ANATOMY OF HATHA YOGA A Manual for Students, ‘Teachers, and Practitioners by H. David Coulter Foreword by Timothy McCall, M. D. Body and Breath‘Text and ilustrations ©2001 by #1, David Coulter Foreword ©2001 hy Tianothy BeCall Author's photugraph ©2001 by yee Barone ody and Bresth Inc. 1409 Wosteide Ave, Honesdale, PA 18431 UBA, oy o8o7 op os a4 VBTO5 PRECAUTIONARY NOYE: Phis is not a medical text, but a compendium of remarks concerning how anatomy and physiology relate to hatha yoga. Any medical questions regarding contraindications and cautions or any questions regarding whether or not to proceed with particular practices or postures should be referred either to health professionals iho have an interest in medical problems associated with exercise, stretching, and breathing, or to hatha yoga teachers who have had experience working with medical probleme in « therapeutie vetting: supervised by health professionals, All rights reserved, With certain exceptions enumerated below, no part ofthis book may be repreaced, tore it retrieval sto o transmitted in any form or By any means slectronic, mechanial, photneopying, recording or ctherwise—without written permission frm the publisher There are three exceptions. Fist brief quotations of upto 300 wars that are embedied in eiical articles ned reviews ene ued foe 2 lore ec Uy are prope acknowledged. cond: blanket permission is granted for institutional and ind vidual photoespying, properly acknowledged, of up to ene hundred expres totaling ne more than 25,000 werds foreach copy with accompanying illustrations (approximately ‘one chapter) or alternatively, a series of extracts from the entire book totaling no more than 25,000 wos, for purposes of teaching o for rvcatch und private study, eneepting that no deletions, alteration or exclusions within individual pags are permitted. For ‘ocample: eutting and pacing of Mlustrations for student syllabi expressly forbidden. (Onky incvidunl pages in their entirety are tobe photocopied, including text if any) and all running heads, captions, and labels that are incorporated within each page. ‘Third rermission for scanning af text, halftones, anata drawings, cca, aed bles either in ioltion oF altered as desired is granted only for trials of eketronie or hard copy Publishing layouts; permission must be sughl trom the publisher (Body and Breath Ine) ‘to use such ilstrations for any kind of electric ee meshavial transmission or in other publications Printed in China, Library of Congress Catsleging-n-Publestion Data Coulter, H. David (Herbert David, 1989 ‘Anatomy of Hatha Vogt manual for stadents, tochers, and practitioners hy H. David Coulter ;freword by ‘Timothy McCall Includes hibilogeaphical references and inde: ISBN 0.9707006-6-1 (alk. poper) 1. Yo, Hoth Physologea aspects 2. Human mechanics. 2. Human anatomy: ‘Tite. RATBI.7.088 2001 era 7046-1 2ontnznean‘To my parents, ‘who guided me lovingly, watched my life with joy and enthusiast, supported my academic and personal interests, and always thought the best of me.meemeyerrys eof eoougoryto() “Why de you never find anything written about that iddosyn cratic thought you advert to, about your fascination with something noone clic understand Tore t expel. tes here to caplet Uecase yous Mave never read it EP Recause tt ts up te you. wcthling you find interesting, for a reason hard lo en any page: there you begin, You were made and set here to give voice to this, your o1an astenithment.” — Annie Dillard, in The Writing LifeCONTENTS Foreword ol Preface 13 Introduction 15 Basie Premises Chapter One - MOVEMENT AND POSTURE. ‘The Neuro-mnusculoskeletal System ‘The Nervous System Reflexes. ‘The Veetibular Systom, Sight, and Touch Connective Tissue Restraints . ‘Stretching Three Pustures Putting It All Together Chapter Two - BREATHING The Desi of he Respiratory Sytem ‘Tho Muscles of Respiration How Breathing Affects Posture. ‘The Somatic and Autonomic Systems ‘The Physiology of Respiration ‘Thoracic Breathing 0... = 102 Paradenical Broathing 7 wr Supine Ahdominal Breathing ~ See) Alnlominal Breathing in Sitting Postures mt Diaphragmatic Breathing 7 120 ‘A Traditional Warning _— in Chapter Three - ABDOMINOPELVIC EXERCISES 139 Crunches and Sips wn ‘The Foundation of the Body Supine Leg Lifts Yorn Sit-ups F ‘The Sitting Boat Postures z a7 ‘The Peacock : ITS ‘The Pelvis and The Anatomical Perineum 17 ‘Ashwini Mudra 182 ‘Mala Bandha, 188‘Agni Sara _— ‘Uddiyana Bandha, ‘The Abdominal Lift Nal : Gontraindieations Benefits Chapter Four - STANDING POSTURES ‘The Skeletal System and Movement Anatomy of the Spine Symmetry and Asymmetry Standing Postures Four Simple Stretches, Backward Bending Forward Bonding on Side Bending What Makes Postures Difficult? ‘The Triangle Postures ‘Two Balancing Postures Benefits Chapter Five - BACKBENDING POSTURES ‘The Anatotny of Flexion and Extension Breathing and Boekhending ‘The Cobra Postures ‘The Locust Posture. ‘The Prone Boat: Postures, ‘The Bow Pastures ‘The Knee Joint Supine Backbending Postures peeling Backbend—The Camel indications ofits fer Six - FORWARD BENDING POSTURES . ard Bending: Head, Neck, and Chest bar and Lumbosacral Forward Bending riliae Nutation and Counternutation rard Bending at the Hip Joints tard Bending at the Ankles and in the Feet Jcal Matters and Cations asterior Stretch Dovn-Facing Dog, e Child's PoseBreathing and Forward Bending... a8 Socroiine Flowiility 355 Hip Flexibility i" 361 Benefits. ~ 6 Chapter Seven - TWISLING POSTURES .... 38s ‘he Fundamentals uf Twisting . 84 ‘The Skull the Atlas, and the Axis... 388 ‘Movements of the Head and Ned non 892 ‘Thoracic Twisting : 395 Lumbar Twisting 396 ‘The Lower Extremities 398 Supine Twists 403 Standing Twists 410 Inverted TWists . 424 Sitting Spinal wists 425 Benefits 435 Chapter Light - THE HEADSTAND ast “The Cavdiovascular System 4x7 ‘The Two Headstands 446 ‘The Upper Extremities — 456 Structural Imbalances an Breathing Taswes 474 Developing Strength and Flexibility - av ending und Twisting in the Headstand 488 Extending Your Time 498 enefits 497 Chapter Nine - THE SHOULDERSTAND Anatomy of The Shoulderstand Inverted Action Postures: ‘The Shoulderstand ‘The Plow - ‘The Lifted Shoulderstand and Plow Girculation Respiration ... Sequelae... Benefits —_— =e Chapter Ten - RELAXATION AND MEDITATION Muscular Relaxation . t= ‘Two Relaxation Poetures Breathing and Relaxation‘The Autonomic Nervous System Deepening Relaxation Meditation Posture ‘Maintaining the Geometry Props ‘The Six Postures Mula Bandha Mastering the Situation Knower of the Veil Glossary Additional Sources Acknowledgments Index of Anatomical ‘Terms Index of Practices Biographical Sketch maromoyopry(s ef ougem7o(2) ou 619 623FOREWORD Hate yore. ts teacher and corious students are convinen of ts power to build strength und confidence, to improve flexibility and balance, and to fostor tanita peice and contentment And beyond tx als ibutes as preventive med- era any of us alsa lieve an the power of yop o heal, to ad in recovering frown everything from ow back strain to carpal tunnel syndrome and (0 belp ee eairahvosic probleme Eko arthritis, tiple slerais and infection with the human immunodeficiency virus GV) ‘Dat despite the Teant boom in your's populaity, moet scientists and physi cians have been slow to embrace this discipline. To many of them perhaps, it Cathe ike a myeticel pursuit, 8 quas-religon with hte bass in the modern Seri otcionce na medical profasion now Hal deninated bya nest religious TReorencs for the randval, controled study, Knowledge acquired through TRonands of years of erect chocrvation, introspect nd ial and error may eer quaint ut ue the West has lowly opened in the pst decades to Faster, experientilly sed fics ike scupunctare’as part of grantor necaplanee of alternative tmeticine in gneral_yoen has begun to stake its aim. Concepts lke prana or {EN However are uot warmly recelved by epi! slentnts. Ty win tem over Sint noad ta prewide the kind of evidonce they buy. Studies. Preferably Jublished in peerreview journals. And you need to propose mechanisms of veil (nat conform with scence an they understand i “Asignifeant breakthrough wae provided by Dr. Dean Ornish, a California- tase cariologist who interrupted fis college years to study with Sri Swami Satehidannnda, His work, published in 1990 inthe prestigious British medical Journal the