You are on page 1of 132

The Endless Web Fascial Anatomy and Physical Reality

R. Louis Schultz, Ph.D. and Rosemary Feitis, D.O.
Illustrations by Diana Salles Photographs by Ronald Thompson

North Atlantic Books Berkeley, California

2 2 8 . Manipulation.Copyright © 1 9 9 6 by R. Published by North Atlantic Books P.5 5 6 4 3 . and to publish and distribute literature on the relationship of mind. I. Box 1 2 3 2 7 Berkeley. 3. social.com or call 8 0 0 733-3000. and artistic fields. photocopying. 8 9 10 11 12 TRANS 12 11 10 09 08 . [DNLM: 1.O. a nonprofit educational corporation whose goals are to develop an educational and crosscultural perspective linking various scientific.3 (paper) 1. WE 5 0 0 S387e 1996] RD736. 2. 1 9 2 7 The endless web : fascial anatomy and physical reality / by R. R. ISBN 1 . to nurture a holistic view of arts. p. For information contact North Atlantic Books. except for brief review. cm. body. Includes bibliographical references and index. Human Body. and nature.1 . California 9 4 7 1 2 Cover drawing of a child by Diana Salles Cover ard book design by Andrea DuFlon Printed in Canada The Endless Web is sponsored by the Society for the Study of Native Arts and Sciences. ISBN 13: 9 7 8 . humanities. Louis (Richard Louis). 4.2 2 8 . may be reproduced.6 Library of Congress Cataloging-in-Publication Data Schultz. Louis Schultz and Rosemary Feitis. recording or otherwise—without the written permission of the publisher. All rights reserved. Holistic Health. and healing. photographs by Ronald Thompson.M25S38 1 9 9 6 615. No portion of this book.8'2—dc20 DNLM/DLC for Library of Congress 96-31550 CIP North Atlantic Books are available through most bookstores. Title.5 5 6 4 3 . 3. or transmitted in any form or by any means—electronic. Feitis. Fascia (Anatomy). II.northatlanticbooks. visit our website at www. Orthopedic. Fascia. Manipulation (Therapeutics) 2. Rolfing. sciences. Louis Schultz and Rosemary Feitis. illustrations by Diana Salles . Rosemary. mechanical. For further information. stored in a retrieval system.

Rolf love fulfilled—with .Dedicated A promise to Ida P.

book the physical .Our thanks go for the his to Sean Hellier on which not exist computer production without would manuscript.

Contents Introduction Part I E a r l y D e v e l o p m e n t Pre. Umbilical Band. and Groin Band 61 68 73 53 Part I V Anatomy and Function 16 17 18 19 20 Proprioception: Internal Body Awareness Upper Body Axial Skeleton Pelvis a n d U p p e r Legs T h e System of Horizontal a n d Vertical Myofascial Structures 106 83 85 93 98 .a n d P o s t .B i r t h 1 2 3 4 5 E m b r y o l o g y : I n t r o d u c t i o n to C o n n e c t i v e Tissue Early E m b r y o l o g i c a l D e v e l o p m e n t Factors in the G r o w t h of t h e E m b r y o D e v e l o p m e n t of M e s o d e r m a l Tissues E m b r y o n i c L i m i t a t i o n s a n d Early Structural Organization Part I I C o n n e c t i v e Tissue B o d y 6 7 8 T h e Effect of t h e Birth Process Developmental Transitions in the N e w b o r n and Young Child Myofascial Structures: T h e Spine as an E x a m p l e of "Living A n a t o m y " 9 10 11 M o v e m e n t and Gravity Body Contour E m o t i o n s a n d t h e Fascial W e b : B o d y Awareness and Response Patterns 27 34 40 46 23 21 15 3 6 11 13 vii Part III Body Retinaculae (Bands/Straps) 12 13 T h e C h e s t B a n d : Implications for M o v e m e n t and Behavior T h e Inguinal Band and the Structure and Function of the Vertebral C o l u m n in Relation to t h e Bands 14 15 T h e Eye B a n d a n d C h i n B a n d The Collar Band.

  v i       T H E  E N D L E S S  W E B   21 22 Reciprocity of Movement Joints 109  114    Part V              Practical Application  23 Doing Bodywork Based on the Connective  Tissue Concept Evaluation First Intervention How to Go Deeper How to Touch How to Make It Last Illustration Index Subject Index About the Authors 119  119  120  123  124  126  127  129  131  .

P e o p l e t e n d t o a p p r o v e a n d d i s a p p r o v e o f t h e i r b o d i e s p i e c e m e a l . T h i s i s o n e o f t h e t w o i d e a s a b o u t b o d y w o r k t h a t Dr. " " M y l e f t f o o t i s b i g g e r t h a n m y right f o o t . M y o f a s c i a per se was n o t e v e n c o n sidered as a d e t e r m i n a n t of structure.b o n e c o n c e p t p r e s e n t e d i n s t a n d a r d a n a t o m i c a l d e s c r i p t i o n gives a p u r e l y m e c h a n i c a l m o d e l o f m o v e m e n t . R a t h e r . T h i s is t h e heart of t h e c o n c e p t t h a t we are p r o p o s i n g in this b o o k . T h e way bodies c h a n g e during Rolfing is n o t satisfactorily explained by any of the usual descriptions of physical m a k e u p . " O n t h o s e o c c a s i o n s w h e n t h e y are feeling g o o d a b o u t t h e m s e l v e s . Today. A t t h a t t i m e a n d u p i n t o t h e 1 9 5 0 s . t h e y l i k e t h e s h a p e o f t h e i r h e a d o r t h e set o f t h e i r s h o u l d e r s . t h e b o d y as a w h o l e responds. W e h a v e c o m e t o the working hypothesis that this variability is a function of certain properties o f t h e c o n n e c t i v e t i s s u e b e s t i l l u s t r a t e d b y its d e v e l o p m e n t f r o m e m b r y o n i c m e s o d e r m i n t o m a t u r e tissue. is implem e n t e d t h r o u g h t h e c o n n e c t i v e tissue c o m p o n e n t . " T h a t c u t o f jacket brings out t h e best in my shoulders. W e are c o n f r o n t e d d a i l y w i t h v e r y w i d e d e v i a t i o n s f r o m s t a n d a r d a n a t o m i c a l description in people w h o function perfectly well. t h e o n l y t i s s u e t h a t c a n m e d i a t e s u c h r e s p o n s i v e n e s s i s t h e c o n n e c t i v e tissue. c h i r o p r a c t i c ) was t h e o n l y t r e a t m e n t for structure t h a t was t h e n considered effective. T h e c o n n e c t i v e tissue c o n c e p t w e discuss a c c o u n t s for m u c h o f t h e success o f R o l f i n g . Including an u n d e r s t a n d i n g of fascia/connective tissue in t h e evaluation of m o v e m e n t gives a n m o r e accurate picture o f t h e p h y s i c a l reality o f t h e b o d y . w h i l e m e n say. B o n e . It's r a r e f o r t h e m t o l o o k a t t h e m s e l v e s a n d s a y t h e y ' r e all b a d o r all g o o d ." . received w i s d o m stated t h a t soft tissue c o u l d n o t h o l d a c h a n g e . m a n y f o r m s of b o d y w o r k i n c l u d e a soft tissue t e c h n i q u e . Her o t h e r seminal idea has to do with t h e c o n c e p t of g r a v i t y a s i t a c t s o n t h e p h y s i c a l b o d y — t h e stress l i n e s t h r o u g h t h e b o d y t h a t ideally establish a n d reinforce physical structure. W o m e n s a y t h e y l o o k g o o d i n t h o s e s h o e s . W h e n o n e part m o v e s . " " I ' v e a l w a y s h a d k n o c k k n e e s . failing to give a picture of t h e seamless i n t e g r a t i o n seen in a living body.Introduction T h e m u s c l e . This. I n fact. Our ideas a n d c o n c e p t s h a v e c o m e directly out of our experience as Rolfers—a c o m b i n e d total of m o r e t h a n forty-five years. Traditional a n a t o m i c a l attitudes a b o u t c o n n e c t i v e tissue do n o t give us a living picture of t h e d y n a m i c s i n v o l v e d i n t h e c h a n g e s w e see i n o u r w o r k . t o o . R o l f a t t h e t i m e she was developing her m e t h o d of working with bodies. People look very different e v e n t h o u g h t h e y are m a d e o f t h e s a m e c o m p o n e n t p a r t s . t h e centrality o f c o n n e c t i v e tissue t o Rolfing a n d our a t t e m p t t o u n d e r s t a n d c o n n e c t i v e tissue has b e e n t h e impetus for this b o o k . Functionally. W h a t h a s i n t e r e s t e d us is t h e body's apparently great capacity for structural c h a n g e at a n y age.s e t t i n g (osteopathy. She started in t h e late 1 9 3 0 s . it's " M y b e l l y sticks o u t . I t s e p a r a t e s m o v e m e n t i n t o discrete f u n c t i o n s . T h i s i s a c o n c e p t t h a t w a s o r i g i n a l a n d u n i q u e w i t h Dr. R o l f e s t a b l i s h e d t h r o u g h her work.

Like an orchestra. I f I w e r e t o g i v e in c o m p l e t e l y to a b r o k e n leg or a w h i p l a s h e d n e c k . A w o m a n ' s b r o a d s h o u l d e r s a r e t a k e n a s a s i g n o f aggression and masculinity. a n d m y w h o l e b o d y s h i f t s i n o r d e r t o a v o i d f e e l i n g w e i g h t o n t h e p a i n f u l p a r t . The pain in the toe makes me n o t w a n t t o s t a n d o n it. t h e w h o l e w o r l d will q u e s t i o n h i s s e x u a l p r e f e r e n c e s ." M o r e t h a n likely this is a carry-over f r o m t h e Puritan n o t i o n that it is u n s e e m l y to speak well of oneself. e c o n o m i c . " " M y n e c k i s stiff.u p s a n d lift w e i g h t s t o b r o a d e n h i s s h o u l d e r s . This kind of connectedness is easy to understand in impact injuries. a w o m a n w i l l d o l e g lifts t o s l i m d o w n h e r legs a n d h i p s . I w a l k l i g h t l y o n t h e side t h a t h u r t s . I am c o n c e i t e d . t h e rest o f t h e o r c h e s t r a a t t e m p t s t o compensate and blend in. as t h o u g h it w e r e still in a s l i n g or a c a s t .b o d y awareness is also piecemeal. a n d t h e pain has persisted for a l o n g t i m e . whether I notice it or not. I w o u l d be in bed. T h e c o m p e n s a t i o n (shortening a n d deviation) b e c o m e s a p e r m a n e n t part of structure. m o r e h e a v ily o n t h e side t h a t d o e s n ' t . there is t h e physical habit of allowing for t h e weight a n d bulkiness of t h e cast. I e n d up feeling guilty. I n t h e h u m a n b o d y . a n d sexual succ e s s e s a r e less i f o n e i s f a t . W h e n I s t u b m y t o e . m y t e n d e n c y i s t o k e e p t h e s h i f t i n w e i g h t t o o n e side l o n g a f t e r t h e t o e i s n o l o n g e r p a i n f u l . W h e n I brag. t h e i n j u r y r e s o n a t e s t h r o u g h m y w h o l e b o d y . b u t a l s o a n d r e c i p r o c a l l y of h o w e v e r y t h i n g else in t h a t b o d y is used. t h e f o c u s i s o n o n e t h i n g a t a t i m e . A m a n fears t h a t i f h i s p e l v i s m o v e s w h e n w a l k i n g . i f o n e s e c t i o n g o e s o f f k e y o r p l a y s o f f t e m p o . E v e n w h e n t h e a i m i s t o i m p r o v e t h e p h y s i c a l self. " " M y k n e e h u r t s . A m a n w i l l d o p u s h . t h e record b e c o m e s fixed w i t h c o n s t a n t replaying. g o o d a b o u t my body. T h i s g e t s i n t e r n a l i z e d s o t h a t w h e n I feel g o o d a b o u t m y s e l f . c e r t a i n p a r t s o f t h e b o d y are m o r e a t t r a c t i v e : " I ' m a l e g m a n . a n d generally negative: " I h a v e a n upset s t o m a c h . Yet t h o s e h i p s o r t h o s e s h o u l d e r s a r e a n e x p r e s s i o n o f e v e r y t h i n g else i n t h a t b o d y . In our living tissue. " I n o u r n a t i o n a l c u l t u r e . I . r u n n i n g . Our bodies t e n d t o r e c o r d o u r r e s p o n s e s t o t h e e v e n t s i n o u r life like a c a l c u l a t o r w i t h a m e m o r y . F o r m a n y . People t e n d to carry an arm that was o n c e broken half b e n t . w h i c h is b a d . t h e y a l s o h a v e t h e s a m e i m p r e s s i o n o f o t h e r s . social. I f I ' m n o t a w a r e o f d o i n g t h i s ." " M y n o s e i s stuffed. E v e n a f t e r t h e cast is r e m o v e d . T h e s e are straightforward responses to straightforward injuries. T h e y ' r e t h e r e s u l t n o t o n l y o f its s t r u c t u r e . A n e v e n m o r e o b v i o u s e x a m p l e i s a b r o k e n a r m o r leg. In an orchestra w h o s e m e m b e r s h a v e m a n y y e a r s o f e x p e r i e n c e p l a y i n g t o g e t h e r . as well as t h e fear of o n c e again freely using t h e part that was b r o k e n . M o s t of i n n e r . c o m p e n s a t i o n i s life s u p p o r t i v e . T h e p a i n f u l side h a s c o n t r a c t e d a w a y f r o m t h e s o u r c e o f p a i n a n d i s s h o r t e n e d . o r o t h e r k i n d s o f m o v e m e n t . This is especially true if t h e toe was b r o k e n . all t h e way to my head. i t s e e m s t o b e a c c e p t e d t h a t o n e ' s business.viii THE ENDLESS WEB N o t o n l y d o t h e y see t h e m s e l v e s t h i s way. " o r " I like m e n w i t h b i g s h o u l d e r s . e a c h part relates to t h e o t h e r segments.

a l l o w i n g a s p r i n g . .l i k e a c t i o n a m o n g all p a r t s o f its b o d y . By tracing c o n n e c t i v e tissue's o r i g i n . W h a t has fascinated us as Rolfers in our w o r k w i t h clients a n d in our experiences of our o w n bodies is the m e c h a n i s m of this record. T h e c o n nective tissue is t h e record. T h e p r o b l e m occurs w h e n w e keep t h e c o m p e n s a t i o n after t h e i n j u r y h a s h e a l e d . b o n e . W h a t a t first i s a w a y t o p r o t e c t a p a r t o f t h e b o d y (particularly a part t h a t hurts) e v e n t u a l l y results in a loss of fluidity throughout the entire body. T h e body's t e n d e n c y is to go toward as m u c h balance in a n y given m o m e n t as it c a n find. b o t h by scientists and by medically oriented practitioners: t h e c o n n e c t i v e tissue or m y o f a s c i a . its h i g h l y s t r u c t u r e d d i r e c t i o n a l o r i e n t a t i o n is suggestive of this k i n d of i n f o r m a t i o n system. . or of h u m a n i t y .INTRODUCTION ix wouldn't be able to function. t h e c o n n e c t i v e tissue is t h e score on w h i c h t h e n o t e s are w r i t t e n . O n e o f t h e m o s t c o m m o n e x a m p l e s o f this is the t e n d e n c y to keep birth trauma as a part of one's physical m a k e u p . snagging. giving us m a x i m u m operational support for t h a t m o m e n t . f u n c t i o n . Its " k n e e b o n e i s c o n n e c t e d t o its . a n d o r g a n s y s t e m s a r e t h e i n s t r u m e n t s . W h e n a h o o k pulls on o n e part of that web. a n d a p p e a r a n c e i n t h e b o d y . How a n d w h e r e d o w e k e e p t h i s m e m o r y o f o l d i n j u r y ? Ida R o l f ' s a n s w e r w a s t o e x a m ine a system of the b o d y that has b e e n neglected. P e r h a p s t h e b e s t i m a g e o f f l u i d i t y i s a t i g e r o n its w a y t h r o u g h t h e f o r e s t . Visualize a n e t curtain or a h a m m o c k . it is an i n f o r m a t i o n b a n k for t h e body. a r m b o n e " w i t h o u t r e s t r i c t i o n . O u r d r e a m i s t o h a v e all o f u s m o v i n g surefootedly t h r o u g h our f o r e s t s — b e t h e y o f w o o d . o f steel a n d c o n crete. It is t h e u n i f y i n g factor i n t h e m o v e m e n t system w e call t h e body. . the resulting distortion influences every part of t h e system to s o m e d e g r e e . or h o l d i n g in a n y part of t h e c o n n e c t i v e tissue w e b results in a g e n e r a l h e a v i n e s s o f m o v e m e n t . n o t m a k i n g a s o u n d a s i t m o v e s a c r o s s l e a v e s a n d t w i g s a n d p a s t b u s h e s . m u s c l e . t h i s b o o k s h o w s h o w myofascia creates an informational w h o l e of t h e living organism. T h i c k e n i n g . A s w e l o o k a t c o n n e c t i v e t i s s u e . To use t h e orchestra analogy.

and Post-Birth .PART ONE Early Development Pre.

