Acquir Immune Defic Syndr. 2nd ed. 4.18 The rectus abdominis is the most superficial muscle of the abdomen all the way from the chest to the pubic bone. New York: Thieme; 2006. Any movement that requires dorsiflexion and toe hyperextension will stretch the plantar-calf section of the SBL around the heel. deeper locals, which are too often ignored because they are out of sight, out of mind. Genu varus involves a lateral shift (and is probably accompanied by a rotation as well) of the knees. The fibers and ground substance, as we shall see, actually form a continuous spectrum of building materials, but the distinction between the two (non-water-soluble collagen fiber and hydrophilic proteoglycans) is commonly used.
In assessing The short and simple movement exercise in the next section (Rolling over) is inspired by the work of Dr Moshe Feldenkrais,25 who devised hundreds of movement explorations he termed Awareness Through Movement (ATM) lessons.
The cells are connected to, and active within, a responsive and actively changing matrix, a matrix that is communicating meaningfully to the cell, via many connections (see Figs A1.95B and A1.96). They talk insistently: if one wants to avoid bites, kicks and scratches and survive while performing treatments, seek pain-free approaches. This form of pre-stress a middle ground between the immediate contraction of voluntary muscle and the fiber-creating remodeling shown by the pure fibroblast can prepare the body for greater loads or facilitate transfer of loads from one fascia to another. Taking the medial to lateral differences first: a common pattern is that the rhomboids are locked long (overstretched, eccentrically loaded) with the serrati locked short (concentrically loaded), pulling the scapula away from the spine. A1.60, p. 295 for more detail.) From the station at the occipital ridge, the epicranial fascia, or galea aponeurotica, runs up over the occipital bone (containing, in most people, slips of the occipitalis muscle), over the top of the head and down the forehead (enveloping the frontalis muscle) to attach to its final station, the brow ridge (see Fig. As long as the knee is bent, these two myofascial units go their own ways, neighboring but loosely connected (Fig. 2007;68:7480. The relative hydration of our tissues, and 312 APPENDIX 1 312 A Fascial Reader especially the interstitial ground substance, is determined by the balance between these centripetal and centrifugal forces. This myofascial line clearly continues from this station with the infrahyoid muscles the sternohyoid express covering the sternothyroid, thyrocricoid, and cricohyoid locals up to the suspended hyoid bone itself (Fig. 7.32 or for a more detailed explanation: www.anatomytrains.com video ref: Shoulders and Arm Lines, 06:2212:59). Edinburgh: Churchill Livingstone; 2012:165170. A3.13 Session 8 is an opportunity to put the head on. Schleip R. Fascial plasticity.
To free the front sheet and the muscle, have your client lie supine with his knees up, feet on the table. The Superficial Back Arm Line with the trapezius and 128 CHAPTER 7 128 The Arm Lines Deep Front Arm Line Deep Back Arm Line Superficial Back Arm Line A Superficial Front Arm Line B Fig. The Root of Thought: Unlocking Glia. 1998;(August):6169. 48 CHAPTER 3 48 The Superficial Back Line Again, the Awareness Through Movement lessons of Moshe Feldenkrais, which separate eye movements from neck and body movements, are unequaled in their ability to clarify and differentiate these muscles and this area.6 Palpation Guide for the SBL Beginning again from the distal end of the SBL, the first station is at the underside of the tips of the toes, which we cannot feel very well through the pads, but we can find the tendons of the short toe flexors under the thinner-skinned proximal part of the toes. 6.6).
In the pelvis and legs, the cylinders appear to be turned in, making the back appear wider than the corresponding area in front. It would be all one network, connected from top to toe, skin to bone, dense in some spots and gossamer in others, but showing both the external and internal shape of the entire body minus the hair. 10.47 A Lateral Line stretch, and a Lateral Line strengthening exercise. This gives a fuller discussion of the terminological issues. broadly, such as a right side tilt of the torso relative to gravity, or very specifically, such as an anterior tilt of the left scapula relative to the right or a posterior tilt of the right innominate bone relative to the sacrum or a medial tilt of the navicular relative to the talus. Online. As in Client 2, the left SL is shorter than the right in the upper body, with the lower anterior SL shorter on the right, and the lower posterior SL shorter on the left.
Those with more weight and substance in the legs and pelvis versus the ribs and shoulders tend toward the 240 CHAPTER 1 1 240 A BodyReading Structural Analysis B Fig. Tarrytown, NY: Station Hill Press; 1987. The section represents numerous structures of the Deep Ventral Line. ( iStockphoto.com, reproduced with permission. 8. The brachioradialis arises from the lateral intermuscular septum and goes to the radius, thus making another connection from the SBAL to the DFAL (Fig. (Photo courtesy of the author. The rhomboids carry us along the same line of pull over to the medial border of the scapula, thus connecting the left side of the skull to the right scapula and vice versa (Fig. A low but strong lumbar curvature might parse out on investigation as: the lumbars have a strong posterior bend from L5S1 to about L3, but have an anterior bend from L3T12. In the spine, the essential difference between a tilt and a bend is whether the deviation from normal is a singlesegment or multi-segment event and it is usually the latter. Thus, when either the lower lumbar vertebrae or the thoracolumbar junction (TLJ) are being pulled down and forward toward the front of the pelvis, any or all three of these pathways could be involved, and all three should be investigated in dealing with a lower lumbar lordosis, compressed lumbars, an anteriorly tilted or even a posteriorly tilted pelvis. Functional Lines Equivalents of the Functional Lines (FL; Fig. Thus, while in extreme cases the biceps might have a role in chronic humeral adduction or elbow flexion, the therapist is far more likely to get results from addressing the underlying locals than from work on the superficial biceps. Only if you push the wall sideways will the underlying tensional forces be evident. Step 3 Bringing all these observations into a coherent story would require weaving them in with a full history, but in general, we can say that most of this womans pattern is built on: 1. Osteopathy Research and Practice. Current Diagnosis and Treatment in Orthopedics. It could be compared to a clock or a compass, but since we are mired in train images for this book, we will call it a roundhouse (Fig. Water has a viscosity of its own (jump off the Golden Gate bridge to have an impactful experience with waters viscosity). Clients who create repetitive strain in the plantar fascia are likely to create plantar fasciitis anywhere along the plantar surface where it tears and inflames. and minor on the other side as part of the same fabric (see Figs. I went over to the window to see, and called my students over to witness a simple but telling phenomenon. A1.82). 1.26 The German anatomist Hoepke detailed some myofascial meridians in his 1936 book, which translates into English as muscle-play. Of course these two halves are not symmetrical to begin with, but we can still observe the balance between the two.
Granulation tissue as a contractile organ, a study of structure and function. 17.
The cranium is interlocked to itself, the thoracic curve is maintained by the ribs and sternum complex, the sacrococcygeal curve by the hip bones and pelvic ligaments, and the heel by the shape of the foot bones (Fig.