Larect, showed that a program tal combinos hatha yoga with Uetury cluges, exercise, and group therapy can actually revere Bockagos in the bears main arteries-which doctors used to think wasn't possible Tn i998, research led by Marian Garfinkel of the Medical College of Peoruylvanin and. published in the Jourmel of the American Medical Ascocation found that Iyengar yogn coud effectively reduee the symptoms af tape cane! gyro, a nulacy ef cnr epee proportions in this ompular tee Of role, Gorinke’ study lasted only eight otha, ad yet the intervention proved effistsusSericus yoge practitioners realize of corse that although come Fenefit may be noticed after evn a single clas, soa's most profound effects scerue over yeu oven decales-not weeks, Yogh is indeed powerful medicine Thu i is low modicne. ‘Mote studie will be needed to convince the medical establishment, but that rexearch could lea be low n coming. Funding i perennial problem. Unlike the situation with, sa, pharmaceutical, there is no private industry to bankroll the scent investigation of hatha yoga. Given the incredible cnet of Tongerange studies which are more likely Lo demonstrate effectivencse— Tsuopeet that were unlikely to sue any time soon the kindof overwhelming Proof thal skoplicl scientists want, This presents © philosophical question:‘When you have an intervention which appears safe and effeetive—and when its side effects are almost entirely positive—should one wait for proof before tuying it? This value judgment lies at the heart of the rocont debate over many traditional healing methods. Tronically, though, even within the world of alternative medicine yoga seems underappreciated. Two years ago, [attended a four-day conference on alter- native medicine sponsored by Harvard Medical School. A wide range of topics from herbs to prayer to homeopathy were covered in detail. Yet in the dozens of presentations T attended, yora was mentioned just once: In a slide that accompanied the lecture on cardiovascular disease, yogu was one of several modalities listed under “Other Stress Reduction Techniques.” Yous is certainly a stress reduction dovioe but to reduee it to just that misees so much, Given the situation, how welcome then is David Coulter's Anatomy of Hatha Yoga. David combines the perspactives of a dedicated yogi with that of a former anatomy professor and research associate at two major American medical schools. THe has set himself the ambitious youl of combining the modern scientific understanding of anatomy and physiology with the ancient practice of hhatha yoga. ‘The result of an obvious labor of love, the book explains hatha yoga in demystified, scientific terms while at the same time honoring its traditions, It should go a long way W helping yogn achieve the selentifle recognition it deserves. Useful as both a textbook and us u reference, Anatomy of Hath Youa is a book that all serious yoga teachers and practitioners will want on their sholves, If will also be welcomed by sympathetic physiciane—and there are more of us all the time—as well as physical therapists and other health profissionals. Speaking as a doctor who had already studied anatemy in deta (though forgotten more than I'd care to admit) and as a dedicated student af ‘yoga, I can happily report that this book heightened my understanding of both hatha yoga and anatomy and—az a nice bonue improved my personal practice. T realize, however, that to those who lack scientific training Anotoney of ‘Hatha Yoga may seem daunting, Some sections use terminelogy sind concepts that may be challenging on first reading. If you feel intimidated, my suggestion Js to adopt the mentality many employ when reading the ancient and some- difficult texts ofthe you: tradition. Read with an epen heart and ifyou get ‘Ghstreet try another pater como beck toi anather dy. As with yogs eal, t students will be rewarded with an ever-greater understanding. ‘Timothy McCall, MD Boston, Massachusetts January, 2001 ‘Timothy MeCall is a board-certified specialist in internal medicine and the hor of Examining Your Doctor: A Patient's Guide to Avoiding Harmful cal Care. His work has appeared in more than a dozen major publicalions iding the New Englond Journal of Medicine, the Nation and the Los yes Times. He can be found on the web at wwviarmocall.com 2PREFACE The orgies of this bok date from twenty. yen ao when Iwas teaching various neuroscience, microscopic anatomy, and elementary avatomy courses fn the Department of Cell Biclogy and Neuroanatomy at the University of Minnesota. At the same time I was learning about yogs in classes at the Meditation Center in Minneapolis. During those years, Swami Rama, who founded the Himalayan Institute, often lectured in Minnesota, and one of his messages was that yoga was neither exercise nor religion, but 1 science, aad he ‘wanted modern biomedical science to examine it in that light. One of hi ‘in coming to the West was to bring this about, @ purpose which is Teflectad by the name he selected for the institute that he founded—The ‘Himalayan International Institute of Yoga Science and Philosophy. The idea of ‘connecting yoga with modern science resonated with me, and the conviction frew that T onald be a part of such # quest. Soon after I communicated my Interest, Swami called and suggested that T pay him a visit to talk about Writing a book on anatomy and batha yoga. And that is how thie projeet hogan in 1976. ‘Apart from several fulse starts and near-fatal errors, 1 did little waiting on this subject belweon 1976 and 1088, but still T benefited from students’ ‘questions in courses on anatomy and hatha yoga al the University of ‘Minnesota (Extension Division), more comprehensive courses on yoga anatomy for graduate students at the Himalayan Institute in the late 1980s, anatomy fand physiology courses in the mid-1990s for the Pacific Insitute for Oriental Medicino (NYC), and from 1990 to the present, teaching anatomy for students fof Ohashiatsu@, a method of Oriental bodywork. ‘These courses brought me in touch with many telling questions from students interested in various aspecte of holistic medicine; without them, the seed planted by Swamiji would never ‘have matured, ‘And co it went, from a working draft in the smmor of 1976 to 1995, when afler many gentle and not-so-gentle nudges, Swamiji insisted that my time was ‘up, Las to finish the book, nish it now, and not run away. IPT tried to escape, he avowed, he would follow me to the ends of the earth; what he would do upon, finding me is better left unsaid. Happily, he saw an early but complete dralt of the toxt u your before hie passing in November of 1996.(-)eirtualmore for NatahausnuINTRODUCTION A comprehensive statementon the anatomy and physiology of hath yrs fought to have been written years ago. But it hasn't happened, and my sim is to remedy the deficiency. After considering the subject for twenty-five {jus it's clear that euch a work might well interweave two themes: forthe tonefit of completeness, a traditional treatment of how to do yoga postures {yoga asanas) using anatomically precise terminology, and, for correlations swith medical science, au objective analysis of how thore portures are realized in some of the great systems of the body. In that regard, special emphasis is placed here on the musculoskeletal, nervous, respiratory, and ‘ardiovascular systems—the musculoskeletal system because that is where allour actions are expressed, the nervous system hoesnse thats the residence ofall the managerial functions ofthe musculoskeletal system, the respiratory ‘stem because broathing is of such paramount importance in yoga, and the cardiovascular aystein because inverted postures cannot be fully comprehended without understanding the dynamics of the circulation. ‘Most ofthe emphasis is practical—doing experiments, learning to observe the body, and further refining actions and observations. "The diccustion ie intonded for an audience of yora teachers, health professionals, and anyone else who is interested in exploring some of the structural and functional aspects of hatha yogs. The work can also serve as A guide for students of wlertiative medicine who would like to communicate with these who place their faith more strictly in contemporary science. To help everyone in that regard T've included only material that is generally cepted in modern biomedical