To the embryologist. I n understanding embryology. T h e b o n e has c h a n g e d its c o n f i g u r a t i o n . I n o u r v i e w . Embryology doesn't stop at birth. r e g e n e r a t e . W e k n o w t h a t cells t u r n o v e r w i t h i n o r g a n s — t h a t is. If tension is applied to a different area. A b o n e c a n b e r e m o d e l e d t h r o u g h o u t life a s t h e r e l a t i v e stresses o n i t c h a n g e . W h a t t h e n appears t o h a p p e n i s t h a t o n t h e o t h e r side o f t h e b o n e there is s o m e localized resorption of b o n e . But in fact. resulting in an i n d e n t a t i o n . structure is t h e result of t h e o r g a n i z a t i o n o f m u s c l e a n d b o n e . In general. C o n n e c t i v e tissue literally c o n n e c t s a n d supports. b u t if t h e y were plotted over time they would nevertheless p r o b a b l y b e m e a s u r a b l e .ONE Embryology Introduction to Connective Tissue T h e b a s i s f o r all b o d y f o r m i s e m b r y o l o g y . thereby. T h e aging process is also a part of t h e e m b r y o l o g i c a l process. It forms t h e structure of t h e body. Undifferentiated cells develop i n t o p o t e n t i a l liver. C o n n e c t i v e tissue. all c h a n g e i s t h e first s t e p i n n e w p o s s i b i l i t i e s . a n o t h e r b u m p . T h e b o d y is always at p o t e n t i a l — t o c h a n g e . W e all see p e o p l e b e c o m e m o r e b e n t with age. This is what we m e a n by developmental anatomy. " We are generalizing the term. w e a r e embryos throughout our lifetime. we understand h o w the adult structure c a m e to be. Research has b e e n published w h i c h describes t h e results of c h a n g i n g a n d increasing t h e pressure on o n e e n d of a b o n e . i n . T h i s i s t r u e o f every organ except the brain. t h i s stage m a r k s t h e o r i g i n o f p o t e n t i a l organs. L a t e r s t a g e s are t e r m e d "fetal d e v e l o p m e n t . its c o n f i g u r a t i o n a d a p t s t o c h a n g i n g stresses over time. E a c h cell has a finite lifetime. using embryological in a m u c h broader sense. T h e b u m p s o n b o n e s are p l a c e s w h e r e m u s c l e t e n d o n s a t t a c h . a n d for n e w t h i n g s t o d e v e l o p . It seems that a certain v o l u m e of b o n e is needed in the body. T h e o r e t i c a l l y t h a t m e a n s t h e r e i s a p o t e n t i a l i n t h e s e cells t o regenerate in a different direction. This m e a n s that if we hold ourselves i n a b e n t p o s i t i o n . We tend to think of structure in terms of muscle a n d b o n e . p o t e n t i a l s k i n . in the c o n t o u r of t h e upper a n d lower jawb o n e s . T h e s e c h a n g e s are slight. All t i s s u e g o e s t h r o u g h t h i s state. as a time w h e n things develop a n d d i f f e r e n t i a t e . i t takes place over m a n y years. a n d even that is b e g i n n i n g to be questioned. This m a y b e w h a t h a p p e n s i n a g i n g . Birth is a c h a n g e in e n v i r o n m e n t . D e g e n e r a t i o n is a n o r m a l part of t h e life c y c l e o f t i s s u e . I t d o e s n ' t h a p p e n i n o n e m o n t h o r six. U n d e r p r o l o n g e d stress t h e b o n e c a n g e t a different configuration. T h e b u m p s are t h e r e f o r e regions of localized rapid g r o w t h of b o n e as a result of prolonged tension on that spot. w h i c h g r o w s a n d d i e s f r o m t h e early m o n t h s o f prenatal life. a slightly different curving. b o n e s as well as soft tissue. W i t h i n seven years. b o n e u l t i m a t e l y a c c o m m o d a t e s its s h a p e t o t h a t p o s i t i o n . t h e y live. I n a s e n s e . n o r m a l l y considered seven years. o n e of m a n y t h a t occurs t h r o u g h o u t life. we have that p o t e n tial f o r c h a n g e all a l o n g . p o t e n t i a l b o n e . d i e . t h e n e w area is stimulated to create an increased a m o u n t of b o n e . every cell in an o r g a n dies a n d i s r e p l a c e d . T h i s i s h o w braces work on the jaw (now being used f o r all a g e s ) : c o n s t a n t p r e s s u r e c r e a t e s s o m e change in the b o n e formation and. This is a new concept. the term " e m b r y o " i s a p p l i e d t o d e v e l o p m e n t t h r o u g h t h e first t r i m e s t e r o f p r e g n a n c y . D e a t h is a n o r m a l part of developm e n t .

(Fig. in the interconnections within the b o d y . c o n n e c t i v e tissue t h i c k e n s a n d hardens. nerve. It makes up a high proportion of body mass. 1-1). B u t f o r c e s a l s o arise f r o m inside. t h e characteristic m u s c l e a c t i o n on t h e c o n n e c t i v e tissue b e d as a w h o l e . I n t e r c o n n e c t i o n s are m a i n t a i n e d w i t h m o v e m e n t or inhibited with lack of m o v e m e n t . t h e c o m b i n a t i o n is called myofascia. reaching t h r o u g h all b o d y e l e m e n t s like a s u p p o r t i v e n e t or spider w e b . a t i g h t e n i n g of t h e w e b in Figure 1-1 This cross section of the arm shows the way in which muscle tissue is embedded within its connective tissue wrapping. Perpetuating this i m m o b i l i t y . . A spider w e b d e p e n d s o n its s u p p o r t — t w i g s o r t h e w i n d o w l e d g e it's s p u n a r o u n d — f o r its s h a p e . This is a g o o d i m a g e because it is organized but irregular—the fibers o f a s p i d e r w e b are a l s o n o t i n a c o m pletely regular p a t t e r n . T h e s e fibers t e n d t o a r r a n g e t h e m selves a l o n g t h e line of t h e pull or friction or t e n s i o n . If a fly g e t s c a u g h t in a s p i d e r w e b . s p i d e r w e b q u a l i t y a n d i s m u c h less adaptable or movable. S t r u c t u r e is t h u s t h e result o f m o v e m e n t . and vascular systems. there's a snag. M o s t of t h e forces acting on a b o d y are f r o m t h e o u t s i d e . is the organizing factor. T h e r e is research s h o w i n g t h a t pressure or t e n s i o n o r f r i c t i o n a p p l i e d i n o n e area o f t h e Epimysium Perimysium' Endomysiunr e m b r y o r e s u l t s i n i n c r e a s e d s e c r e t i o n o f fibers b y t h e c o n n e c t i v e t i s s u e cells a t t h e s t i m u l a t e d p l a c e . for e x a m p l e . S i m i l a r l y . As a r e s u l t .4 THE ENDLESS WEB response to m o v e m e n t . c o n n e c t i v e t i s s u e i n t h e b a c k l o s e s its e l a s t i c . Movement is the outcome of embedded muscle tissue a c t i o n o n t h e surrounding c o n n e c t i v e t i s s u e . C o n n e c t i v e tissue (myofascia) defines t h e b o d y c o n t o u r a n d is t h e organ of structure a n d m o v e m e n t (as I d a R o l f c a l l e d it) i n t h e body. m y o f a s cia is adaptive. M u s c l e tissue is e n f o l d e d w i t h i n t h e fascia. C o n n e c t i v e tissue supports t h e organ. M a n y people m o v e o n l y a part of their b a c k s w h e n t h e y walk. T h e c o n n e c t i v e tissue t h e n c h a n g e s from a lacelike elasticity to s o m e t h i n g m o r e d e n s e .

This is n o t unusual. (D) Fully formed tendon with muscle developing along the line of connective tissue tension between the two bones. c r e a t i n g a directional pressure in t h e c o n n e c t i v e tissue bed between t h e two growing heads (ends) of t h e b o n e (Fig. Figure 1-2 This schematic shows an idealized sequence of normal development of tendon from early gestation to just before the baby is born. W e h a v e said t h a t e v e r y t h i n g i n t h e b o d y is supported by c o n n e c t i v e tissue. b u t t h e p h y s i c a l o n e s a r e m o r e r e a d i l y a p p a r e n t . a n d larger. It has certain physical laws t h a t i t lives b y . (A) Early undifferentiated connective tissue near early newly differentiated bone. i n t h e first c o u p l e o f m o n t h s o f g e s t a t i o n . C o n n e c t i v e tissue is alive in t h e sense t h a t it responds to stimulus. C o n n e c t i v e tissue cells (fibroblasts) b u i l d a n d s e c r e t e f i b e r s . This t h e n affects t h e physical state of the intercellular matrix. Everything is pulled toward t h a t s n a g . T h e pattern of m u s c l e a n d t e n d o n a n d l i g a m e n t i s e s t a b l i s h e d v e r y early. i t t e n d s t o g r a b — c o n n e c t i v e t i s s u e fibers concentrate there. (B) The growth of the bone exerts a directional pull within the connective tissue bed. t h e b o n e s get bigger. • B C D . m o r e set. W h e n an area is compressed. s u c h as pressure. i f t h e r e ' s a s n a g i n t h e m y o f a s c i a l w e b . T h e r e a r e c h e m i c a l l a w s a s well. I n t h e later m o n t h s . note that potential muscle tissue is developing within the tendonous bed. As t h e e m b r y o gets bigger. T h i s i s t h e n o r m a l f o r m a tion of ligaments and (where there is muscle tissue) o f t e n d o n s .EMBRYOLOGY 5 that area. I n g r o w i n g . The process continues throughout life. t h e b o n e p u s h e s o u t . U n d e r a certain kind of stimulus. T h e d i r e c t i o n o f t h e ligam e n t or t e n d o n is determined by t h e directional pull. it is t h e n o r m a l way for a t e n d o n or ligament to grow and take shape before birth. t h e b l o o d supp l y t o t h a t area i s a l s o c o m p r e s s e d a n d t h u s impeded. this process can be speeded up. s t r u c t u r e s b e c o m e m o r e e l a b o r a t e . A g i v e n s i t u a t i o n a l w a y s g i v e s rise to a specific reaction. W i t h i n t h a t tissue i s a r i c h n e t w o r k o f c a p i l l a r y b e d s . p a r t i c u l a r l y a s t h e fly m o v e s a r o u n d . with far-reaching results o n p a r t i c u l a r stages o f d e v e l o p m e n t . Similarly. 1-2). (C) Beginning of a more recognizable tendon shape.

w h i c h organize i n t o layers at a b o u t t h e seco n d week. T h e e m b r y o grows b y t h e m u l t i p l i c a t i o n o f cells. w h e n a n a r e a o f m o r e rapid cell f o r m a t i o n develops i n o n e p a r t o f t h e disk.TWO Early Embryological Development Extraembryonic. t h e cell has b e c o m e a disk t h a t is s u r r o u n d e d b y c a v i t i e s filled w i t h f l u i d . the urogenital system. as well as the notochord. It rapidly c o n d e n s e s i n t o a line w h i c h is called t h e p r i m i t i v e streak. mesoderm It's a b i g j u m p f r o m t h e first g e r m c e l l t o t h e f o r m a t i o n o f g e r m l a y e r s t h a t a r e t h e first r e c o g n i z a b l e f o r m o f t h e e m b r y o . Direction in the e m b r y o is established at the beginning of a b o u t t h e t h i r d w e e k (Fig. T h e r e are t h r e e g e r m layers: • t h e e c t o d e r m g i v e s rise t o t h e b r a i n a n d nervous system a n d t h e superficial epidermis (skin) • t h e e n d o d e r m g i v e s rise t o t h e d i g e s t i v e system a n d t h e digestive glands • t h e m e s o d e r m g i v e s rise t o m u s c l e . T h e disk has a t o p layer (ectoderm) a n d a b o t t o m layer ( e n d o d e r m ) . b o n e . disc Ectoderm Endoderm* Amnion Primitive yolk sac Second week of pregnancy Head Tail Primitive streak Primitive^ yolk sac Early third week of pregnancy Nolochord Primitive -"streak Mesoderm Ectodernr Endodemv Late third week of pregnancy . T h e area of greater proliferation is approximately a quarter of the total surface area. T h i s is t h e tail e n d of the embryo. t h e m i d d l e layer ( m e s o d e r m ) begins to develop. At the beginning of the third week. blood. it eventually becomes the anal region. and connective tissue in general By about the end of the second week of pregnancy. W h e n t h e primitive streak is established.. showing the initial differentiation of ectoderm and endoderm and the first indication of directionality. T h e process of growth in the embryo Figure 2-1 A three-dimensional view of the embryo at the beginning of the third week of pregnancy. Ectoderm EndodermAmnionEmbryonic. 2-1). which marks the location of the future spine. the e m b r y o i s a b o u t t h e size o f t h e t i p o f a p e n c i l p o i n t .

Logically. C e l l s p r o l i f e r a t i n g f r o m t h e p r i m i t i v e streak are e n l a r g i n g a n d e l o n g a t i n g t h e disk. T h e primitive streak r e m a i n s primitive (undifferentiated). we w o u l d e x p e c t t h a t either everything is established at the same time in t h e e m b r y o and grows bigger and m o r e c o m p l e x . T h e top e n d is pushed farther a n d farther away from the source. t h e n t h e pelvis. or.EMBRYOLOGY 7 n o w b e c o m e s twofold: cell m u l t i p l i c a t i o n b y division o f existing cells. body-like s h a p e . T h e s h a p e c h a n g e s f r o m a disk i n t o a r o u n d . M u l t i p l i c a t i o n o f cells i s t a k i n g p l a c e throughout the embryo. t h i s e n d d e v e l o p s first (initially tail. neither is the case. a n d internally. not only at the source. s i n c e e v e r y t h i n g g r o w s f r o m t h e p r i m i t i v e s t r e a k ( t a i l ) . a n d finally t h e head). a n d t h e g e n e r a t i o n o f n e w cells f r o m t h e primitive streak. sideways. The embryo is growing geometrically: lengthwise. Cells i m m e d i a t e l y in front of t h e source (the p r i m i t i v e s t r e a k ) d e v e l o p i n t o t h e rest o f t h e body. T h e head is gradually pushed away from t h e s o u r c e a s t h e rest o f t h e b o d y g r o w s b e t w e e n . w e c a n n o w k n o w w h i c h a r e its r i g h t a n d l e f t sides. Having established top and b o t t o m (ectoderm a n d e n d o d e r m ) as well as a tail (primitive streak) a n d t h e r e f o r e a h e a d f o r o u r e m b r y o . T h e e m b r y o at this stage is r o u g h l y oval and b e c o m i n g m o r e elongated as it grows. a l t h o u g h t h e greatest generation is there. t h e n chest. T h e circular disk was like a slab of "silly p u t t y " t h a t got pulled l e n g t h Figure 2-2 This cross section sequence illustrates stages of development during the third and early fourth week of gestation. . Nature doesn't share our sense of logic. neck. In fact. showing the changes from early germ layer pattern to recognizable structures. T h e n e w cells created f r o m the primitive streak b e c o m e t h e h e a d a n d t h e n t h e rest o f t h e b o d y f r o m t h e t o p d o w n .

A cell s o m e w h e r e in t h e h e a d . T h e least differentiated (the least m a t u r e ) is t h e pelvis. and so forth. At birth. t h e oldest part of t h e digestive system is t h e m o u t h . T h e o u t s i d e ( w h i c h w a s t h e t o p o f t h e disk) i s t h e ectoderm. T h e s u r r o u n d i n g cells m a k e u p t h e Heart. As cells c o n t i n u e t o d i v i d e . w h e n it divides i n t o two. t h e edges b e g i n to curve inward. A s l o n g a s t h e s e cells stay i n s i d e t h e t u b e . t h e y split t h e i r potentiality. T h e inside (originally t h e b o t t o m o f t h e disk) i s t h e e n d o d e r m . T h e m e s o d e r m is t h e filling b e t w e e n t h e s e t w o layers. its e n v i r o n m e n t h a s s h a p e d i t suffic i e n t l y t h a t i t c a n b e c o m e o n l y itself. 2-3). It later b e c o m e s the anal region. a c e l l in a g i v e n p o s i t i o n h a s a n u m b e r of potentialities. the s t o m a c h is older t h a n the small intestine. I f t h e c e n t r a l c e l l i s p u t i n a n o t h e r part of t h e b o d y early e n o u g h . a n d s o f o r t h . After t h e anus. t h i s e n v i r o n m e n t will d e t e r m i n e t h a t t h e y b e c o m e liver. 2-2.8 THE ENDLESS WEB wise. p o t e n t i a l liver at first is j u s t a l i t t l e t u b e w h o s e cells are s e p a r a t i n g f r o m t h e rest o f t h e g u t . it c a n Tail -•fold Heart. The same structures are present as in Figure 2-2. T h e primitive local structures mature. a liver c e l l . c o n t r i b u t i n g t o its s t r u c t u r e . ecto- Ectoderm- Primitive streak d e r m a l cells i n t o t h e v a r i o u s e c t o d e r m a l struct u r e s . a b r a i n cell. its s h a p e . cells b e c o m e s p e c i f i c — a m u s c l e c e l l . closing to f o r m a m o r e t u b u l a r s h a p e (Figs. Endoderm^ Notochord'" Tail A t t h e e a r l i e s t stages o f e m b r y o n i c d e v e l o p m e n t . o n e o r g a n . F o r e x a m p l e . T h e p r i m i t i v e s t r e a k i s t h e first " s t r u c t u r e " differentiated from the general mass of the primitive e m b r y o . E v e n t u a l l y . b e c o m i n g more and more focused toward a purpose. E n d o d e r m a l cells m u l t i p l y a n d d i f f e r e n t i a t e i n t o specifically e n d o d e r m a l structures. Differentiation o c c u r s w h e n cells h a v e b e e n i n o n e l o c a t i o n long enough to have multiplied and elaborated. T h e b a c k o f t h e m o u t h i s older t h a n t h e esophagus. m a y b e d i v i d i n g i n t o t h e l e f t a n d r i g h t sides of t h e head. . T h e r e are structural a n d c h e m i c a l changes within the cell as it zeros in on b e c o m i n g o n e t h i n g . so t h a t we m a y say t h a t this r e g i o n is t h e " o l d e s t " part o f t h e body. t h e y m a y b e c o m e structures in front a n d back. W h e n these in turn divide. t h e m o s t differentiated part of t h e e m b r y o i s t h e h e a d . E a c h c e l l c r e a t e s its o w n s p e c i f i c e n v i r o n m e n t w i t h i n t h e g e n e r a l m a t r i x . T h e sigmoid c o l o n just in front of t h e anus is the " n e w e s t " part of t h e body. I f o n e c o u l d Figure 2-3 This mid-sagittal (lengthwise) sequence shows the folding of the body during the third week of gestation. Yet a t s o m e p o i n t i n t i m e . As longitudinal pressure increases. primordium' b e c o m e a d i f f e r e n t o r g a n . for e x a m p l e . primordium Heade fold e n v i r o n m e n t o f t h a t o r g a n .

stimulates cells locally to increase p r o d u c t i o n of fibers. t h e k i n d o f s t r i n g y . Its s h a p e i s t h e result b o t h o f s e l f .p r o l i f e r a t i o n a n d o f t h e s p a c e r e s t r i c t i o n s a s d e t e r m i n e d b y its outside e n v i r o n m e n t . it could b e c o m e a pancreas. T h e resulting c o m p l e x i t y o f pulls a l o n g a n d b e t w e e n t h e d e v e l o p i n g b o n e s results i n t h e differentiated ligaments that c o n n e c t the bones (Fig. cause it to respond by getting hard and directional—ligaments and t e n d o n s begin to form. p a r t i c u l a r l y a t t h e h e a d e n d . Fat is a p a r t of t h i s m a t e r i a l . t h e b o d y gets a "packing material" support from connective t i s s u e . o r g a n i z i n g a n d m a i n t a i n i n g t h e integrity of the growing vertebral c o l u m n . fluffy s t u f f t h a t sticks t o y o u r f i n g e r s . i t m a y b e t h e s p e c i f i c e n e r g y field that makes t h e difference for this tissue. its p u s h i n t o t h e c o n n e c t i v e t i s s u e b e d c r e a t e s a stress l i n e .O i n t e x t u r e . Relat i o n s h i p to t h e surrounding fascial tissue is i m p o r t a n t . As described in m a n y standard e m b r y ology texts. a n d i n t e r c e l l ular m a t r i x . it has b e e n s h o w n that potential pancreas does n o t differentiate into mature p a n c r e a s cells u n l e s s it is in a s p e c i f i c m e s o dermal e n v i r o n m e n t (potential fascia). the embryo has developed primitive arms and legs as w e l l as a p r i m i t i v e b r a i n . T h e m a t r i x i s s t i c k y a n d s o m e w h a t like J e l l . e s t a b l i s h i n g a directional pull. I n m o s t p l a c e s i n t h e b o d y . A r o u n d all o f t h e s e p r i m i t i v e s t r u c t u r e s p r i m i t i v e cells are p r o l i f e r a t i n g i n t o " f i l l e r .EMBRYOLOGY 9 dissect a w a y o n e o f t h o s e cells a n d p u t i t i n a nearby e n v i r o n m e n t . " T h i s filler i s m e s o d e r m a l t i s s u e — p r i m i t i v e fascia m a d e u p o f c e l l s . As it g r o w s . In a d d i t i o n to a grid-like support f r o m b o n e . cells enlarge by a c c u m u l a t i n g droplets o f i n t r a c e l l u l a r fat. 2-4). I n a d i p o s e (fat) tissue. together with external pressures f r o m t h e c o n f i n i n g walls of t h e uterus. A B C D Figure 2-4 Tendon/ligament formation. . I n t h e places w h e r e b o n e will f o r m . Hardness a n d direct i o n o f fiber are t h e n o r m a l f a c t o r s c r e a t i n g structure in c o n n e c t i v e tissue. p r o t e c t . An e x a m p l e is p r e v e r t e b r a l c a r t i l a g e . Its t e x t u r e i s like glass w o o l o r a n g e l hair. This tissue is i m p o r t a n t in t h e spatial a r r a n g e m e n t of structures. This internal tension. i t a c t s t o c u s h i o n . fibers. a n d l i g a m e n t . a n d t h e b e g i n n i n g s of vertebrae to protect t h e central nervous system. About the end of the fourth week. t e n d o n . a n d pad the b o d y or to provide support a n d spaci n g w h e r e it's m o r e d e n s e . pressures a n d t e n s i o n s . p r i m i t i v e spinal c o l u m n . D e p e n d i n g o n its d e n s i t y . fibers a n d m a t r i x a r e p u s h e d aside by t h e engorged cells. In o t h e r places. i t stays s o f t u n t i l b i r t h . b o t h internal and external. I t i s n o w s h a p e d like a t u b e a n d i s g e t t i n g bigger. t h e soft m a t r i x b e c o m e s m o r e rigid. It is a n o t h e r kind of c o n n e c t i v e tissue. Fat is o n e of t h e body's ways of i m m o b i l i z i n g or wedging an area.

1 0       T H E  E N D L E S S W E B   As the head fold grows. however. As  folding continues. Thus the inner organs and their ʺpacking  materialʺ affect overall body ease and mobility.  Mesenchyme (the primitive mesoderm or middle layer) fills  the space between them. Emptying  the digestive tract. For the most part. and so forth.  Cells start out with the potential to become anything. If the transverse colon is filled with fecal  material. can have a dramatic effect  on posture. filmy layer of connective tissue.  Fully developed endodermal tissue is held in position  inside the body by a thin. forming esophagus. is almost literally glued to  the back part of the abdominal cavity. the endoderm layer (inner  lining) grows within the ectoderm (outer lining). it is necessarily restricted in mobility. the back  of the mouth begins to take shape out of the endoderm.  The large intestine. connecting to the  backbone in the area of the lowest attachments of the  diaphragm. and  eventually the curvature of the stomach. It  is like a spider web that holds structures in place. As the head fold begins. where it forms a  heavy fascial connection that includes a    considerable amount of fat. stomach. more and more endoderm is brought  into an internal lining. This  compresses the back part of the diaphragm and related  spinal junctions. particularly of that  part which runs across the abdomen. for example. developing into  specific parts of the embryo as it grows. This fat is an important part of  the environment of the large intestine.  . the coiling of the  small intestine. for example. healthy  endodermal tissue can and does adapt freely to other body  structures.  Gradually they become more specialized. Endoderm structures do influence the  conformation (shape and relationship) of bony structure. like thin  guy wires.

Minor variations in this developmental p a t t e r n a l l o w p r e d i c t i o n o f t h e i n d i v i d u a l ' s future structure a n d behavior. Every g r o w t h stage t h u s creates n e w d e m a n d s a n d challenges i n t h e internal environment of the embryo. they change the internal environm e n t o f t h e i m m e d i a t e area. T h e r e are m a n y slight differences in t h e rate of d e v e l o p m e n t inside t h e e m b r y o . M e s o derm remains relatively a m o r p h o u s . t h e r e m a y b e s o m e insufficiency of t h e p l a c e n t a (there are child r e n w h o are b o r n w i t h m a l n u t r i t i o n ) . H o w e v e r . and dosage and/or frequency. t h i s will h a v e a g r e a t e r or lesser i n f l u e n c e d e p e n d i n g o n t h e d r u g . t h e r e s p o n s e is a g r e a t e r d e g r e e of s p e cialization of function. and in the mature adult. Yet c o n n e c t i v e t i s s u e b e c o m e s increasingly important. T h e s e cells are p r e s e n t in the embryo. a c h a n g e i n t h e d i r e c t i o n a l stress i n t h e m e s e n c h y m e m o d i f i e s t h e o r g a n i z a t i o n o f surr o u n d i n g tissue. establishing the arrangement of structures as t h e e m b r y o g r o w s i n size. W i t h i n t h e w o m b . N o t w o sides o f t h e b o d y a r e t h e s a m e . T h e r e h a v e b e e n f e w t i s s u e studies of late p r e g n a n c y t h a t detail w h a t goes on u n d e r n e a t h t h e skin of t h e developing infant. in terms of structural organization. N o t w o o f u s are t h e s a m e . In general. At o n e p o i n t .THREE Factors in the Growth of the Embryo E c t o d e r m a n d e n d o d e r m structures are f u n c tionally b o t h m o r e discrete a n d m o r e stable i n f o r m . It is reasonable to suppose that the great spurts in g r o w t h t h a t take place toward t h e e n d o f p r e g n a n c y are t h e result o f a n increase in t h e v o l u m e of c o n n e c t i v e tissue. It is a h i s t o r y of g e n e r a l p a t t e r n s of growth. As t h e e m b r y o develops. the child. We have termed this the " e m b r y o n i c This overview of early embryological developm e n t has b e e n necessarily sketchy a n d general. It h a s types of n o n s p e c i f i c cells t h a t a p p a r e n t l y g i v e rise t o d i f f e r e n t k i n d s o f s p e cialized cells as n e e d e d . creating c h a n g e s a t t h e a n a t o m i c a l level. At another time. G e n e t i c p r e d e t e r m i n a t i o n sets t h e stage. internal growth and differentiation m a y take precedence. t h e s t a g e o f gestation. of the kind we have b e e n describing. I f t h e m o t h e r ' s diet is i n a d e q u a t e . As described in Section 1. even before the embryo is recognizably human. t h e e m b r y o will be affected. this exerts pressure on t h e uterus. T h e r e are s h i f t s i n t h e i m p o r t a n c e o f o n e factor over a n o t h e r as t h e e m b r y o grows. both internal and external. v a r i a t i o n s are a k i n d of p r o b l e m solving. T h e s e v a r i a tions relate to differences in e n v i r o n m e n t . O n e factor in this kind of problem solving is t h a t cells h a v e a m u c h wider ability to respond to changing environment than is generally believed. c o n n e c t i v e tissue is t h e least s p e c i f i c o f t h e d e v e l o p i n g t i s s u e s . . solving probl e m s a n d m e e t i n g n e e d s a s t h e y arise. This is true long before birth. If she is constipated during m u c h of the pregnancy. D e s c r i p t i v e e m b r y o l o g y tells o n l y p a r t o f t h e story. M e s o d e r m is a p r i m e e x a m p l e . T h e o r c h e s t r a t i o n o f t h e s e variables makes up t h e physical c o m p o n e n t s of individuality. t h e size l i m i t a t i o n s o f t h e w o m b may be the most important. rather t h a n b e i n g set u p a c c o r d i n g t o a p r e d e t e r m i n e d p l a n . If t h e m o t h e r takes m e d i c a t i o n or drugs. As b o d y structures develop. T h e b o d y grows organically. The external environment becomes increasingly i m p o r t a n t as t h e e m b r y o gets larger. it p r o v i d e s a f r a m e w o r k f o r discussion of embryological concepts as t h e y predispose a n d influence t h e shape a n d characteristic m o v e m e n t of t h e individual.