sciences, evoiding comment on non-physical concepte stich ae prana, the nadis, and the chakras, none of which are precently testable in the scientific sense, and none of which have obvious parallels in turn-of-the-millennium biology "The book begins with an introductory discussion of some basic premises that set a philosophical tone and suggest a consistent mental and physical approuch to postures. Ten ehupters follow, the first three fundamental to the last seven, Chapter 1 summarizes the basic principles of the anatomy And physiology of hatha yoga. Broathing next in chapter 2sines the manner in which we breathe in hatha yoga is important for expediting: movement ‘and posture. Breathing is followed by pelvic and abdominal exercises in chapter 3 for three reasons: muy of Whose exercises use specialized methods of breathing, they are excellent warm-ups for other postures, and the pelvis ‘and ubdomen form the foundation ofthe body. Standing postures will then DDecovered in chapter 4 because these pores are 0 important for beginning 5students, and because they provide a preview of backbending, forward ending, and twisting peatores, which are covered in detail in chapters 5, 6, and 7. The headstand and shoulderstand, including a brief introduction to cardiovaseular function, are included in chapters 8 and 9. Postures for relaxation and meditation are treated last in chapter 10. It will be helpful to experiment. with each posture, preferably in the order given. This approach will lead you logicelly through « wealth of ‘musculoskeletal anatomy, bring the academic discourse to life and pers ‘you to understand the body's architecture and work with it safely. I'some of the sections on anatomy and physiology scem formidable, there is an easy colution. Turn the page. Or turn several pages. Go directly to the next section on postures, in which most of the discussion ean be understood in context. Just keep in mind, however, that knowledge is power, and that to ‘communicate effectively with laypeople who have technical questions as ‘well as with health professionals to wham you may go for advice, it may be desirable to refer back to the more challenging: sections of this book as the need arises. And those who do not find these sections particularly demanding, ‘can look to Alter's definitive Setence of Flexibility, as well us to other sources that are listed after the glossary, i they require more tochnieal details than, are provided here. macomorgnreys of coongonyze(2)BASIC PREMISES "The tact half ofthe brenticth contury mi many schon of hath you ‘uike root in the West. Some are based on authentic oral traditions passed ‘down through many generations of teachers. Some are pitched to meet modern needs unxl expectations but are still consistent with the anciont art, sconce, and philosophy of yoga. Still others have developed New Age tangents that traditionalists view with suspicion, Picture this title placed, near the exit of your local bookstore: Get Rien, Young, an Bewtifl with “Hatha Yoga. V0 not seon it, but it would hardly be surprising, and T have ‘0 admit that I would look carefully before not buying it... Givon human differences, the many schools of hatha yoga approach even the most basic postures with differing expectations, and yoga teachors find themselves facing a spectrum of students that ranges from accomplished dancers and gymnasts to nursing home residents who are afraid to lie down on the floor for fear they won't be able to get back up. That’ fine; it’s not fa.problom to transcend such differanens, heeause for everyone. no matter ‘what their age or level of expertise, the most important issue in hatha yoga is not flexibility and the ability to do difficult, postures, but awareness— awuruuiess of the body and the breath, and for those who read this book awareness of the anatomical and physiological principles that underlie ‘each posture, From this awareness comes control, and from control comes, ‘ace and beauty, Even postures approximated by beginning students can ‘carry the gorm of poise and elegance How to sccomplish these goals is another matter, and we often see disagreement over how the poses should be approached and taught ‘Therefore, ihe guidelines that follow are not set in stone; their purpose is to provide a common point of reference from which we can discuss the anatomy and physiology of hatha yoga. Focus voun aTTENrI0N Lock your attention within the body. You can hold your concentration on breathing, on tissues that are being stretched, on joints that are being: stresed, (x the spadd of your movetnents, or on the relationships between breathing and stretching. You can also concentrate on your options as you Tove in and out of postures. Practicing with total attention within the Dody is advanced yoge, no matler how easy the posture; practicing with Your attontion eetlored is tho pradtica ofa bene ne matter hows dif ‘the posture. Hatha yoga trains the mind as well as the body, so focus your Attention without lapse.88 anarosn ar resis vos BE AWARE OF YOUR BREATH We'll see in chaplers 2-7 that inhalations lift you more fully into many postures and create a healthy internal tension and stability in the torso. ‘You can test this by lying prone on the floor and noticing that lifting: up higher in the cobra posture (Gig. 2.10) is aided by inluslation. Paradoxically, however, exhalations rather than inhalations carry you further into many other postures. You can test this by settling into a sitting forward bend and noticing that exhalation allows you to draw your chest down eloser to your thighs (fig. 6.13). But in either ease you gut two benefits: diaphragmatic breathing assists the work of strotching the tissues, and your awareness of those effects directs you to make subtle adjustments in the posture. While doing postures, as a general rule keep the airway wide open, breathe only through the nose, and breathe smoothly, evenly, and quietly Never hold the breath at the glottis or make noise as you breathe except as required or suguested by speetfic practices. BUILD FOUNDATIONS ‘As you do each asana, analyze its foundation in the body and pinpoint the key muscles that assist in maintaining that foundation. the lower extrem ities and their extensor muscles in standing postures: the shoulders, neck, spine (vertebral column), and muscles of the torso in the shoulderstand; ‘and the enlirety of the musculoskeletal system, but especially the abdominal ‘and deep back museles, in the peacock, Focus your attention accordingly on the pertinent regional anatomy, both to prevent injury and to refine your understanding of the posture. ‘Then there is another kind of foundation, more general Ua whith we appreciate from the point of view of regional anatomy—the foundation of connective tissues throughout the body, especially those that bind the ‘musculoskeletal system together. ‘The connective tissues are like steel rein- forcing rode in conerote; they are hidden but intrinsic to the integrity of the whole, To strengthen these tissues in preparation for more demanding work with postures, concentrate at first on toughening up joint capsules, tendons, ligaments, and dhe fascial sheathes that envelop muscles, The | method for accomplishing these aims is to build strength, and to do this from the inside out, starting with the central muscles of the torso and then moving from there to the extremities. Aches and pains frequently develop if you attempt extreme stretches before you have first developed the strength and skill to protect the all-important. joints. Unless you are already a weightlifter or body builder, stretching and becoming flexible should be a secondary concern. Ouly as your practiee matures should your emphasis be changed to cultivate # greater range of motion around the joints.asec presses 19 moving, (To AND OUT OF POSTURES Being in a state of silence when you have come into a posture is eoothing ‘and even magical, but you cannot connect with that state except by know- ing how you got there and knowing where you're going. If you jerk from posture to posture you cannot enjey th journey, and the journey is just ae jmportant asthe destination, So move into and out of postures slowly and consciously. As you move, survey the body from head to toe: hands, writs, forearms, elbows, arms, and shoulders; feet, ankles, legs, knees, thihs, an hips; and pelvis, abdomen, chest, neck, and head. You will soon develop awareness of how the body functions as a unit and notice quirks and iscontinuities in your practice which you ean then smooth out. Finally, as {you learn to move move gracefully, the final posture will ecm lees difficult HONOR THE SUGGES! i NS OF Do you honor or ignore messages from aches and pains? If you have back pain, do you adjuet your posture and activities to minimize it, or do you just tough it out? And do you keep a deferential eye on your body. or do you find that you get £0 wrapped up in some challenge that you forget about it? If ‘you do not listen: W messages from your body you will be a eandidate for pulled muscles, tendinitis, pinched nerves, and ruptured intervertebral disks, ‘To avoid injury in hatha yoga you have to develop a self-respecting awareness Begin your program of hatha yoga with a resolution to avoid pain Unless you have had years of experience and know exactly what you are doing, pushing yourself into a painful stretch will not only court injury, it will also create a state of fear and anxiety, and your nervous system will store those memories and thwart your efforts to recreate the posture. Pain is. gift; it tells us that some problem has developed. Analyze the nature of the problem instead of pushing ahead mindlessly. With self-awareness and the guidance of a competent teacher, you can do other pestures that circumvent the difficulty. ASM, AND CAUTION Try to practice at the same time and in the same place every day. Such habits will make it easier to analyze day-to-day changes. Mornings are best for improving health—stiffness in the early morning tells you where you ‘need the most careful work and attention, Later in the day; you lose that Sensitivity and incur the risk of injury. Cultivate a frolicsome enthusiasm in the morning to counter stiffness, and cautiousness in the evening to ‘void hurting yourself. And at any time, if you start feeling uncommonly strong, flexible, and frisky, be careful. That's when it is easy to go too far.TAKE PERSONAL RE! Study with knowledgeable teachers, but at the sane Gane take responsibility for your own decisions and actions, Your instructor may be strong and vigorous, and may urge you on, but you have to be the final arbiter of what you are capable of doing. Because many hatha yoga postures make use of ‘unnatural positions, they expose weaknesses in the hody, and it is up to you to decide how and whether to proceed. One criterion is to make sure you not only feel fine an hour after your practice, but twenty-four hours later 2 well. Finally, honor the contraindications for each posture and each class of postures; if in doubt, consult with medical practitioner who has had experience with hatha yoga, CULTIVATE PATIENCE Learn from the tortoise. Cultivate the patience to move forward steadily, no ratter how slow your progress. Remember as well that the benefits of Jhatha yoga go beyond gtting strongor and more flexible, and that if you are monitoring only that realm, you may be disappointed. For any kind of beneficial result you have to be patient. The main culprit is thinking that ‘you should be able to accomplish somethings without making consistent fort. That attitude has two unfortunate side effects: first, it diverts your attention from the work before you to what you believe you are entitled to; and second, it makes it impossible to learn and appreciate what is taking placo this minuto, So resolve to practice being with your experience in the present moment, enjoy yourself no matter what, and let go of expectationsCHAPTER ONE MOVEMENT AND POSTURE “Emery yor Felling students inimy fos Cactare that at east Kall of what Fam about to teach them will eventually be towne to be wrong. The trouble cs de not kavw which bal The future isc rough takmaster, Nevertheless, a herd dastinct often grins the imaginations of scientists, Like Aonmings, we are prone to charge over cliffs when a large enough pack of us meves in that dirction.” — Michael Gershon, in The Second Brain, p. 34- Toro frst organizing principle underlying human movement and posture {sour existence in a gravitational field. Imagine its abeence in a spacecraft, where astronauts float unless they are strapped in place, and where outside the vessel little backpack rockete propel them from one work site to another. ‘To get exercise, which is crucial for preventing loss of bone calcium on long voyages, they must work out on machines botted to the floor. They can't do the three things that most of us depend on: walking, running, and lifting. UF they tried to partner up for workouts, all they could dois jerk one ancther hack and forth. And even hatha yoga postures would be valueless; they ‘would involve little more than relaxing and squirming around. Boek on earth, itis helpful to keep recalling how the force of gravity dominates our practice of hatha yoga. We tend to overlook it, forgetting that it keeps us grounded in the most literal possible sense. When we lift Lup into the cobra, the locust, or the bow postures, we lift parts of he Luly away from tho grenind against the force of gravity. In the shoulderstand the force of gravity holds the shoulders against the floor. Ina standing posture ‘we would collapse if we did not either keep antigravity muscles active or lock joints to remain erect. And even lying supine, without the need either to balance or to activate the antigravity muscles, we make use of gravity in ‘other creative ways, as when we grasp our knees, pull them toward the ‘hen, oll from side to side, and sllow our body weight to massage the buck ‘muscles sgninst tho floor Keeping in mind that the earth's gravitational field influences every Movement we make, ve'll turn our attention in the rest of this chapter to 21the mechanisms that make movement and posture possible. First we'll lok ‘at how the ckeletal muselee move the body, then we'll diseuss the way the nervous system controls the operation of the skeletal muscles, and then we'll examine how connective tissues restrict movement. If we understand how these three function together within the field of gravity, we ean begin to understand some of the principles underlying hatha yoga. Finally, we'll ppt it all together in a discussion of three postures. We'll begin with the role of skeletal muscles, THE NEURO-MUSCULOSKELETAL SYSTEM ‘To any informed observer, it is plain that the musculoskeletal system executes all our acts of will, expresses our conscious and unconscious habits, breathes air into the lungs, articulates our oral expression of words, ‘and implements all generally recognized forms of nonverbal expression and ‘communiestion. And in the practice of hatha yoga, tts plainly the musculo- skeletal system that enables us to achieve external halance, to twist, bend, ‘tum upside down, to be still or active, and to accomplish all eleansing and breathing exercises. Nevertheless, we are subtly deceived if we think that. is the end of the story, Just as we see munchkins sing and dance in The Wizard of Oz and do not learn that they are not autonomous until the end of the story, we'll find that muscles, like munchkins, do not operate in ‘isolation. And just as Dorothy found that the wizard kept e tether on every- ‘thing going on in his realm, 50 we'll soo that the nervous system keeps an absolute rein on the musculoskeletal system. The two systems combined form a neuro-musculoskeletal system that unifies all aspects of our actions and activities. To illustrate how the nervous system manages posture, let's say you are standing and decide to sit. First your nervous system commands the flexor ‘muscles (muscles that fold the limbs and bend the spine forward) to pull, the upper part of the trunk forward and to initiate bending at the hips, kknoes, and ankles, A bare moment after you initiate that movement, gravity takes center stage and starts to pull you toward the sitting position. And at. the same time—accompanying the action of gravity—the nervous system commands the extensor muscles (those that resist folding the limbs) to counteraet gravity and keep you from falling in heap. Finally, as soon a you are settled in a secure seated position, the nervous system permits the ‘extensor muscles and the bedy as 1 whole to rela. ‘The musculoskeletal system does more than move the body, it also serves as a