Internal e n v i r o n m e n t is primary at the cellular level. p o t e n t i a l of m e s o d e r m . i t c o n t i n u e s t o f u n c t i o n a s a k i d n e y . w h e r e i t s e e m s t h a t t h e y are a b l e to assume multiple functions as needed in the healing process. m o r e d i f f e r e n t i a t e d syst e m . external e n v i r o n m e n t b e c o m e s a m a j o r factor. o n l y fingers or forearms m i g h t be affected. From t h e n o n . This c a n be a little lagging or a little a h e a d of t h e average pattern. For e x a m p l e . h o w t h e arms are curled a r o u n d — a l l t h e s e are important factors in t h e final shape.12 THE ENDLESS WEB area as a w h o l e . Reticular cells in c o n n e c t i v e tissue very probab l y a c t a s s o u r c e c e l l s . I f i t w a s t a k e n early. T h e coordination of t i m i n g is a m a j o r factor in embryonic development. C e l l s f o r t h i s r e g e n e r a t i o n c o m e from within the b o d y As the kidney g r o w s . L y m p h o c y t e s i n b l o o d a n d l y m p h o i d tissue a c c u m u l a t e n e a r a n area o f i n f e c t i o n . . external environm e n t takes on an increasingly significant role. t h e e m b r y o has dealt w i t h t h e problem of b e c o m i n g w h a t it is—an identifiable creature of h u m a n type. w h e n a r m s a n d legs w e r e j u s t b e g i n n i n g t o d e v e l o p . all t h e e l e m e n t s are i n place. Its cellular processes are fully l o a d e d — e v e n overloaded—yet it can make this compensation. As t h e fetus b e c o m e s a child and t h e n an adult. D e v e l o p m e n t takes place in spurts. T h e e m b r y o d e v e l o p s i n all its p a r t s b o t h Figure 3-1 The way the baby lies within the uterus determines the ultimate pattern of the spine. t h i s c h a n g e s t h e e n v i r o n m e n t o f t h e on a general timetable (the genetic contribut i o n ) a n d o n its o w n i n d i v i d u a l t i m e t a b l e . By t h e e n d of t h e s e c o n d or third m o n t h o f p r e g n a n c y . If it h a p p e n s later. it c r e a t e s a s l i g h t l y d i f f e r e n t s t r u c t u r e . w i t h i n a short time the remaining kidney doubles in size t o c o m p e n s a t e . o r m o r e c o m p l e x . Increasingly. T h a l i d o m i d e is a r e c e n t i l l u s t r a t i o n . m o r e influential w h e n t h e e m b r y o is very y o u n g . Also at this p o i n t . as a few cells b u d off the e n d o d e r m tube to begin to form the liver. even m e t a m o r p h o s i n g into p h a g o c y t i c ( r e s t r u c t u r i n g cells) o r b e c o m i n g a source of additional c o n n e c t i v e tissue cells. This is t h e reason that drug effects c a n be so devastating at o n e e m b r y o n i c stage a n d less so at a n o t h e r . I f t a k e n later. As it grows. T h e w a y t h e b a b y lies i n t h e u t e r u s determines t h e ultimate pattern of the spine (Fig. g i v i n g rise t o s p e c i a l ized c e l l s o n d e m a n d . if a k i d n e y is r e m o v e d . Even in t h e adult. 3-1). " Reticular cells a n d l y m p h o c y t e s are e x a m p l e s of this type of cell. growth is a matter of b e c o m i n g bigger. From t h e n on. meshing internal and external environmental d e m a n d s . it creates o n e kind of structure. E v e n a m a t t e r o f h o u r s i s signific a n t . W h e t h e r t h e h e a d i s t o t h e r i g h t o r t o t h e l e f t o r b e t w e e n t h e t w o legs. it is dealing with a different problem. The embryo shows individual body shape and conformat i o n . After t h e t h i r d m o n t h o f p r e g n a n c y . t h e e m b r y o (and t h e infant a n d adult) expands in size b u t r e t a i n s t h e e a r l y p a t t e r n o f r o t a t i o n . m o r e coiled. n a m e l y the developm e n t i n t o a b i g g e r . individual variations b e c o m e increasingly apparent. t h e r e w o u l d b e n o a r m s o r legs a t all. Yet all c e l l s c h a n g e t h e i r r a t e o f g r o w t h i n response to environmental stimulus. Such m o r p h o l o g i c a l (shape a n d structure) responses t o e n v i r o n m e n t are t h e e x t r e m e . If this h a p p e n s at o n e time schedule.

Ligam e n t s a n d t e n d o n s d o n o t really a t t a c h t o b o n e — t h e y are c o n t i n u o u s w i t h t h e p e r i o s t e u m (a fibrous covering of t h e b o n e ) . The process continues throughout life. and myofascial elements of c o n n e c t i v e tissue.FOUR Development of Mesodermal Tissues study of tissues). a n d o r g a n i z a t i o n . T h e s e are t h e structural c o m p o n e n t s of mesoderm. they share a characteristic pattern of growth. l i g a m e n t s . It is better described as an area of greater c o n c e n t r a t i o n of c o n n e c t i v e tissue. a s t h e b i c e p s m o v e . T h i s is especially true of its c o n n e c t i v e t i s s u e c o m p o n e n t s . d i r e c t i o n . t e n dons. It is usually assumed t h a t c o n n e c t i v e tissue (fascia) c o n d e n s e s a r o u n d a m u s c l e b e c a u s e e x i s t i n g m u s c l e t i s s u e n e e d s a w r a p p e r . A l i v i n g b o d y i s a c o n t i n u o u s w h o l e . Further g r o w t h i n c r e a s e s m u s c l e size b y c e l l r e p r o d u c t i o n . a b l e t o e x p a n d a n d c o n t r a c t a n d s o e x e r t p r e s s u r e a n d f r i c t i o n o n its surr o u n d i n g fascial bed. 4-2). T h e e r r o r arises w h e n w e t h i n k o f f a s c i a a s a t u b u l a r W e n e e d t o digress f o r a m o m e n t t o d i s c u s s t h e d e v e l o p m e n t o f t h o s e m e s o d e r m a l tissues t h a t will b e c o m e t h e b o n e s . c o n n e c t i v e tissue g e n e r a l i z e s l o c a l m u s c l e a c t i o n . It is our belief that t h e direction of t h e c o n n e c t i v e tissue ( t e n d o n o r l i g a m e n t ) i s e s t a b l i s h e d first. including the shoulder and neck. . i n t h e first or second m o n t h of pregnancy. This development m a y be stimulated by the physical tension present in the connective tissue. t h e whole arm moves. t h e fascial wrapping of m a t u r e m u s c l e is n o t a true w r a p p i n g . P o t e n t i a l m u s c l e tissue c a u g h t w i t h i n t h i s directional pull differentiates i n t o m a t u r e muscle oriented along the line of pull. In terms of histology (the microscopic B c D Figure 4-1 This schematic shows an idealized sequence of normal development of tendon/ligament from early gestation to just before the baby is born. w h i c h in turn is continuous with the next tendon or l i g a m e n t . C o n n e c t i v e t i s s u e gives i t s h a p e . (Fig. o r i t m a y b e s t i m u l a t e d b y t h e a s s o c i a t e d e n e r g y field (Fig. T h e c l u m p of primitive m u s c l e cells elongates t h r o u g h directional pressure. 4-1). Because it is c o n t i n u o u s t h r o u g h o u t the body. muscle. At this stage t h e g r o u p o f p r i m i t i v e m u s c l e cells c h a n g e s i n t o differentiated m u s c l e cells. m u c h a s t h e c a n d y w r a p p e r s h a p e s t h e taffy. Muscle tissue is caught in the middle of the connective tissue d i r e c t i o n a l l y w h i l e i t i s still p r i m i t i v e . T h i s i n t e r a c t i o n d e v e l o p s early. Anatomists tend to describe the b o d y in t e r m s o f its d i s s e c t i b l e p a r t s . T h e r e is no b e g i n n i n g o r e n d t o t h e s e s t r u c t u r e s . M u s c l e tissue is similar i n c o n s i s t e n c y t o taffy. Muscle itself i s s p o n g y . For e x a m p l e .

c o m p e n s a t i o n to injuries. T h i s is a wider. showing the connective tissue continuity. size l i m i t a t i o n s in t h e uterus b e c o m e a factor. T h e ends of t h e original b a n d of fibers remain as the tendon o u s a t t a c h m e n t s . the stimulation causes a heavier c o n c e n t r a t i o n of fibers. Traditional a n a t o m y describes the average soft tissue structures of t h e body. f o r m i n g a t h i c k e n e d s h e e t o f f a s c i a .14 THE ENDLESS WEB b o n e ) p u s h e s o u t i n t o t h e c o n n e c t i v e tissue b e d . T h e c o n n e c t i v e t i s s u e a r o u n d t h e p o t e n t i a l m u s c l e l o s e s its t e n d o n o u s c h a r a c t e r a n d b e c o m e s fascia (bedding). but a r e s p o n s e to o u t s i d e p r e s s u r e (Fig. t h e greater t h e likelihood of adaptation. In m a n y infants. Brachialis- Tendon* Figure 4-2 Upper arm (brachialis muscle). s t i m u l a t i n g m o r e fiber production. Periosteum^ Tendon' These have one character along the bone and another between the bones. i n d i v i d u a l rates o f g r o w t h . W h a t do we m e a n b y differentiation? W h a t really h a p p e n s w h e n c o n n e c t i v e tissue structures get organized? As cartilage ( w h i c h will be replaced by o f t h e leg b e c o m e s t h i c k e n e d . Keep in m i n d that in t h e embryological s t a g e o f d e v e l o p m e n t . The connective t i s s u e c o m p o n e n t w i t h i n t h e s e stress l i n e s i s s t i m u l a t e d t o i n c r e a s e fiber p r o d u c t i o n . for e x a m p l e . flatter e q u i v a l e n t of t e n d o n as it connects to the broader muscles. t h e c o n n e c t i v e tissue o n t h e o u t s i d e Figure 4-3 The folding of the fullterm baby in the uterus creates normal fascial tensions. resulting in localized thickenings of connective tissue. all o f t h e s e s t r u c t u r e s are p o t e n t i a l . T h e legs are held folded within t h e uterus so that tension is created between the knee cap and the hip. A r o u n d t h e s i x t h m o n t h o f p r e g n a n c y . covering a r o u n d m u s c l e tissue. T h i s k i n d o f i n d i v i d u a l response is apparent as early as t h e third m o n t h o f intrauterine life. . T h e m o r e stringent this limitation. 4-3). t h e y are called a p o neuroses. This reinforces t h e directional pull within t h e c o n n e c t i v e t i s s u e b e d . Periosteum -> tendon -> myofascia -> tendon -> periosteum. a n d Intramuscular -connective tissue fibers Fascia>- t h e s e fibers are a r r a n g e d a l o n g stress l i n e s . We have interpreted these as an individual response to idiosyncratic patterns. W h a t starts a s p o t e n t i a l t e n d o n or ligament has potential muscle developing w i t h i n it. We h a v e isolated a particular part of m e s o dermal differentiation—that of tendons and ligaments a n d associated muscle within the c o n n e c t i v e tissue bed as a w h o l e . s u c h as t h e b a c k . W h e r e there is this kind of pressure. It is m o r e a c c u r a t e t o say t h a t t e n d o n goes t h r o u g h m u s c l e t h a n t h a t t h e m u s c l e lies w i t h i n t h e tendon. d i r e c t i o n a l stress l i n e s a r e e s t a b l i s h e d . This is n o t a response to internal need. These patterns can include habitual gestures or posture. W h e r e t h e c o n n e c t i v e tissue b a n d s e x t e n d across a b r o a d area of t h e body. a n d e n v i r o n m e n tal stresses o f all k i n d s . We h a v e f o u n d a v a r i e t y o f a t y p i c a l c o n n e c t i v e tissue b a n d s a n d c o m p r e s s i o n s t h a t are i l l u s t r a t e d i n no a n a t o m y text.

is simple efficiency? It m a y be visualized in terms of the concept of an embryonic. however. T h e sheet of fascia also t h i c k e n s o n t h e side o f t h e t h i g h . N o w h e r e are t h e s e pulls in i s o l a t i o n . 5-1). so that it does have s o m e o n g o i n g choice. prov i d i n g f o c a l p o i n t s o f s o f t t i s s u e t e n s i o n (Fig. Figure 5-1 The rotations in the fetus continue into the structure of the adult. S u c h p r i m a r y r o t a t i o n s are a u g m e n t e d a n d compensated by intrauterine limitations during late pregnancy. w h i c h i s t h e groin. W h e n this is t o o h e a v y a n d short. t h e "situ p " m u s c l e o n t h e f r o n t o f t h e a b d o m e n . Its ease a n d l e n g t h s e e m to relate to t h e degree o f c u r l a s t h e c h i l d lies i n t h e u t e r u s . W h a t .FIVE Embryonic Limitations and Early Structural Organization w h e r e it is called t h e ilio-tibial tract. As t h e b o n e s grow i n t o this bed. T h e r e are a l w a y s c r o s s . e n v i r o n m e n t a l pressures begin to d o m i n a t e . t h e a n t e r i o r s u p e r i o r s p i n e of the ilium (the top front corner of the hip b o n e ) " s n a g s " t h e b r o a d fascial sheet t h a t c o m e s u p t h e leg f r o m t h e k n e e .t e n s i o n s a m o n g t h e m . Other places in t h e b o d y m a y s h o w idiosyncratic changes in structure. w h e r e t h e a r m s are i n r e l a t i o n s h i p t o t h e s p i n e — t h e s e f a c t o r s establish t h e individual pattern of t h e vertebral c o l u m n . It w a s I d a Rolf's assumption that this relationship is establ i s h e d a s e a r l y a s t h e first w e e k o f p r e g n a n c y . W e assume t h a t t h e p o s i t i o n o f the head on the neck is determined by these s p i n a l r o t a t i o n s (Fig. W h e t h e r the head is to t h e right o r t o t h e left o f t h e k n e e s . I n a d d i t i o n . W e have described a line of force d o w n to the pubic b o n e and o n e up to t h e anterior superior s p i n e . changes away from simple efficiency. t h e fetus is really b e i n g pressed by t h e l i m i t a t i o n s of space. T h e m u s c l e m o s t directly influenced is t h e rectus a b d o m i n i s . Especially toward t h e eighth m o n t h of pregnancy. T h e m u s c l e s o f t h e t h i g h lie w i t h i n t h e folds. T h e anter i o r s u p e r i o r s p i n e a c t s like a h o o k s u s p e n d i n g a p i e c e o f f a b r i c . undifferentiated c o n n e c t i v e tissue b e d in w h i c h t h e r e are directional pulls. a rope-like b a n d from t h e anterior superior spine to t h e pubic b o n e . T h e c h i l d m o v e s a r o u n d q u i t e a bit. their protuberances act as hooks. T h i s c r e a t e s c o n v e r g i n g folds at t h a t p o i n t . This is particularly true if t h e m o t h e r ' s posture or structure supports t h e p r e g n a n c y w i t h difficulty. this m o v e m e n t tends to be restricted to t h e limbs because there is so little space. W i t h i n t h e s h e e t t h e r e are specific areas of c o n c e n t r a t i o n of c o n n e c t i v e tissue fibers. . A n o t h e r pull is d o w n to t h e pubic b o n e f r o m t h e rib region. t h e n . For i n s t a n c e . T h e soft tissue organizes as a s h e e t across t h i s area. T h e child's position in the uterus is thus i m p o r t a n t i n its s t r u c t u r a l d e v e l o p m e n t a n d alignment. t h e r e i s a t o r s i o n between these two b o n y protuberances. At six m o n t h s . it restricts As t h e fetus grows. 5-2). T h e m o s t a p p a r e n t is the inguinal ligament.

d o r s a l f a s c i a . B y t h e t i m e t h e f e t u s i s full t e r m a n d r e a d y t o b e b o r n . i t i s a segIlio-tibial tract . T h e l u m b o .S. These junctions probably determine regional variations in t h e shape of the vertebrae. t h e g r o i n sags. i t h a s t o start w o r k ing—literally—to counteract some of the habits t h a t a r e a l r e a d y e s t a b l i s h e d i n its b o d y . w h e n it is insufficiently establ i s h e d . w h i c h lies i n a A. i t i s a b a l a n c e d n e t w o r k o f soft tissue pulls reflecting t h e i n t e r a c t i o n b e t w e e n its g e n e t i c b l u e p r i n t a n d i n t r a u t e r i n e stresses. . Note the tensions on the inguinal ligament are bidirectional between the ASIS (anterior superior iliac spine) and the pubic bone (not labeled). i s a s o f t tissue structure that is established by t h e h o o k ing effect at t h e spinal flexures. there seems to be gene t i c d e t e r m i n a t i o n f o r t h a t c u r v e t h a t i s later reinforced a n d redirected by the muscular Rectus femoris m. h e a v y v e r t i c a l b a n d o n t h e b a c k . Inguinal ligament Rectus abdominis m.Sartorius m. W h e n t h e c h i l d i s b o r n . Its spinal curve and a kind of crouched position o f legs a n d a r m s m u s t b e o p e n e d a n d l e n g t h ened (Fig. T h e f e t a l c u r v e i t s e l f i s n o t a r e s p o n s e t o restriction from the w o m b . those places where t h e degree of b e n d i n g in the spine is greater. pressure of t h e u t e r i n e walls as t h e child grows. m e n t e d curve.16 THE ENDLESS WEB m o v e m e n t . These segmental junctions a r e e s t a b l i s h e d b e f o r e t h e b o n e s start t o f o r m . 5-3). Figure 5-2 Arrows pointing in one direction indicate the major tensions that are unidirectional.S.I. T h e f e t a l s p i n e d o e s n o t d e s c r i b e a s m o o t h c o n t i n u o u s " C " c u r v e .