movable container for the internal organs. Just asa robot. houses and protects its hidden supporting elements (power plant, integrated Circuits, programmable computers, selérepairing components, and enough fue to function for a reasonable length of time), so does the musculoskeletalsystem house and protect the delicate internal organs, Hatha yoga postures {each us to control both tho muscles that operate the extremities and the ‘muscles that form the container SceLETAL MUSCLE ‘The term “nusele” technically includes both its central fleshy part, the felly of the muscle, and its tendons. ‘The belly of a muscle is composed of individual muscle flders (muscle ells) which are surrounded by connective tivsue fibers that run into a tendon. The fendon in turn connects the belly fof the muscle to a bone. Under ordinary circumstances muscle cells contract, oF shorten, only rcauze nerve impadeee signal them to do so. When many nerve impulses per second travel to most of the individual fibers in a muscle, it pulls strongly on the tendon; if only a few nerve impulses per second travel to a Smaller population of fers within the muscle, i pulls weakly on the tendons and if nerve impulses are totally absent the muscle is totally relaxed. {Technical note: One of the most persistent misconceptions doggedly surviving in the biomedical community that all musce, even thie ol ret always kep receiving fb lout some nerve impulses Fifty years f electromyography with fine-wire needle Sectrodes is at odds with this belief, doeumenting from the 9950s on that i's not Deceserly true, and that with biofeedback training we ea learn to rlax roa! of cour skeletal museles completely] ‘A muscle usually operates on a movable joint such as @ hinge or a ball and socket, and when 1 muscle is stimulated to contract by the nervous system, the resulting tension is imparted to the bones on both sides of the fulcrum of the joint. In the case of a hinge such as the elbow that opens to about 180°, any muscle situated on the face of the hinge that ean close will eercase the angle between the two bones, and any muscle situated on the Ihack sde ofthe hinge will open it up from a closed or partially closed position. For example, the biceps brachii musele lies on the inside of the hinge, so it ‘cts to flex the forearm (by definition, the segment of the upper extremity between the writ and the elbow), pulling the hand toward the shoulder. The triceps brachii is situated on the back side of the arm (the segment of the upper extremity between the elbow and the shoulder) on the outside of the hinge, 20 it acts to extend the elbow, or unfold the hingo (fig, 1. ORIGINS ANO INSERTIONS We use the words “origin” and “insertion” W indivate where muscles are Attached to homes in relation to the most common movement ata joint. The Origin of a muscle is on the bone that is relatively (or usually) stationary, ‘nd the insertion of a musele is on the bone that is most generally moved. Flexion of the clbow is again a good example. Since ordinarily the arm is fixed and the forearm is moved, at least in relative terms, we say that the24 axeronv or wari youn biceps brachii and triceps brachii take origin from the arm and shoulder, ‘and that they insert on the forearm (Fg. 11). ‘The origins and insertions of muscle can be functionally reversed. When the fatissimus dorsi muscle (figs. .9-10) pulls the arm down and back in a swimming stroke, its textbook origin is from the lower back and pelvis, and its insertion is on the humerus in the arm, But when we do a chin-up the arm is the relatively stable origin, and the lower back and ppelvis become the insertion for lifting the body as a whole. In the coming, chapters we'll see many examples of how working origins and msertions are reversed. AGONIST AND ANTAGONIST MUSCLES ‘The muscles surrounding. a joint act cooperatively, but one of them—the ‘agonist—ordinarily serves as the prime mover, assisted in its role by function- ally related muscles called synergésts. While the agonist and its synergists are acting on ane side of the joint, muscles on the opposite side act as antagonists. As suggested by the name, antagonists monitor. smooth, and even retard the movement in question. For example, when the biceps brachii and the brachialis in the arm (the agonist and one of its synergists) shorten to flex the elbow, the triceps brachi (on the opposite side of the arm) resists flexion antagonistically while incidentally holding the joint surfaces in correct apposition (fig 1). ‘Muscles also aet in relation to the force of gravity In the lower extrom- ities extensor muselos act as antigravity muscles to keep you upright and resist crumpling to the floor. Examples: the quadriceps femoris muscle (gs. .2, 3.9, and 8.1) on the front of the thigh (Whe segment of the lower ‘extremity between the hip joint and the knee joint) extends the knee joint 1s you step onto a platform, and the calf muscles extend the ankles as you lift your heels to reach an objeet on a high shelf. Flexor muscles are antag. nists to the extensors. They ean act in two ways. They often aid gravity as when you settle into a standing forward bend and then pull yourself down more insistently with your hip flexors—the ilfopsoas muscles (gs 2.8, 375 34 and 8.13). But they also act to oppase gravity: ifyou want to run in place the iliopsoas muscle complex flexes the hip joint, lifting the thigh and drawing the knee toward the chest; and if you want to kick yourself in the buttocks the hamstrings (fig. 38, 310, 8.10, and 8.2) flex the knee, pulling the leg (the segment of the lower extremity between the kinoo and the ankle) toward the thigh. Even so, the flexor muscles in the lower extremities are not classified as antigravity muscles, because under ordi- nary postural circumstances they are antagonists to the muscles that are supporting the body weight as a whole. For the upper extremities the situation is different, because unless youmcrnaranp nniae 9 ‘are doing something unusual like taking a walk in a handstand with slightly ‘pent clbows (which necessitates a strong commitment from the triceps ‘brachii muscles), the extensor muscles do not support the weight of the ‘bod. In most practical circumstances, it is likely to be the flexors rather ‘han extensors that act as antigravity museles in the upper extremities, as ‘when you flex an elbow to lift-a package or complete a chin-up. ical note: Throughout this book, in order to Keep terminclogy simple andl yet precise, I'l stick with sit anatomical definitions uf ar, forearm thigh, and lg, Pinch means never using ambiguous {erms such as “upper arm,” “lower arm,” aanenr ioe” and "lower ley.” The same goes for the carci use ofthe term “arm” ta ehcompass an undetermined portion of the upper extremity and the careless use tthe tern ley” to encompass an undetermined portion ofthe ower extremity. supraspinalus muscle triceps beach forearm at bow ips brachi ‘as prime mover ee forearr as prime brachiais muscle: synergst or Nexion ol orearr ‘tecranon. bony tip of ‘elton en Insericn of twicers brachit oper part ohterearm Figure 1.1. View of the right scapula, arm, and upper part of the forearm from behind and the side (Irom Sappey; see “Acknowledzements” for discussion of edits rogarding drawings, ilustrations, and other visual materials)And snother technical note: Just to avoid confusion, I'll not use the word flex ‘except in regard to the opposite of extend. Exeryone knows what a first grader ‘means by saying “Took al me flex my museles," but heyeind this childhood expres: sion, it can lead to ambiguity: For example, having someone “flex their biceps” results in flexion of the forearm, but “flexing” the gluteal museles-—the “gluts"— results notin flexion but in extension of the hips, For deseribing voua postures it's better just (6 avoid the usage altogether] [And one more: Until getting used to terminology for movements of hedy parts, often @ puzzle whether it's better to refor to moving a joint through some range of motion, or to moving the body part on the far side of the joint. For example, the choice nid be betwees ssn: extend! Ue knwe joint versus extend the leg, abduct, the hip joint versus abduct the thigh, flex the ankle joint versus flex the foot, extend the elbow joint versus extend the forearm, or hyperextend the wrist joint versus hyporestend the hand. Even though