EMBRYONIC LIMITATIONS AND EARLY STRUCTURAL ORGANIZATION 17 At birth. t o m i m i c . as is m o r e usual. T h e knee-up position in t h e fetus makes an almost direct line of restriction across t h e pelvis b e t w e e n t h e lower b a c k a n d t h e inside o f t h e t h i g h . f o r efficiency of movement. As these new physical habits are established. Figure 5-3 The myofascial structures elongate and change relationship as the baby moves from fetal curve (A). or t h e y m a y remain as a substructure w i t h i n t h e body. to crawling (C). T h e lumbar spine (lower back) m a y c o m e t o o far f o r w a r d . This m a y be t h e origin of so-called spontaneous curvatures. o r t h e legs m a y b e pulled up and into the body. He straightens for m a n y r e a s o n s : f o r c o m f o r t . t h e y m a y be modified. t h e y i n d u c e additional cross-stresses w i t h i n t h e c o n n e c t i v e tissue n e t w o r k . T h e c o m b i n a t i o n is a compressed. A h u m a n being in t h e w o m b is b o r n in a natural s t o o p . I t i s p o s s i b l e t h a t t h e pattern of the curve m a y have been established in t h e soft tissue relationships of t h e spine early o n . Gradually. and on to the first steps (D). t h e s h o r t n e s s is felt as a restriction that inhibits secure upright bala n c e . T h i s stress l i n e i s c o n t i n u o u s with t h e fascial t h i c k e n i n g o n t h e small o f t h e back. But as t h e b o d y b e g i n s to stand. the head nods forward and the hip turns under. Or. P r e v i o u s l y e s t a b l i s h e d stresses d i s s i p a t e f r o m l a c k o f u s e . T h i s s t r u c t u r e i s f u n c t i o n a l i n t h e w o m b a n d as the child crawls. as d e m a n d for stable m o v e m e n t i n c r e a s e s . leaning " S " curve between the lower back and t h e leg. to creeping (B). t h e growing child finds c o m p e n s a t i o n s a r o u n d t h e s h o r t n e s s t o s e r v e its needs. T h e r e are n u m e r o u s e x a m p l e s o f s u c h restrictions in fascial sheets a n d c o n n e c t i o n s as the child develops in the w o m b . T h e d e m a n d s f r o m growing body weight and increasing control of movem e n t then bring out the inherent weakness. to explore. Children w h o have s h o w n n o prior structural problems can suddenly develop a curvature (scoliosis) just before puberty. t h i s t i s s u e m u s t l e n g t h e n . T h i s i s n o t a rare o c c u r r e n c e . A B C D .

PART TWO Connective Tissue Body .

t h e a c t u a l p a s s a g e n e e d n o t b e s t r u c t u r a l l y d a m a g i n g . 6-1. It has no established ways of deali n g w i t h all t h i s n e w n e s s . a n d s o m e a m n i o t i c fluid n e e d s t o b e e x p e l l e d . such as b e i n g held upside d o w n under bright lights. B r e a t h i n g h a s actually started before b i r t h . t h e d i a p h r a g m also m o v e s up and down. Chest b r e a t h i n g draws t h e focus of e n e r g y u p w a r d i n t o a m o r e a c t i v e p a t t e r n . In chest breathing. It is a truism in psychology that what we learn under panic c o n d i t i o n s is w i t h us for life. The first b r e a t h a f t e r b i r t h starts t h e p r o c e s s o f p u s h i n g t h e fluid o u t o f t h e lungs. A prolonged period of labor m a y be a source of tension. Abdominal b r e a t h i n g quiets t h e b o d y a n d draws t h e focus of energy lower in t h e body. but not as much. M o r e traditional birthing n o w includes vigorous toweling and drying t h e b a b y as well as suctioning to clear t h e airway. T r a u m a t i c sensory attack. are m a g n i f i e d i n t h e i r i m p o r t b o t h physically a n d e m o t i o n a l l y . T h a t w a s t h e r a t i o nale for t h e shock." W e h a v e n o comparisons. c a n i n d u c e structural c o n tractions or sensory shutdown that m a y never go away. we t e n d to be either chest breathers or abdominal breathers. As adults. N e w stimuli. o n e s a r i s i n g o u t o f c o g n i t i v e i m p a c t . T h e French obstetrician instituted deliveries of t h e b a b y u n d e r water. ( I n o u r v i e w . From a physiological point o f view.The Effect of the Birth Process The term "birth trauma" has considerable emotional impact. t h e d e s i r a b l e resting state is a b a l a n c e b e t w e e n t h e t w o — s e e Fig. A t b i r t h . Birth is the beginning of n e w e n v i r o n m e n tal i n f l u e n c e s o n s t r u c t u r e . T h e infant is e x p e r i e n c i n g a total c h a n g e in envir o n m e n t . W h a t happens to the diaphragm and the ribs w i t h b r e a t h i n g i n t h e d i f f e r e n t k i n d s o f birthing? Intrauterine breathing m o v e m e n t s have to be shallow because the a b d o m e n and u p p e r ribs a r e s h a r p l y c o m p r e s s e d i n t h e f e t a l p o s i t i o n . t h e b a b y is a wide-open system. because t h e y are n e w . Does the first breath of the n e o n a t e initiate t h e pattern? In abdominal breathing.) As t h e support of uterine constriction is SIX . yet this should be transitory. Birth is an extraordinary condition. It would be intere s t i n g t o c o m p a r e a L e B o y e r f i l m o f t h e first minutes of infant delivery with a film of m o r e traditional births. but even twenty-four or forty-eight hours should not under ordinary conditions make that m u c h difference to structure. T h e spanking a n d h o l d i n g the n e w b o r n upside d o w n were used to ensure that the lungs were cleared. O n l y t h e l o w e r ribs ( a n d p o s s i b l y the diaphragm) can be involved. T h e r e m i g h t b e s o m e diffic u l t y b e c a u s e o f t h e size o f t h e h e a d a n d shoulders. T h i s is a c u l t u r a l r a t h e r t h a n a p h y s i ological part of the birth process. the diaphragm moves up and down and the increased volu m e o f air i s a c c o m m o d a t e d i n t h e a b d o m e n . W e t e n d t o a c c e p t t h e l a t t e r because "that's just t h e way t h e world is" or "that's just t h e way m y b o d y is. Birthing t e c h n i q u e s of t h e first half of this century included holding the baby inverted by t h e feet until t h e first cry was h e a r d to be sure t h e airway was clear. a pattern well suited to m e d i t a t i o n . Breathing is one of the major new things that happens with birth. First e f f o r t s t o c l e a n o f f t h e b a b y w e r e d o n e in the water and no suctioning of airway was deemed necessary. We can never know h o w we w o u l d feel w i t h o u t t h a t stress. T h e r e a r e b a s i c a l l y t w o different kinds of m a l f u n c t i o n in t h e b o d y — t h o s e c a u s e d b y t r a u m a t i c ( e x t e r n a l ) stress a n d t h o s e t h a t result f r o m d e v e l o p m e n t a l ( i n t e r n a l ) stress.

it is all k n o w t o b e i m p o r t a n t . 1984). rubber-gloved fingers. Lately. lost at birth. i n s t e a d o f p u t t i n g t h e child under a blanket.22 THE ENDLESS WEB very thin. . A t b i r t h t h e r e are s u d d e n i n t r u s i o n s o f f o r e i g n t e x t u r e s s u c h as sheets. it seems as t h o u g h a baby's first c r i e s are r e a l l y a n g r y o r f e a r f u l . W i t h the work of the second generation of progressive ideas in b i r t h i n g / gentle ways of s t i m u l a t i n g sensory a w a k e n i n g h a v e b e e n f o u n d — f o r e x a m p l e . It was o n c e c o m m o n to pin d o w n i n f a n t s h e e t s . taking the i n f a n t d i r e c t l y i n t o d e f e n s e . sensory input is increased in intensity. A shock to the system. f S e e Michel Odent. a n d rectal t h e r m o m e t e r s . T h e c o n n e c t i v e t i s s u e r e s p o n s e t o t h a t first e m o t i o n c a n last t h r o u g h l i f e . t h i s a m n i o t i c fluid i s n o l o n g e r t h e r e . H o w t h i s c h a n g e is h a n d l e d has a marked effect on identity. t h e r e i s fluid c o v e r i n g t h e c h i l d i n addition to the uterine musculature. Birth Reborn (New York: Pantheon. A f e t u s is subjected to m o r e sound t h a n we suspect. the abdomen lengthens (vertical arrow) and the rib c a g e widens (horizontal arrow). establ i s h e d a t a b o u t o n e m o n t h o f g e s t a t i o n . Structurally. There m a y even be an intrau t e r i n e n e e d for t h e i n f a n t t o w i t h d r a w b y contracting. Birth Without Violence (New York: Knopf. d i a p e r s . In t h e u t e r u s . b l o w i n g air on the chest or using the mother's voice in a low m o n o t o n e to stimulate breathing. T h e w h o l e skin is an organ of t o u c h . Probably it b e c o m e s a traumatic factor o n l y if it is s u d d e n a n d / o r h i g h l y i n t r u s i v e . I t i s g o o d t o see i t so beautifully represented in LeBoyer's* film of birthing. we have exaggerated the drawing for greater visual i m p a c t — this is what it feels like but the visible effect is less than this illustration suggests. T h e child was exposed to light and sound in t h e w o m b . m a y start a w a y of being. Tactile s t i m u l a t i o n c h a n g e s radically at birth. T h e c h a n g e in the quality of sensory response to the new environment is the first c h a l l e n g e t h e b a b y f a c e s . suctioning devices. D i a p e r s are t h e m o s t insistent pressure. At birth. s h e e t s . At birth. but even sheets a n d blankets probably create m o r e pressure t h a n we suspect. a defense response is expressed as tissue c o n t r a c t i o n a n d withdrawal. W h e n t h e uterine wall is fully e x t e n d e d . *See Frederick LeBoyer. Both light a n d sound can and do c o m e through. he or she is put into o n e or m o r e sleepers a n d has a little m o r e freedom of movement. Often. The inhale is shown in Figure ( 2 ) . t h e r e are n e w pressures f r o m b l a n k e t s . T o u c h is t h e earliest sense response. 1 9 7 5 ) . but these were muffled. T h e laying on of gentle hands at birth is something we Figure 6-1 In a balanced combination of chest and abdominal breathing.

m o r e skilled. g e t t i n g r u b b e r y o n h i s legs. T h o s e m u s c l e s t h a t t e n d t o pull t h e leg t o w a r d t h e m i d d l e ( a d d u c t o r s ) a r e e v e n less s t r o n g . m o r e e m b r y ology texts concentrate on t h e growth of external form. all i s well. getting rubbery. a f t e r b i r t h . If he o r s h e lies o n t h e b a c k o r f r o n t . Increased d e m a n d for m o v e m e n t furthers maturation of t h e c o n n e c t i v e tissue. we explore a wider range of m o v e m e n t . T h e sequence in which the head develops a h e a d o f t h e tail a n d t h e b a c k a h e a d o f t h e b e l l y i s m a i n t a i n e d . or t h e circuit c a n get s h u n t e d a n d g o i n t o a d o w n w a r d spiral. pulling u p w i t h h i s a r m s . B e c a u s e t h e h i p c a r t i l a g e is m a l l e a b l e . T h e r e is very little i n f o r m a t i o n available about muscle. O b s e r v e a s m a l l c h i l d w h o has just discovered h o w to stand. t h e least complete system is t h e c o n n e c t i v e tissue. a s w e b e c o m e m o r e s k i l l e d . At birth. stimulate balance in the hip joint. S w a d d l i n g . But children (and parents) are o f t e n t o o eager. This is especially noticeable in the space between the bony ossifications in the pelvis and legs when compared to the shoulders and ribs. a n d o r g a n d e v e l o p m e n t l a t e i n t h e f e t a l c y c l e . w i t h s m a l l disks o f b o n e (Fig. After t h e first t h r e e m o n t h s o f p r e g n a n c y . T h e erector spinae (long m u s c l e s of t h e b a c k ) are strong. Feedback systems can operate to increase the range of m o v e m e n t . the practice of binding a n e w b o r n closely i n c l o t h . He is visibly exploring the bala n c e possibilities in his pelvis. T h e c o n n e c t i v e tissue i s t h e s y s t e m b y w h i c h w e m e d i a t e m o v e m e n t . centers of ossification are more fully developed in the upper body than in the lower. In the newborn. T h e y are u s i n g t h e i r stronger parts to h o i s t themselves up on the cartilaginous. the m o s t developed pelvic musculature is in the back. it b e c o m e s m o r e capable. p u l l themselves up with their arms and shoulders. T h e p e l v i s falling down. the bones of the head and c h e s t are r e l a t i v e l y w e l l d e v e l o p e d . c o m i n g up. Birth marks a transition toward a greater a n d ultim a t e l y m o r e refined use o f m o v e m e n t . As we use a part. Development is not complete at birth. w r a p s t h e legs s o t h a t t h e y a r e h e l d close together. 7-1). l e a r n i n g t o u s e t h e b o d y r e i n forces t h e process. If t h e h i p j o i n t has r e a c h e d t h e stage w h e r e t h e tissues are m a t u r e e n o u g h t o s u s t a i n t h i s e x e r c i s e . O v e r u s e o r u s e o f a j o i n t b e f o r e i t i s adequately developed can physically change t h e s h a p e o f t h e j o i n t i t s e l f (Fig. It m a y be that isometric m o v e ments of the infant within this wrapping Figure 7-1 At birth. I n t u r n . 7-2). T h e gluteus m a x i m u s muscle is very well developed. rubbery legs a n d p e l v i s .SEVEN Developmental Transitions in the Newborn and Young Child i s l a r g e l y c a r t i l a g e . t h e legs t e n d to be splayed out because of limited pelvic ossification as well as lack of soft tissue t o n e t o p u l l t h e legs t o g e t h e r . yet structurally. O r t h e . w h i l e t h e b e l l y w a l l i s less s o . T h e m a j o r i t y of children. a s far a s w e c a n tell. D e v e l o p m e n t a l r a t e s a n d p a t t e r n s set u p t h e stresses. h o w a c h i l d h a b i t u a l l y lies i n t h e c r i b has great effect on this lower structure. w h e n t h e y start t o s t a n d u p i n t h e i r c r i b s . F e e d b a c k s y s t e m s a r e c h a r a c t e r i s t i c o f all l i v i n g organisms. T h e child spends the day going up and down. c o n n e c t i v e tissue. and so forth.