the two usages are roughly equivalent, the con- {xt usually makes one or the ether seem more sensible. For example, sometimes we refer specifically to the joint, as in “flex the wrist.” In that ease, saying “flex the thand” would be ambiguous because it could mean any one of three things: making ‘fist, flexing the wrist, or hoth in combination. On tho other hand, referring to the body part is often more velfexplanatory, as in “lex the arm forward 9o'.” Although the alternative—"flex the shoukler joint 9o°"—isn't nonsensical, tsa litle arcane for the non-professional.] ‘To understand how the musculoskeletal system operates in hatha yous we ‘must look at how individual museles contribute to whole-body activity. The simplest situation, concentric contraction, or “concentric shortening,” is ‘one in which musele fibers are stimulated by nerve impulses and the entire ‘muscle responds by shortening, as when the bicens brachii muscle in the forearm shortens concentrically to lift « book. ‘When we want to put the book down the picture is more complicated. We do not ordinarily drop an object we have just lifted —we set it down eare. fully by slowly extending the elbow, and we accomplish that by allowing the ‘muscle as a whole to become longer while keeping some of its muscle fibers in a state of contraction. Whenever this happens—whenever @ muscle increases in length under tension while resisting gravity—the movement is called “eccentric lengthening. We see concentric shortening and eccentric lengthening in most natural activities. When you walk up a flight of stairs, the muscles that are lifting ‘you up are shortening concentrically; when you walk back down the stairs, the same muscles are lengthening eccentrically to control your descent. ‘And when you haul yourself up a climbing rope hand over hand, muscles of the upper extremities shorten concentrically every time you pull yourself up; as you come back down, the same muscles lengthen eccentrically. In hatha yoga we see concentric shortening and ecventne lengthening in hundreds of situations. The simplest is when a single musele or muscle {group opposes gravity, as when the back muscles shorten concentrically toJift the torso up from a standing forward bend. ‘Then as you slowly lower ‘back down into the bend, the hack muscles resist the foree of gravity that is pulling you forward, lengthening eecentrically to smooth your descent. {soTONIE AND ISOMETRIC ACTIVITY ‘Most readers are already familiar with the terms “isotonic” and “isornetrc. Sirictly speaking, the term isotonic refers solely to shortening of a muscle funder a constant kes, but this never happene in reality except in the case ff vanishingly small ranges of motion. Over time, however, the term {isotonic has become corrupted to apply generally to exercise that involves movement, usually under conditions of moderate oF minimal resistance. Trometrie exorcise, on the other hand, refers to something more precise— holding still, often under conditions of substantial or maximum resistance. Raising and lowering a book repetitively is an isotonic exercise for the biceps brachii and its synergists, and holding it etill, neithor allowing: it to fall nor raising it, is an isometric exercise for the same muscles, Most athletic endeavors involve isotonic exercise because they involve move- ‘ment, Japanese sumo wrestling between equally matched, Lightly gripped, fend momentarily immobile opponents is one obvious exception. And isometric exercise is also exemplified by any and every hatha yoga posture ‘which you are holding steadily with muscular effort. RELAXATION, STRETCH, AND MOBILITY If few or no nerve impulses are impinging on muscle fibers, the muscle tissue will be relaxed, as when you are in the corpse posture (fig. 1.14). But if a relaxed mucclo is stretched, the situation becomes more complex. Working with a partner ean make this plain. If you lie down and lift your hands straight overhead, and then ask someone to stretch you gently by pulling on your wrists, you will notice that you can easily go with tho stretch provided you have good Nexibility. But if your partner pulls too suddenly or if there is any appreciable pain, the nervous system will resist relaxation and keep the muscles tense; or at the least, you will sense therm {ightoning up to resist tho stretch. Finally, if yon allow yourself to remain hear your limit of passive but comfortable stretch for a while longer, you Tay feel the muscles relax again, allowing your partner to pull more insistently Many ofthese same responses are apparent i'you set up similar eonlitions of stretching on your own, as when you place your hands overhead against wall and stretch the underside of the arms. This is more demanding of Your concentration than relaxing into someone else’s work. however, ‘because you are concentrating on two tasks at the same time: creating the ‘ecessary conditions for the stretch, and relaxing into that effort. But thesume rules apply. Ifyou go too far and too quickly, pin inhibits lengthening, prevents relaxation, and spoils the work. ‘To discover for yoursolf how skeletal muucelos operate in hatha yous, try & warrior posture (warrior 1) with the fect spread wide apart, the hands stretched overhead, and the palms together (figs. 1.2 and 7.20). Feel what happens as you slowly pull the arms to the rear nd lower your welght, To pull the arms up and back, the muscles facing the rear have to shorten concentrically, while antagonist muscles facing the front passively resist ‘the stretch and possibly completion of the pasture. As you lower your weight ‘the quadriceps fernoris muscle on tho front of the floxed thigh resiste gravity and lengthens eoeentricaly. Finally, as you hold still in the posture, muscles throughout the body will be in a state of isometric contraction, Several important principles of imusculuckelets) activity eannot be addressed until we have considered the nervous system and the connective tissues in detail. For now, it is enough to realize that all muscular activity, Whether it be contraction of individual cells, isotonic or isometric exercise, sugonist or antagonist activity, concentric shortening, or cocentre length ning, takes place strictly under the guidance of the nervous system ‘muscles facing the ont resect paling ol the fame to the roar Fight quadticops temons muscle lengirans: conn Figure 1.2, Wartior 1 pase’ THE NERVOUS SYSTEM We experience all—or at least everything pertaining to the material world—through the agency of specialized, irreplaceable cells called ‘neurons, 100 billion of them in the brain alone, that channel information throughout the body and within the vast supporting cellular milieu ef the ‘central nervous system (the brain and spinal cord). This is all acoomplished by only three kinds of neurons: sensory neurons, which earry the flow of sensation from the peripheral nervous system (by definition ull parts of the nervous syetem excopting the brain and spinal cord) into the central nervous system and consciousness; mofor neurons, which carry instructions from the brain and spinal cord into the peripheral nervous system, and from there to muscles and glands; and interneurons, or association neurons, ‘which are interposed between the sensory neurons and the motor neurons, ‘and which transmit our will and volition to the motor neurons. The sensory {information is carnied into the dorsal horn of the spinal eord by way of dorsal roote, and the motor information is carried out of the ventral horn ‘ofthe spinal cord by way of ventral roots. The dorsal and ventral roots join to form mixed (motor and sensory) spinal nerves that in turn innervate structures throughout the body (figs. 13-9) [Technical notes: Because this is a book correlating biomedical scionce with yor, ‘which many consider (o be a science of mind, a few comments are required on a fuject of perennial, although possibly overworked, philosophical interest—the haure of mind vis-a-vis the nervous system. Speaking for neuroscientists, T think F fan say that most of us aoe a tagomatie that neurons are collectively responsible forall of our thinking, cognition, emotions, and other activities of mind. and that the totality of mind ts inherent in the nervous system. But [also have to say as a Iracticing yeqi that according to that tradition, the principle of mind is separate from and more subtle than the nervous system, and is considered to bea life principle that extends even beyond the beds] {ow ana whether these yuestions become reelved in the third millennium isanyonc's ‘guess They are topics that are not usually taken seriously by working scientists, ‘Who usually consider it @ waste of time to ponder non-testable propositions, which fre by definition propositions that cannot possibly be proven wrong. Such state ‘ments ahcund in new age commentaries, and are a source of mild embarrassment ‘to those of us who are trying to examine older traditions using techniques of modern science, This says nothing about the aecuracy of such proposals. It may be true, for ‘example, that “life eannot continue in the abenes of prana." The problem is that Short of developing a definition and assay for prana, such a statement can not be fected it can only be accepted, denied, or argued ad infiniturs {This approceh to experimentation and observation desu't require a lot of brilliance: It simply stipulates thet you must alwagis ask yourself the nature and content of a Statement make it potentially relutable with an experimental approach. IF it’s not, ‘You will be accurate 90% ofthe time if yeu conclude that the idea is spurious, even though it may sound inviting or may’ even appear self-evident, as did the chemical 9 of phleginton in the mid-8th century. To give the benefit of the doubt to the urveyors of such statements, it's rare that they are outright fabrications. On theother hand, one should always keep in mind that all of us (including scientists) have fine capacity fur dexeiving ourselves when iC comes to defending our ideas and innovations. The problem is that it's often impassble to distinguish fantasy, wishful thinking, mild exaggeration, and ampreeise language from out-and-out fraud. What to-do? In the end its @ waste of time to make a enreer of ferreting out errors—one ‘can't get rid of bad idens by pointing them out. On the other hand. if we turn our Sttention to propositions that ean he tested, the creative attention this requires Sometimes brings inspiration and hetter ideas, which in turn disposes of bad ideas ty displacing them. Lavoisier discredited the theory of phlogiston by pointing to brilliant experiments (many of them earried out by others), not by crafting cunning, arguments. {one las concern: if'your complaint is that you can’t understand a particular concept ‘and do not feet competent to criticize it, don’t assume that the problem is your own lack of intelligence or scientific background. More than likely, the idea wasn't presented in a straightforward manner, and it usually happens that this masks one ‘axons of sensory \ ventral neurons nant ight dorsal oot emai fgangton with col badies f sorsory neurons. mixed spinal dorsal ventral reot containing metor nerve (metorand Oot ‘eurenal exons tt Course ‘sonsory lft side) ute the med spral rere ‘gh sce) Figure 1.3. Microscopie section of dorsal root ganglion (above), and thrce dimensional view of the first kimbar segment (L1) of the spinal cord, showing paired dorsal and ventral roots and Iniued (motor and semmony) opinal nerve rom Quoin)‘or more fatal las in the reasoning. One dependable test of a concept is whether Jou! can convingingly explain it, along with the mechanies af how it-gperates, te 3 third party. If you find yourself getting your explanation garbled, or if your listener does nt eoniprehend your argument or is urpersunded, please examine and research the idea more eritically, and if it still does not pass muster, either discard itor putt on the back burner. Tinvite the reader to hold me to these standards. To honor ther, ' Limit inquiries to what we ean appraise and discuss in the realm of | imedern biomedical science, and to refine and improve my presentation, 1 ask for your written input and cordial eritieism.) Returning to our immediate concerns, itis plain that neurons channel ‘our mindful intentions to the muscles, but we still need working definitions for will and volition. In this book Tu arbitrarily defining, will as the decision-making process associated with mind, and I'm defining. volition as ‘the actual initiation of the on and off commands from the cerebral cortex ‘and other regions of the central nervous system that are responsible for ‘commanding our actions. So “will” is.a black box, the contents of which are sill largely unknown and at best marginally accessible to experimentation. ‘Phe nature and content of volition, by contrast, can be explored with estab- lished methods of neuroscience. NEURONS ‘The neuron is the basic structural and funetional unit of the nervous aystem. Although there are other cell types in the nervous eystem, namely the neuroglia, or “nerve gue cells,” which outnumber neurons 10:1, these supporting cells do not appear, as do the neurons, to be in the business of ‘transmitting information from place to place. So the neuron is our main Intorest. It has several components: a nucleated cell body that supports growth and development, and cellular extensions, or processes, some of them very long, that receive and transmit information. ‘The cellular [processes are of two types: dendrites and axons. Picture an octopus hooked na fishing ine. Its eight arms are the derdrites, and the fishing line is the ‘axon. A typical motor neuron contains many dendrites that branch off the «all body. Its single axon—the fishing line—may extend anywhere from a fraction of an inch away fram the cell body to four feet in the case of a ‘motor neuron whose cell hody is in the spinal cord and whose terminal ‘ends in a muscle of the foot, or even fifteen feet long in the ease of similar heurone in a giraffe. ‘The axon may have brunches that come off the main trunk of the axon near the cell body (axon collaterals), and all branches, including the main trunk, subdivide profusely as they near their targets. Dendiites are specialized to receive information from the wavironment from other neurons, and an axon transmits information in the form of Retve impulses to some other site in the body, Dendrites of sonsory neurons “are in the skin, joints, muscles, and internal organs; their cel bodies are sm dorsal root vanilia, which are located alongside the spine, and their axonscarry sensory information into the spinal eord (figs, 13-9). Dendrites of motor neurons are located in the central nervous system, and axons of motor neurons fan out from there (in peripheral nerves) te innervate muscle cells and glands throughout the body: Between the sensory and motor nourons are the association neurons, or interneurons, whose dendrites receive information from sensory neurons and whose axons contact other interneurons or motor neurons that innervate muscles (fig. 4). As a class, the interneurons comprise mast of the neurons within the brain and spinal cord, including secondary and tertiary linking neurons that relay sensory signals to the cerebrum, projection neurons that relay motor signal& from the corobrum and cerebellum to intermediary neurons that eventually ‘contact motor neurons of the spinal cord, and commissural neurons that connect the right andl left cerebral hemisplieres—that is, the “right brain” and the “left brain Interneurons put it all together: You sense and ultimately do, and between sensing and doing are the integrating activities of the interneurons. It’s true, as the first-grade reader suggests, that you ean think and do, but ‘more often you sense, think, and do. "To operate the entire organism, neurons form networks and chains that contact and influence one another at sites valled “synapses.” Synaptic terminals of axons at such sites release chemical transmitter substances that affect the dendrite of the next neuron in the chain (fig. 1.4). ‘The first neuron is the pre-synaptic neuron, and the neuron affected is the post-synaptic neuron. ‘The pre-synaptie axon terminal transmits to the post-synaptic dendrite—not the other way around: it’s a one-way street. ‘Two types of transmitter substances are released at the synapse: one facilitates (speeds up) the activity of the post-synaptic neuron, the other inhibits (slows down) the activity of the post-synaptic neuron. Thousands of axon terminals may synapse on the dendrites of one post-synaptic neuron, and the level of activity of the recipient neuron depends on its pre- synaptic input. More