a n d so forth. m i s u s e m a y b e less d r a s t i c — s i m p l y a h a b i t u a l way of moving. a n d learning. T h e b o n e a n d tissue e l e m e n t s are present. . W h e n it is inelastic. It has to because t h e heel c a n ' t reach t h e floor. A n y j o i n t c a n b e i m m a t u r e e i t h e r s t r u c t u r a l l y o r i n its pattern of use. Thus the immature joint is more pliable and. We define a myofascial structure as i m m a ture w h e n it is insufficiently developed to m e e t t h e d e m a n d for m o v e m e n t . It is important to remember that a child doesn't Immature Mature start w i t h w a l k i n g . is more deformable by misuse. reading. W h e r e t h e r e is i m m a t u r i t y in a j o i n t . A m a t u r e h e e l a c t s as a f u l c r u m t h r o u g h w h i c h t h e f o o t a n d leg relate t o e a c h other. W h e n t h e c h i l d starts to walk. seeing. W i t h o u t a well-developed heel. looking around. Range of m o v e m e n t is restricted. it is c h i e f l y a quality of t h e soft tissue p o r t i o n of t h e joint. T h e child m a y also h a v e a brain i n c o o r d i n a t i o n . This process accelerates after birth with kicking.24 THE ENDLESS WEB course. In crawling. Babies don't have this kind of heel u n t i l t h e y b e g i n t o w a l k (Fig. it is likely to h a v e m o t o r u n c o o r d i n a t i o n for life. Concurrently note the change in the position of the calcaneus. b u t t h e soft tissue h a s n ' t b e e n s h a p e d b y use. Adequate flexibility at t h e joints is t h e anatomical definition of maturity. or pulled off Immature (4 yrs) •Tibia Talus •Calcaneous Mature Figure 7-3 The black outlines in the immature foot represent cartilage that will eventually be replaced by bone. t h e muscles c o n n e c t i n g u p t h e leg a r e n o t y e t e x t e n d e d a n d t h e t w o h e e l b o n e s a r e still w e d g e d u p i n t o t h e a n k l e joint b e t w e e n t h e tibia a n d fibula. Cartilage Synovial membrane Cleft Joint cavity Joint capsule Perichondrium Mesenchyme Articular cartilage Periosteum Maturity in a j o i n t is t h e exploration of t h e full r a n g e o f p o s s i b i l i t i e s w h i l e still r e t a i n i n g stable m o v e m e n t . t h e f o o t w o u l d be m o r e like a l o n g e x t e n s i o n of t h e leg. it usually stands on t h e balls of t h e feet. an infant works with the c o n n e c t i o n o f t h e fascial s h e e t s b e t w e e n t h e Figure 7-2 The essential difference in the comparison of mature and immature joints is that the immature " b o n e " is still cartilage. J o i n t s b e c o m e mature with use. rocking. Note the difference in the shape of the talus as it is molded by ossification and use. m o v e m e n t c a n n o t "flow t h r o u g h " to t h e b o n e s . T h e heel is an excellent e x a m ple of this. I f t h e c h i l d d o e s n ' t c r a w l before it walks. unfortunately. m a n i f e s t i n g as disabilities in t h i n k i n g . Eventually. 7-3). t h e b o n e s are w o r k e d free a n d t h e m a t u r e h e e l rests f i r m l y o n t h e g r o u n d . contracted.

(B) creeping. W i t h i n limits. Reversibility of tissue density is an i n s t a n c e of the embryological nature of connective tissue in t h e adult. t h e y are t h e f u n c t i o n a l r e s p o n s e t o n e e d . W h e n t h e r e i s still c a r t i l a g e i n t h e v e r t e b r a l c o l u m n . Crawling develops t h e use of t h e pelvis. Proportionately. c a n f e e l like t e n d o n s . (C) crawling. Fibrocartilage itself c o m p r i s e s a s p e c t r u m of d e n s i t y — i t c a n b e rigid like b o n e o r r u b b e r y l i k e c a r t i l a g e . We create short "ropes" and A B C D . D i s k s consist of fibrocartilage. W e all h a v e w a y s o f s h o r i n g o u r s e l v e s u p a g a i n s t t h e stresses o f w e i g h t a n d constriction. a n d t h e u p p e r v e r t e b r a e h a v e m o r e b o n e than the ones down toward the lumbar r e g i o n a n d t h e s a c r u m . b r i n g i n g it t o w a r d t h e level o f m a t u r i t y o f t h e s h o u l d e r s a n d belly. such as b e t w e e n t h e shoulder blades or across t h e t o p o f t h e p e l v i s . w h i c h t h e n b e c o m e m o r e o r less r i g i d . t h e pelvis a n d legs are p r i m a r i l y cartilage. L i k e t e n d o n s o r l i g a m e n t s . w h i c h is dense a n d fibrous. (D) standing. A t b i r t h . A c r a w l i n g c h i l d p r a c t i c e s s y n c h r o n i z i n g t h e a r m s a n d legs. An e l d e r l y p e r s o n w i t h a s e v e r e s c o l i o s i s is at the other end of the spectrum of malleability of cartilaginous tissue. T h e full r e p l a c e m e n t of cartilage by b o n e in t h e skeleton is n o t c o m p l e t e until t h e age of t w e n t y to t w e n t y five. Crawling seems to establish the lower back (lumbar) curve. stability in position is harder to keep. I m p a c t e d areas. T h e difference between o n e kind of connective tissue a n d a n o t h e r is in t h e a m o u n t a n d o r g a n i z a t i o n o f t h e fibers a n d i n t h e d e n s i t y of the intercellular matrix. t h e arms h a v e m o r e b o n e . I t i s n e c e s sary f o r t h e c h i l d a c t i v e l y t o u s e t h i s p o s i t i o n before going on to the elongations of t h e body required in walking. any o f these tissues m a y m o v e i n t h e direction o f increased rigidity or at a n o t h e r t i m e . 7-4). i t m a y b e e a s i e r t o c h a n g e its c o n f o r m a t i o n b e c a u s e o f its g r e a t e r m a l l e a bility. i t m a y b e t h a t a n y Figure 7-4 (A) before birth. T h e r e are m i n e r a l d e p o s i t s i n t h e disks b e t w e e n t h e v e r t e b r a e . C r a w l i n g r e d i r e c t s t h e f l e x u r e s o f t h e fetal p o s i t i o n . Functionally it is similar to b o n e . histologically it is an i n t e r m e d i a t e stage b e t w e e n cartilage a n d b o n e tissue. T h i s c a n h a p p e n at a n y age.DEVELOPMENTAL TRANSITIONS IN THE NEWBORN AND YOUNG CHILD 25 outside of the knee and the h i p a n d on up i n t o t h e b a c k (Fig. reverse t o t h e d i r e c t i o n o f g r e a t e r fluidity. It r e i n f o r c e s a s i m u l t a n e o u s p a t t e r n of r i g h t angles at b o t h the hip a n d the knee. t h e r e i s a fair a m o u n t o f b o n e i n t h e ribs. a s w e l l a s r i g h t a n d left sides. A t t h e s a m e t i m e .

and the head comes forward to balance. pain. As h i s legs m o v e o u t i n f r o n t . s h e sits. A s i t g r o w s older. t h e activities of b r e a t h i n g .26 THE ENDLESS WEB folds across a j o i n t or wide cross b a n d s to stabilize an u n b a l a n c e d shoulder or hip. " Infants and c h i l d r e n are n a t u r a l p e r f o r m e r s a n d t h e y get a great deal of r e i n f o r c e m e n t to act. W e e x p e c t d i f f e r e n t t h i n g s f r o m a b a b y girl t h a n f r o m a b a b y boy. t h e r e w i l l b e t r o u b l e . to m i m i c . h e f e e l s t h a t h e i s f a l l i n g b a c k w a r d a n d starts c o m p e n s a t i n g : t h e lower back c o m e s forward. t u r n i n g over. I t i s i n t e r e s t i n g t o see h o w m a n y adults walk with this kind of c o n f i g u r a t i o n — h e a d f o r w a r d a n d legs s p l a y e d . Premature use. the child is talked about as " h e . and eventually. ( " I s n ' t t h a t c u t e . sitting u p . for e x a m p l e . j u s t like h i s f a t h e r . inappropriate i m i t a t i o n . As a b a b y l e a r n s to u s e its b o d y . lack of precision. . A w o m a n w h o h a d a l o t o f i n j u r i e s t o o n e leg said. l o o k i n g for things. S o m e of this m a y e v e n start b e f o r e b i r t h . T h e r e a r e a l s o less o b v i o u s d e m a n d s — s u b t l e e x p e c t a t i o n s t h a t start v e r y y o u n g . independent child. W h e n a c h i l d first starts t o w a l k . a n d walking are the primary stimuli to convert the immature Figure 7-5 structure of the n e w b o r n into a c o m p e t e n t . it h a s m a n y o p t i o n s . this was t h e s a m e leg s h e r e p e a t e d l y i n j u r e d ." Perhaps n o t surprisingly. After birth. a n d h e r legs m o v e under her to keep her upright. i n s o m a n y c a s e s . W h e n a child is held with his arms up. s h e gets up a n d a i m s toward a table or s o m e o t h e r s u p p o r t . If she l e a n s b a c k a t all. or a too-early d e m a n d for precision c a n skew t h e j o i n t out of true. he b r i n g s h i s legs f o r w a r d to w a l k (Fig 7-5). T h e result is t h a t s h e starts to b a l a n c e o n t h e b a c k o f her legs. " M y m o t h e r used to tell me t h a t w h e n I was a b o u t three years old I followed my father around in the garden a n d imitated his limp. S h e s o o n l e a r n s t o prefer falling on her b o t t o m to falling forward on h e r face. creating restriction. A further c o m p l i c a t i o n is t h a t b u l k y diapers f o r c e t h e legs a p a r t . I f this p a t t e r n persists i n t h e a d u l t . grabbing things. the shoulders go back. " ) A n o t h e r way of saying the same thing is that children are natural seekers of a t t e n t i o n a n d approval. The problems begin when we attempt to work against rather t h a n with gravity as we m o v e . S h e s o r t o f falls f o r w a r d . crawling. t h i s w i d e o p e n range of possibilities narrows in favor of greater precision of m o v e m e n t .

it makes up our contours and holds us in place. We consider fascia to be a c o n t i n u o u s system. 1 Figure 8-1 Brachialis muscle in upper arm showing continuity of connective tissue: periosteum and tendon with fascia. It is a heavier c o n d e n s a t i o n o f fibers a t t h e s u r f a c e o f m u s c l e . is a specialized type of exerting internal pressure on this myofascial tissue. t h e fibrous FasciarIntramuscular -•connective tissue fibers Brachialis- Epimysium Tendorw Perimysium' Endomysium. M u s c l e fibers e x p a n d a n d c o n t r a c t . this m e a n s t h a t s o m e is h a r d e r o r softer. I t i s t h e p a c k ing material of the body. Figure 8-2 Cross section of the upper arm showing the fascial sheaths (labeled) surrounding muscle fibers (dots) and muscle groupings. 8-2). Ligaments similarly bridge the periosteum of one bone to the periosteum of the other bone in a joint. Histologically.t e n d o n .l i g a m e n t ) (Fig. relating t h e m o r e superficial surface muscles to t h o s e deeper in t h e b o d y as well as c o n n e c t i n g adjacent muscles into groups. b o n e is c o n t i n u o u s with t h e total b e d of c o n n e c t i v e tissue. is a c o n c e n t r a t i o n of h a r d intercellular m a t r i x w i t h i n a c o n n e c t i v e tissue b e d . Myofascia. I n a d d i t i o n . t o o . These hard a n d soft tissues t o g e t h e r m a k e u p w h a t Ida R o l f c a l l e d t h e " o r g a n o f s t r u c t u r e . Periosteum* Tendon^ The Spine as an Example of "Living Anatomy" The "organ" that transmits m o v e m e n t in the body. Bone. is t h e mesodermal tissue—the c o n n e c t i v e tissue. I n descriptive terms. 8-1) a n d t h e l a y e r j u s t u n d e r t h e s k i n ( t h e s u p e r f i c i a l f a s c i a ) . It is a l a y e r i n g of s h e e t s of fibrous tissue t h a t flows t h r o u g h t h e body. Acting like a guy rope. w r a p p i n g a r o u n d smaller m u s c l e fiber groups (Fig. that makes a structural w h o l e of us. " C o n n e c t i v e tissue v a r i e s i n t e r m s o f t h e p h y s i c a l n a t u r e o f its i n t e r c e l l u l a r m a t r i x a n d i n t h e n u m b e r a n d d e n s i t y o f its f i b e r s . M u s c l e lies w i t h i n f a s c i a l s h e a t h s . e x t e n d i n g throughout the b o d y between the deepest b o n e level ( p e r i o s t e u m . eddying around b o n y protuberances that c o m p r e s s a n d r e d i r e c t its flow. M y o f a s c i a also exists as layers b e t w e e n m u s c l e s . s o m e i s m o r e e l a s t i c o r m o r e rigid.EIGHT Myofascial Structures c o n n e c t i v e tissue. for e x a m p l e . . C o n n e c t i v e t i s s u e i s c o n t i n u o u s throughout the body from toe to head. therefore. f a s c i a l fibers i n t e r p e n e t r a t e t h e m u s c l e .

An e x a m p l e is t h e coracoid process. The underlying fascial pulls graphically illustrate the complex dynamics focused on the coracoid process (drawing). as well as of t h e e m b r y o . H o o k s are o n e w a y t h a t b o n e a n d m y o f a s c i a interact to redirect. As we h a v e said. responds to habitual t e n s i o n with a localized increase of f i b r o b l a s t s a n d i n c r e a s e d s e c r e t i o n o f fiber in t h e direction of pull. In adults as well as in t h e e m b r y o and neonate. (short head) Figure 8-3 A look at the surface of the shoulder demonstrates the continuity of the fascial sheath (photo). Hooks are f r e q u e n t l y points o f a t t a c h m e n t f o r m y o f a s c i a l s t r u c t u r e s . Yet t h e t a i l b o n e ' s Coracoid process Coracobrachialis m. On the other hand. a b o n y projection on t h e inside of the shoulder b l a d e just a b o v e t h e armpit. T h e c o r a c o i d p r o c e s s r e a c h e s i n t o t h a t fascial c o n t i n u u m . We therefore have reason to believe that this toughening of the myofascial s h e a t h is reversible. and c h e s t all t h e w a y u p t o t h e n e c k a n d h e a d . 8-3). fascial s h e a t h t h e n transmits t h e m o v e m e n t to the periosteum of the b o n e with which it is c o n t i n u o u s . . stabilize. to encase the muscle in such a way that there i s less c a p a c i t y t o l e n g t h e n a n d t o m o v e . Fascial s h e a t h s get " s n a g g e d " o n b o n y h o o k s . This creates a t o u g h e n v e l o p e t h a t e n c a s e s t h e m u s c l e . the tailbone is only mini m a l l y a p o i n t of a t t a c h m e n t for t h e muscles f r o m t h e l e g t o t h e t r u n k . For e x a m p l e . t h e coracoid process is the point of a t t a c h m e n t of muscles from t h e arms to t h e shoulder. Fascia e x t e n d s as a continuous sheet from the hand. and i t c a n b e f e l t t o r e g a i n its n a t u r a l e l a s t i c i t y a s Rolfing proceeds. it condenses . or m a g n i f y m o v e m e n t p o t e n t i a l .Pectoralis minor m. S i m i l a r l y . where the myofascial covering h a s b e c o m e t o u g h e n e d (as i t d o e s t h r o u g h habitual tension or holding).28 T H E E N D L E S S W E B Coracoclavicular ligament & Subclavius m. T h e s e are t h e r e f o r e areas o r s t r u c t u r e s t h a t w i t h i m proper use m a y b e c o m e foci of i n h i b i t i o n of movement. i n t e r r u p t i n g t h e c o n t i n u i t y o f fascial tissue f r o m t h e outside i n t o t h e inside of t h e pelvis. arm. t h e t a i l b o n e ( c o c c y x ) a c t s like a h o o k . Biceps m. t h e m y o f a s c i a l b e d of t h e adult. r e d u c i n g its c a p a c i t y t o l e n g t h e n o r m o v e freely. m o d i f y i n g its f l o w (Fig. T h e f o c u s of Rolfing is this t o u g h e n e d myofascia.