facilitation yields more activity in the postsynaptic neuron in the form of increasing numbers of nerve impulses that travel down its axon; more inhibition yielés diminished activity. For example, the pre-synaptic input of association neurons to motor neurons either facli- tates the activity of motor neurons, causing: them to fire more nerve impulses per second to skeletal muscles, or it inhibits their activity, causing them to fire fewer nerve impulses per second. The peacock posture fig, :24¢) requires maximum facilitation and diminished inhibition of the motor neurons that innervate the abdominal muscles, deep back muscles, muscles that stabilize the seapulae, and flexors of the forearms. On the other hurd, muscular relaxation in the corpse posture (ig. 134) requires reduced facilitation and possibly increased inhibition of motor neurons‘axon terminals af sensory neuron pin endings: ‘synapsing wih denertes of an cal body [aera interneuron otasersory jit capsule coral root ‘sangion ‘axon of sensory neuron in ranst To doveal hom of spinal cord Fermecron {ecrooston wh te ences ant col body tho Sorel reer of the spin cw, snd 7 axon termine ‘synapsing ~ wh dendtes chameter ventral om of the spinal coed ‘axon of motor neuron pasting Gut of spiel ord inte vertral root, Spinal nerve and 1 & meter necro, shevtal muscle ca wih cel bey In vertral nom tthe spinal feud and xen that 2 a = outceniihoe ‘synapse fea aoa sf mts we Figure 1.4. Cross-section of the fifth lumbar segment (L5) ofthe spinal cord, With sensory input from a joint receptor a generic intemeuron, and! motor Sutput oa skeletal muscle cell The small rows indicate the direction of pulses and pre. to post-synaptic inforneuronal relationships. The long, heavy arvowsindicale the locations ofthe generic intemcuron In the spinal Re errr Reet enear ere44 ANATOMY OF MATH 1064 throughout the central nervous system (see fig. 10.1 for a summary of possible mechanisms of muscular relaxation). voUITION: TH .THWAYS TO ACTIVE VOLUNTARY MOVEMENT Exercising our volition to ereate active voluntary movement involves dozens of well-known circuits of association neurons whose dendrites and cell bodiee aro in the cerebrum, cerebellum, and other partions of the brain, and whose axons terminate on motor neurons. A small but important sub- set of projection neurons, the subset whose cell bodies are located in the ‘eerebral cortex auid whose axons terminate on motor neurons in the spinal cord, are known as “upper motor neurons” because they are important in controlling willed activity. These are differentiated from the main class of ‘motor neurons, the “ower motor neurons,” whose cell bulies are located in. the spinal cord. Collectively, the lower motor neurons are called the “final ‘common pathway” because itis their axons that directly innervate skeletal ‘muscles, In common parlance, if someone refers simply to “motor neurons,” they are invariably thinking of lower motor neurons (fig. 15). LOWER MOTOR NEURON ‘The best way to understand how the motor pathways of the serous system operate is to examino the classic neurological syndromes that result from illnesses, or from injuries that have an impact on some aspect of motor function. We'll start with one of the most famous: poliomyelitis, commonly known as polio, which destroys lower motor neurons. Anyone who grew up in the 19408 and early 19508 will remember the dread of this disease. And then a miracle—the Salk vaccine—eame in 1954, putting an end to the fear Poliomyelitis ean be devastating because it destroys the lower motor neurons and deprives the muscles of nerve impulses from the spinal cord, and this results in muscular paralysis. Our power of volition in the cerebral cortex has been disconnected from the pathway of action out of the spinal cord becatise the fini) common pathway has been destroyed. In its most ‘extreme form the resulting paralysis eauses muscles to become completely flaccid, and this accounts for its medical name: flaceid parelysis, ‘The same thing happens in a less global fashion when a peripheral nerve is severed orcrushed, Destruction of the lower motor neurons or their axons at-any site in the spinal cord or peripheral nerves eauses paralysis of all their muscular targets. Will, volition, and active voluntary movement are totally frustrated. RALYSIS: FLAC! PALYSIS UPPER MOTOR NEURON PAMALYSIS. When the upper motor neurons or their axons are destroyed as in an injury or stroke (the interruption of blood supply to the brain) that destroys the ‘motor resion of the cerebral cortex, we lose much of our voluntary control1 movewevranp postin 35 cerebral conex, ‘motor region for thigh masces rear view of spinal cora ‘and paired spiral nerves ‘on each side we see Barca rerves (C18). ‘2 thoracic nerves (11-12), Slumber nerves (LIS) 5 sacral nerves (S18), and small coccygeal nerves "decussate tothe Loppecs cide of the brain inthe motor decussation, ‘vhich ie loose in the lowermost sogment of the brain ctor ho media oblongata) example ofa tower moter euren wth Send tree spinal cord. second imbae (2) ors level, and lower motor feuron whose col boy ¢ shown wth fesr dene turk Figure 15. Upper and er motor Meu. The cell body of an Upper motor neuron is shown above in the left cerebral cortex, adits target the cel body of motor neuron whose Jaxon i destined to fnnervate the right quadricope femoris ‘muscle—is on the right de of the epnal sre ‘axon of a moter neuron tustatec rete a8 passing ‘ut ot the vertebral court by way ofthe nort 26 anaroMy OF HATA 106 ‘of the lower motor neurons, especially on the side opposite to the site of the injury. Our will can no longer be expressed actively and smoothly. The ultimate result of this, al least in severe cases in which a vascular mishap occurs at a site where the axons of othor motor systems are interrupted along with those of the upper motor neurons, isnot flaccid paralysis but spastic paralysis, jn which the muscles are rigid and not easily controlled, A semblance of ‘motor function remains beenuse other parts of the nervous system, parts that have been spared injury, also send axon terminals to the lower motor ‘neurons and affect motor Function. The problom is that these supplemental sources of input eannot be controlled accurately andl seme of ther facilitate the lower motor neurons to such an extent that skeletal museles are driven into strong and uncontrolled states of contraction. Although most of the time the condition does not result in total dysfunction, severe spastic paralysis is only mildly less devastating than flaccid paralyeis; some active voluntary movements are possible, but they are poorly coordinated, especially those that make use of the distal muscles of the extremities (fig. 1.6) SPINAL cono INJURIES If the entire spinal cord is severed or severely damaged at some specific level, there are two main problems. First, sensory information that comes into the spinal cord from below the level of the injury eannot got to the corchral cortex and thereky to conscious awareness. The patient is not ‘aware of touch, pressure, pain, or temperature from the affected region of the body. Second, motor commands from the brain cant get to the lower motor neurons that are located below the injury. Spinal cord injuries at different levels illustrate these conditions: a spinal cord transection in the thoracic region would result in paraplegia —paralysis and loss of sensation in the lower extremities; ula spinal cord trunscetion in the lower part of the neck would cause quedriplesia—paralysis and loss of sensation from the neck down, including all four extremities (fig. 212). Injuries such as these are usually the result of either automobile or sports accidents. REFLEXES So far our discussion has focused on neuronal connections from the top down—from our intentivs, to the cerebral cortex, to upper motor neurons, lower motor neurons, and skeletal muscles. But there is something else to consider, something much more primitive and elemental in the nervous system that bypasses our conscious chuices: e/lexes, or unconscious motor teoponees to sensory stimuli, In this context reflexes have nothing at all to do with the lightning-fast reactions (“fast reflexes”) that are needed for ‘expertise in video games or quick-draw artistry, These reactions refer to unconscious responses eartied out at the spinal level.