There is a f u n c t i o n a l reasonableness to t h e c o m b i n a t i o n of myofascial sheets and b o n y p o i n t s o f r e f e r e n c e . m o v e m e n t f r o m a g e s t u r e t r a v e l s t h r o u g h t h e a r m o r leg o r h e a d t o w a r d t h e spine. T h e g r o w i n g b o n e sets u p stresses ( d i r e c t i o n a l pulls) i n t h e c o n n e c t i v e tissue i n u t e r o . I n j u r i e s t o t h e c o c c y x are c o m m o n i n c h i l d h o o d . t o o . W h e n t h e p u l l s are f r o m a b r o a d a r e a (for example. T h u s . I n t h e c h e s t region. B o n e projects i n t o t h e c o n n e c t i v e tissue bed with broad surfaces as well as w i t h h o o k s . w h e n t h e arm moves. " All o f t h e spinal c o l u m n ' s 1 8 6 j o i n t s are i n v o l v e d i n every m o v e m e n t of t h e body. This is especially well d e m o n s t r a t e d in b r e a t h i n g . The upper rim of the hip bones. It is i m p o r t a n t to r e m e m b e r t h a t f a s c i a c o n t i n u e s p a s t t h i s p o i n t o f reference. s e r v e a s a r e a s o f a t t a c h m e n t for myofascial units. Figure 8-4 Dowager's hump. t h e s e b r o a d e r surfaces a r e c o n n e c t e d w i t h m o r e s u p e r f i c i a l s o f t tissue o r g a n i z a t i o n . t h e r e are three articulations of each of the twelve t h o r a c i c v e r t e b r a e w i t h its a s s o c i a t e d r i b . S m a l l e r p o i n t s o f a t t a c h m e n t usually serve to redirect deeperlying tissue. In general. Holding patterns can and do occur b e t w e e n a n y o n e o r (usually) m o r e o f t h e s e articulations.MYOFASCIAL STRUCTURES 29 e f f e c t o n leg m o v e m e n t b e c o m e s a p p a r e n t i f it has been displaced in a n y w a y — m o v e d to t h e r i g h t o r t h e left. w e will g o i n t o s o m e d e t a i l a b o u t its s t r u c t u r e a s a n e x a m p l e o f w h a t w e c a l l " l i v i n g a n a t o m y . w h i c h is n o t generally t h o u g h t of as a " m o v e m e n t . the transverse muscles covering t h e a b d o m e n ) . that movement should continue wavelike through the neck a n d i n t o the head. For e x a m p l e . T h e y are d i f f i c u l t t o t r e a t — i t i s i m p o s s i b l e to p u t a c a s t on a t a i l b o n e . a n d t h e s h i n b o n e s a r e e x a m ples. Yet t h e r e i s f r e q u e n t l y a b l o c k i n g o f t h e m o v e m e n t . t h e r e s u l t i s m o r e like a b r o a d sheet. 8-5). the edge of t h e l o w e r ribs. W h e n t h e s e a r e f r o m a s i n g l e p o i n t (for e x a m p l e . M o v e m e n t transmits as a wave d o w n the spine as well as across t h e spine a n d i n t o t h e o t h e r side o f t h e b o d y . 8-4). T h e r e are f u n c t i o n a l a r t i c u l a t i o n s b e t w e e n t h e c e n tral b o d i e s o f t h e v e r t e b r a e a s t h e y r e l a t e t o t h e disks b e t w e e n t h e m ( t h e s e a r e n o t u s u a l l y considered true joints. Since the spine is the focus of so m a n y m o v e m e n t difficulties. Points of a t t a c h m e n t c h a n g e the quality of movement. They change the strength of t h e gesture a n d absorb s o m e of t h e energy of a m o v e m e n t b e f o r e t r a n s m i t t i n g i t t o t h e rest of the body. t h e w a y t h e h a m s t r i n g s a t t a c h to t h e ischial tuberosities). t o o d e e p o r t o o c l o s e t o the surface—then there is interference with t h e easy s w i n g o f t h e leg. restricting m o v e m e n t througho u t t h e s p i n a l c o l u m n (Fig. but t h e y do f u n c t i o n as joints). . " T h e r e are t h r e e or four articulations b e t w e e n e a c h vertebra. a n d e a s i l y i g n o r e d . there is often a c h r o n i c h o l d i n g p a t t e r n t h a t i n l a t e r life i n w o m e n is c a l l e d a d o w a g e r ' s h u m p (Fig. " P o i n t of a t t a c h m e n t " designates t h e supposed e n d p o i n t of m o v e m e n t for a muscle or group of muscles. t h e result tends to be a grouping of rope-like structures. a t t h e j u n c t i o n o f t h e neck with the chest vertebrae. Ideally. T h e s e .

w h e n we i n h a l e .30 THE ENDLESS WEB We i n c l u d e b o n e . conn e c t i v e tissue wraps m o r e tightly a r o u n d t h e s p i n e . process Ventral Dorsal - Figure 8-6 Lumbar vertebrae with associated ligaments illustrating the complexity of fiber direction. T h e spinal c o l u m n is constantly moving in response to breathing. Anterior longitudinal ligament 1 „ Interspinous ligament "at rest. . heartbeat. M o v e m e n t between individual vertebrae is p r o p a g a t e d t h r o u g h this spirally arranged c o n n e c t i v e tissue i n t o t h e spine as a w h o l e . In d i s s e c t i o n . disc Vertebral body (centrum) -Ligamentum flavum . 8-6). a spiral p a t t e r n is v i s i b l e in t h e c o n n e c t i v e tissue a r o u n d t h e spine. t h e r e is a t e n d e n c y for t h e c o l u m n to l e n g t h e n . fascia. W h e n w e e x h a l e . I n d i Costal facet of Inferior costal articular facet transverse process vidual vertebrae m u s t b o t h separate vertically and rotate with every body m o v e m e n t . N e i t h e r t h e spine n o r t h e c o n n e c t i v e tissue t h a t wraps t h e vertebrae a n d their associated muscles is ever Superior costal articular facet Figure 8-5 In the thorax. T h e p a t t e r n o f c o n n e c t i v e tissue t h e n goes f r o m a primarily vertical at-ease position Intervertebral. These types of m o v e m e n t s are c o m b i n e d to give t h e spring-like action of the spine that is characteristic of v i r t u a l l y all m o v e m e n t i n a t r u l y m o b i l e s p i n e .Spinous process Posterior 'longitudinal ligament Transverse. spinal curves decrease in a n g l e . blood c i r c u l a t i o n . the articulations of the ribs with the vertebrae add another level of complexity to spinal mechanics. t h e b o d y settles b a c k i n t o its n o r m a l c u r v e s (Fig. e t c . c r a n i a l r h y t h m . Figure 8-7 Inhale (B) and exhale (C)." As m o v e m e n t b e c o m e s more active. For e x a m p l e . 8-7). a n d m u s c l e in our d e f i n i t i o n of a s p i n a l c o l u m n (Fig. The spinal c o l u m n as a w h o l e integrates rotation w i t h l e n g t h e n i n g a n d s h o r t e n i n g t o allow for diagonal m o v e m e n t s .

an improved positioning with respect to t h e gravity line is essential to a c h a n g e in fiber density. T h e physical state of t h e m a t r i x also plays a role in t h e ability of t h e c o n n e c t i v e tissue t o respond t o m o v e m e n t . maintaining and spreading m o v e m e n t through the spine and out into the body. the underlying chronic muscular t e n s i o n ( h o l d i n g p a t t e r n ) c u t s o f f c a p i l l a r y circulation to t h e area. Some c o m m o n examples are areas u n d e r t h e s h o u l d e r b l a d e o r k n o t s j u s t a l o n g t h e s p i n a l v e r t e b r a e (at t h e s p i n o u s processes). W h e n an area of t h e b o d y is n o t stimulated by movement.l i k e . As the muscle fiber r e l a x e s . T h e y a r e e m b e d d e d in a m a t r i x t h a t itself is h i g h l y organized. C o n n e c t i v e tissue fibers d o n o t e x i s t i n a v a c u u m . T h e a c t i o n o f c o n n e c t i v e tissue i s b a s e d o n e l a s t i c r e c o i l . This type of solution is called a c o l l o i d . Gesture t h e n b e c o m e s b o t h faster a n d m o r e integrated (smoother). t h e m o r e f o r c e b e h i n d t h e m o v e m e n t . t h i c k (gel) i n c o l d e r temperatures. it is m u l t i d i r e c t i o n a l . is a c o l l o i d . fibers p r o l i f e r a t e w h e r e v e r t h e r e i s t i s s u e stress. As t h e c o n n e c t i v e tissue wraps m o r e c l o s e l y t o t h e s p i n e . T h e s e are places t h a t are o f t e n very sore as well as tight. A s w e h a v e d e s c r i b e d . narrower wrapping a r o u n d t h e vertebrae and muscles. it c a n be palpated as a glassy m a s s . T h e elastic recoil of t h e c o n n e c t i v e tissue arises f r o m t h e a r r a n g e m e n t o f fibers w i t h i n t h e c o n n e c t i v e t i s s u e m a t r i x . T h a t is. It is generally close to t h e b o n e a n d is usually difficult to influence toward renewed movement. T h e r e s u l t i n g m a s s o f t h i c k e n e d m a t r i x a n d increased fiber m a s s can be palpated as an unmoving. a n d m o d u l a r (all o r n o t h i n g ) . closer . C o l l a g e n fibers t h e m s e l v e s are n o t elastic. W h e n t h e s e fibers a r e densely matted or not aligned in the direction o f m o v e m e n t . paradoxically causing the spine to elongate. O n e of the chief properties of protein solutions is their response to changes i n t e m p e r a t u r e — t h e y w i l l b e f l u i d (sol) i n w a r m e r t e m p e r a t u r e s . R e c o i l c a n b e p a r t i a l . As capillary circulation decreases. O t h e r sore places. intelligent exercise and/or stretching also has t h e desired effect. its e l a s t i c r e c o i l p r o p e r ties b e c o m e a n i n c r e a s i n g l y larger p r o p o r t i o n o f t h e m o v e m e n t . t h e greater t h e inv o l v e m e n t of t h e c o n n e c t i v e tissue. u n i d i r e c t i o n a l . This intercellular m a t r i x is a protein solution. t h e i r e l a s t i c p o t e n t i a l i s dispersed. f o r e x a m p l e . a n d it is p r o p a g a t e d in waves. T h e action of t h e muscle fibers i s r a c h e t . t h e colloid m a t r i x c h a n g e s state f r o m sol t o g e l . a n d its c o n s i s t e n c y b e c o m e s m o r e glue-like. This kind of buildup can be reversed by t h e intervention of manipulative or movement techniques. trapping c o n n e c t i v e tissue fibers i n t o a n o n . It is this wavelike propagation of m o v e m e n t through the b o d y as a w h o l e that supports continuity of m o v e m e n t and creates m o v e m e n t t h a t i s s m o o t h r a t h e r t h a n jerky. T h e i m m e d i a t e effect is to modify the physical nature of the matrix. This can be palpated a n d is sensed as restriction and/or pain.m o v i n g m a t t e d m a s s . This is t h e case w h e r e there is t h i c k e n ing and b u n c h i n g of c o n n e c t i v e tissue. T h e c o n n e c t i v e tissue m a t r i x is an i m p o r t a n t factor in tissue resilience. painful thickening. Blood circulation n o r m a l l y provides h e a t as well as nutrients and waste removal. T h i s is o n e of t h e m o s t t r o u b l e s o m e types of tissue restriction. T h e ensui n g g r e a t e r f l u i d i t y o f m a t r i x g i v e s rise t o a changed m o v e m e n t pattern and eventually to a c h a n g e in fiber d e n s i t y a n d d i r e c t i o n . but t h e y are coiled a n d t h e i r i n t e r w e a v i n g a l l o w s f o r e l a s t i c disp l a c e m e n t a n d r e t u r n . w h i c h i s less rigidly p a t t e r n e d . M a n i p u l a t i o n appears to be a faster m e t h o d of c h a n g e . t h e c o n n e c t i v e t i s s u e r e c o i l s . g e l a t i n . T h e c o n t r a c t i o n o f m u s c l e fiber i m p e l s t h e c o n n e c t i v e tissue to wrap itself m o r e closely around muscle and vertebrae. W h e r e t h e matrix is t h e primary factor in a h o l d i n g pattern.MYOFASCIAL STRUCTURES 31 to a spiraling. In either case.

in this m o d e l . (B) The trapezius as it crosses the scapula below the scapular spine. (D) The interaction between the trapezius and latissimus dorsi at about the lumbo-dorsal hinge. T h e y have fluid b e t w e e n t h e m . Here t h e c o n n e c t i v e tissue is t h e supportive aspect of t h e structure. T h e concept of physical support of movem e n t is simplified if we t h i n k in terms of the c o n n e c t i v e tissue b e d rather t h a n in terms of Figure 8-8 These fascial dumpings are the common "sore places" that we complain about. As t h e c o n n e c t i v e tissue compresses around the spinal c o l u m n . Muscles execute movement. An increase in c o n n e c t i v e tissue resilience is o n e of t h e goals of w a r m u p before exercise. provide t h e source a n d direction of m o v e m e n t energy. serving to position a n d relate different areas o f t h e c o n n e c t i v e tissue. (E) The attachment of the levator scapulae to the base of the occiput. it is described as t o n e . we are describing t h e a c t i o n o f o p p o s i n g a n d b a l a n c e d tissue g r o u p s . b a l a n c e d p l a n e s o f c o n n e c t i v e tissue s u p p o r t b o t h m u s c l e a n d b o n e b y t h e i r elastic capability. B o n e s " f l o a t " i n r e l a t i o n ship to e a c h other. . F . b u t i t s h o u l d b e mentioned now that between each of the m a n y a r t i c u l a t i o n s o f t h e s p i n a l c o l u m n (as well as in a n y j o i n t of t h e b o d y ) t h e r e is fluid that is similar in c o m p o s i t i o n to t h e intercellular m a t r i x . M u s cles. T h i s r e s i l i e n c e i s felt a s e a s e . For this t o h a p p e n . W h e n we speak of a m o v e m e n t b e i n g supported. s u c h as a h o u s e . 8-8). This is a n e w picture of physical structure. B o n e s are n o t t h e supporting structures of t h e body. t e n d t o b e w h e r e large m u s c l e masses cross e a c h o t h e r or attach to bone (Fig.32 THE ENDLESS WEB t o t h e b o d y s u r f a c e . p u s h i n g t h e v e r t e b r a e f a r t h e r a p a r t (Fig. B o n e s are spacers. b o n e s do n o t t o u c h . 8-9). (A) The trapezius as it crosses the tip of the shoulder (acromion). B D C . S u p p o r t in a m o v i n g structure is very different f r o m s u p p o r t in a s t a t i c s t r u c t u r e . However. t h e y are n o t in direct c o n t a c t with e a c h other.Latissimus dorsi m. ALevator 'scapulae m. It is thus impossible for t h e m to support t h e b o d y the w a y a t a b l e is s u p p o r t e d by its legs. all j o i n t s s h o u l d l e n g t h e n w i t h m o v e m e n t a s t h e c o n n e c t i v e tissue w r a p s a n d s u p p o r t s t h e j o i n t c a p s u l e . the fluid c a p s u l e s b e c o m e l o n g e r a n d t h i n n e r . A s i n t h e s p i n e . (C) The interaction of the levator scapulae and the supraspinatus at the upper medial point of the scapula (often especially intractable). T h e spinal c o l u m n is l e n g t h e n e d by a c o m b i nation of the narrower coiling of the connective tissue a n d t h e pressure of t h e c o m p r e s s e d fluid b e t w e e n b o n e s . t h e c o n n e c t i v e t i s s u e serves t h i s f u n c t i o n . S u p p o r t i n a m o v i n g s t r u c t u r e arises f r o m t h e organization and arrangement of the connective tissues. T h e r e c i p r o c a l . i n p h y s iological terms. /Supraspinatus m. We describe the c o n c e p t of joints in more d e t a i l l a t e r (see S e c t i o n 2 2 ) . (F) The pad created by the latissimus dorsi at the lumbosacral junction. As b o n e s articulate. E Trapezius m. t h e c o n n e c t i v e tissue m u s t b e r e s i l i e n t . In t h e classically taught picture of t h e body. b o n e s are t h e supporting structures.

S o m e forms of exercise. S h i atsu. t'ai chi. B o n e s are spacers. a n d reflexology act by releasing energy t h r o u g h t h e c o n n e c t i v e tissue. Alexander work. Poorly d o n e exercise a n d exercising w h e n exhausted. h o l d i n g patterns b e c o m e habitual. m o v i n g b o d y c o m e s f r o m above as well as f r o m below. Feldenkrais Functional Integration). c a u s i n g i t t o harden and contract. either generally or locally. Notice that the connective tissue fibers change direction.MYOFASCIAL STRUCTURES 33 m u s c l e m o v e m e n t . B o t h Rolfing a n d m a s s a g e m i g h t b e classified a s d i r e c t i n t e r v e n t i o n t e c h n i q u e s . M a n y p h y s i c a l t h e r a p i e s a d d r e s s t h i s loss o f ability. Exercise that is properly d o n e also t o n e s a n d l e n g t h e n s c o n n e c t i v e tissue. or by a c o m b i n a t i o n of active a n d passive (Rolfing M o v e m e n t work. a n d swimm i n g . T h e Rolfing i n t e r v e n t i o n is t h e o n e we k n o w b e s t . Lumbar vertebrae resilient. process Ventral Dorsal- . Rolfing reeducates the b o d y toward an improved relationship to the gravity line. s u c h as yoga. S u p p o r t in a l i v i n g . There is a c o n c o m i t a n t loss o f range o f m o v e m e n t a n d o f energy. like t h e m e m b e r s o f a g e o d e s i c d o m e . however. creating greater c h a n g e where m o v e m e n t originates and rippling into more attenuated change farther away from t h e origin of m o v e m e n t . O t h e r therapies work t h r o u g h retraining m o v e m e n t . T h e h e a d a n d t h e fingertips are as m u c h a part o f t h e s u p p o r t s t r u c t u r e a s are t h e t o e s . are b y design activators o f c o n n e c t i v e tissue t o n e . W e t e n d t o have a n easier t i m e e n v i s i o n i n g support from below from a base such as t h e e a r t h or a c h a i r . acupuncture. A s i m plified m o d e l i s a t e n t . becoming more vertical as the spinal column elongates. Anterior longitudinal' ligament Interspinous ligament Intervertebral. Physical a c t i o n alters t h e shape of t h e c o n n e c t i v e tissue b e d t h r o u g h out t h e structure. w h e r e t h e t e n t p o l e i s held upright by the balanced tension between r o p e s o n b o t h sides. B y w o r k i n g t o e n h a n c e t h e resilie n c e of t h e c o n n e c t i v e tissue bed. e i t h e r p a s s i v e l y (Trager m e t h o d ) or actively. have an opposite e f f e c t o n c o n n e c t i v e t i s s u e . W h e n t h e c o n n e c t i v e tissue b e d is n o t Figure 8-9 The figure to the right shows the lengthening that occurs with spinal movement as connective tissue more closely wraps the joint. Adequate length in the neck and adequate lift i n t h e h e a d a r e e s s e n t i a l t o t h e m o v e m e n t integrity of t h e b o d y as a w h o l e . disc' Vertebral body* (centrum) tigamentum flavum ^Spinous process Posterior •longitudinal ligament Transverse.

T h e leg becomes longer with m o v e m e n t . we push off from the ground u s i n g t h e j o i n t s i n t h e f o o t (Fig. W h e n m o v i n g forward. But this is seldom fully realized. shortened. T h e pattern of compression is transmitted through the body. C o n n e c t i v e tissue wraps t h e i n t e r f a c e b e t w e e n t h e h e a d o f t h e leg b o n e (femur) and the hip socket (acetabulum). Above t h e ankle. all p a r t s o f t h e b o d y are free t o respond to m o v e m e n t . thereby increasing the horizontal space in the foot as well as t h e vertical space b e t w e e n foot and ankle. t h e entire b o d y responds. this is m o v e m e n t by lengthening. w h e n w e sit. t h e hip joint is compressed. they narrow and arch as the foot lifts u p . In walking. ( T h e t h i r d m o v e m e n t i s swiveling.s e c o n d . T h e leg m a y b e pulled u p against t h e h i p joint. T h e hip j o i n t l e n g t h e n s as well as widens w i t h m o v e m e n t . t h e shin b o n e c o m e s forw a r d w h i l e t h e h e e l b o n e slides b a c k w a r d . w h i c h results f r o m t h e f r e e d o m of m o v e m e n t between sacrum and ilium). A base of support is an u n m o v i n g surface or structure f r o m w h i c h m o v e m e n t is initia t e d . there is also w i d e n i n g b e t w e e n t h e b o n e s o f t h e f o o t t h a t are side b y s i d e . T h i s i n i t i a t e s m o v e m e n t i n t h e first s p l i t . t h e h i p b o n e s (generally c o n s i d e r e d relatively i m m o v a b l e ) also widen. t h e resulting m o v e m e n t is literally a falling forward of t h e w h o l e b o d y —unless s o m e part of the b o d y is held back. t h e pelvis rocks forward. so that t h e h e a d of t h e femur drops slightly out o f t h e s o c k e t a n d d o w n w a r d . T h i s frees t h e pelvis for t w o of t h e three m o v e m e n t s characteristic of walking: rocking forward a n d back a n d f r o m side t o s i d e . N o t o n l y i s t h e r e l i n e a r e x t e n s i o n i n . T h e spaces between the bones of the foot widen and lengthen as the foot comes in contact with the ground. This is the result of l e a n i n g forward f r o m t h e base of support. t h e r e m a i n d e r of t h e b o d y is propelled forward. t h e p e l v i s widens. t h e hip m a y b e i m m o b i l i z e d a n d used a s a n i n t e r n a l b a s e o f s u p p o r t . 9-2). A s f o r w a r d m o t i o n starts.NINE Movement and Gravity the joints of the bones going from heel to toes. As the shin b o n e c o m e s forward. We always m o v e f r o m a base o f s u p p o r t . Ideally. T h i s c u s h i o n i n g o f m o v e m e n t acts b o t h t o protect t h e structure a n d t o provide spring for t h e n e x t step. J o g g i n g a n d r u n n i n g are a m a t t e r o f l e a n ing farther forward t h a n w h e n walking. T h e m o v e m e n t is like a spring. t h e pubic b o n e drops slightly toward t h e sitting surface. Ideally. in walking we contract s o m e part rather t h a n fully l e n g t h e n i n g . i t i s t h e first p a r t o f a n y f o r w a r d m o v e m e n t . m o v e m e n t is initiated f r o m t h e part of t h e pelvis t h a t is resting o n t h e chair. h o w e v e r slightly. In walking. It starts at t h e pelvis a n d is quickly t r a n s m i t t e d t h r o u g h t h e b o d y u p t o t h e h e a d a n d d o w n t o t h e feet. The most extreme exaggeration of this kind of walking is the goose step. T h e r e is an increase in t h e space across t h e sacroiliac j u n c t i o n and a widening at the pubic b o n e (pubic s y m p h y s i s ) . allowing t h e leg to c o m e forward b y l e n g t h e n i n g a t all o f its j o i n t s . T h e spring action c o m e s from the lengthening provided as the connective t i s s u e w r a p s a n d e x t e n d s t h e j o i n t s . there is a great i m p a c t on t h e foot. A s t h e leg i s pulled up. As a result. O n c e again. T h i s falling-forward m o t i o n takes o n l y seco n d s . and particularly in running. you adjust your speed in walking or running by W h e n a n y part o f t h e b o d y m o v e s . a n d t h e t a i l b o n e is e l e v a t e d o f f t h a t s u r f a c e (Fig 9-1). m o v e m e n t is t h e n transmitted to the ankle. M o r e often. Ideally.

T h e b o d y is t h e n literally leaning backward. M o v e m e n t reverberates t h r o u g h the spine a n d is released t h r o u g h m o v e m e n t of t h e head.MOVEMENT AND GRAVITY 35 h o w far y o u l e a n f o r w a r d . A m o r e accessible c o n c e p t has to do with controlled/ allowed m o v e m e n t . Insofar as the joints are free t o o p e n . W e c a n Figure 9-1 Rising Figure 9-2 Walking. w e a r e afraid t h a t we will be so jarred t h a t our h e a d will be seriously disturbed. In m o v i n g with length. T h e other end of this c o n t i n u u m is allowed movement. A c o m m o n exaggeration of this is holding the body tensely upright as we walk o r r u n . Almost universally. W h e n w e w a n t t o focus on something. H o l d i n g t h e h e a d rigidly on t h e n e c k is c o n t r o l . T h i s i s t h e h a r d e s t t h i n g f o r u s t o d o . We bring t h e shoulders b a c k . w i t h t h e r e s u l t t h a t t h e legs a r e i n front of t h e torso. r e s u l t i n g i n a n audibly heavier tread. t h e ass b a c k . T h i s h o l d i n g t r a v e l s d o w n t h r o u g h t h e s p i n e a n d i n t o t h e legs. In day-to-day living. we d o n ' t t h i n k about m o v e m e n t in anatomical terms. W e a r e afraid we will lose t h e i m a g e . This kind of rigidity is a l m o s t always a response to u n c o n s c i o u s fear: w e a r e a f r a i d o u r h e a d w i l l fall o f f . Holding can also originate at t h e t o p e n d . t h e m o v e m e n t o f w a l k i n g ripples all t h e w a y t h r o u g h t h e b o d y t o t h e head. as m o v e m e n t is initiated. the knee joint opens. w h e n w e t h i n k o f s o m e t h i n g o r c o n c e n t r a t e i n a n y way. most of us automatically f e e l a s t h o u g h w e h a v e t o h o l d still. b e s u r e t h a t w e c a n see t h e w o r l d i n m o v i n g p i c t u r e s . i n o r d e r t o h a v e a f e e l i n g of control. This allows us to visualize h o w t h e h e a d c a n m o v e " i n l i n e " w i t h t h e rest o f the spine. we're a l m o s t afraid our brains will get rattled. w e t e n d t o resist l e t t i n g everything go forward. As it reaches the proper limit. We can be confident that as we walk our brains will n o t b e rattled. t h e h e a d is its last s e g m e n t . W h e n the m o v e m e n t of the spine is like a s p r i n g . Holding anywhere in t h e structure reflects m o s t strongly at t h e ends of t h e body—between the ankle and heel and between the head and neck. a n d / o r h a n g o n t o o u r s p i n e i n s o m e way. w e h o l d our h e a d s rigidly. It is a m i s u s e of our abilities. T h i s h a p p e n s w h e n we are visualizing i n t e r n a l l y ( l o o k i n g at t h e pictures inside our head) as well as w h e n we are seeing externally. First t h e a n k l e opens. the joints open (lengthen) spont a n e o u s l y a n d s e q u e n t i a l l y . yet it is very c o m m o n . M a n y people have a t e n d e n c y to carry their h e a d s as t h o u g h t h e y were i n d e p e n d e n t structures. W h e n t h i n k i n g (which is most of the time). W e all are a b l e t o see a n d u n d e r s t a n d . A m o r e workable image is to consider t h e skull a s a g r e a t b i g v e r t e b r a s i t t i n g o n t o p of t h e spine. we c o m e down heavily on our heels. and so on.

I n t h e a r m . it is m o r e elastic for flexibility. a n d t h e s e diago n a l s are b a l a n c e d . We exist in gravity—we have weight and w e rest o n t h e s u r f a c e o f t h e E a r t h . We believe that there is a difference in t h e c o m p o s i t i o n of t h e c o n n e c t i v e tissue in t h e legs a n d t h e a r m s . T h e idea that structure determines f u n c t i o n i s a n o l d o n e . E v e r y g e s t u r e i s o n a d i a g o n a l . T h e t ' a i c h i c o n c e p t i s t h a t t h e a r m s f l o w like r i b b o n s after m o v e m e n t has b e e n initiated in t h e legs a n d p e l v i s . T h e shoulder blade a n d c o l l a r b o n e ideally float freely in t h e c o n n e c t i v e t i s s u e . There is reason to believe that the c o n n e c t i v e tissue of t h e organs is also a part of movement. sacrum. t o g i v e t h e n e c e s s a r y difference in compressor ability (resistance to compression). There is always this kind of reciprocal m o v e m e n t taking place a r o u n d t h e central axis of t h e body. o n e leg a n d h i p c o m e forward t o gether with the opposite shoulder and arm w h i l e t h e o t h e r leg a n d h i p w i t h t h e o p p o s i t e arm and shoulder balance backward. T h e differe n c e lies i n t h e w a y t h e l i m b s a t t a c h t o t h e trunk. I n t h e l o w e r leg. a body's o n l y g o o d c h o i c e with respect to g r a v i t y i s v e r t i c a l i t y . reflecting a difference in n e e d a n d use. merely a useful abstraction. T h e r e must therefore be e n o u g h elasticity of action at t h e ankle joint and between the foot b o n e s to allow not only for b e n d i n g at t h e j o i n t but also for rotation so as to m o v e quickly and smoothly from o n e side t o t h e other. I n g e n e r a l . Bodies also d o n ' t m o v e straight forward. Ida R o l f g a v e e x p a n d e d m e a n ing t o t h e reverse c o n c e p t — t h a t f u n c t i o n determines structure. It is this b a l a n c e a m o n g c r o s s . T h e b a l a n c e d diagonals of the limbs function best in c o m b i n a t i o n w i t h t h e free spring a c t i o n o f t h e core. W i t h s o m e c a u t i o n . We don't have t o h o l d e a c h f r a m e still i n o r d e r t o see it. I n t h e arm and shoulder. t h e i n t e r osseous m e m b r a n e must be denser to support t h e leg a n d c o n t r o l r o t a t i o n b e t w e e n t h e two bones as the foot moves. T h e density a n d a r r a n g e m e n t o f t h e fibers a s w e l l a s t h e physical nature of t h e intercellular matrix m u s t b e d i f f e r e n t . This can be demonstrated in . w e n e e d t o let ourselves m o v e a n d a b s o r b a n d let g o . a t t a c h m e n t s a r e p r i m a r i l y f o r l i n ear tracking. T h e concept of a core includes both spine (with head. Using the connective tissue m o d e l . h o w e v e r . t h e r e i s n o structural correlate for this core. p a r t i c u l a r l y i n s t r u c t u r e s like t h e i n t e r o s s e o u s m e m b r a n e s o f t h e f o r e a r m a n d l o w e r leg. is mediated t h r o u g h t h e feet. in t h e a r m . t h e primary need is for r o t a t i o n a s w e l l a s f o r m o b i l i t y i n all t h e joints. I n t h e leg. It is a n o t h e r u s e f u l a b s t r a c t i o n . w h i l e t h e h i p b o n e a n d leg are m o r e closely knit. i n walking. We have discussed the spring action of the spine. there is rarely static verticality. I n t h e leg. w e use t h e a m b i g u o u s word " c o r e " for t h e body's central axis. W e don't need to control every aspect of our m o v e m e n t . For e x a m p l e . i t i s s t r u c tured for stability. T h i s is a very different kind of lengthening. Turning the b o d y is initiated from the base of support which.36 THE ENDLESS WEB movies even though they show a new frame twenty-four times a second. in walking. In m a n y m o v e m e n t s . the a r m a c t s i n r e s p o n s e t o t h e rest o f t h e b o d y w h i l e t h e legs i n i t i a t e m o v e m e n t . T h e o r g a n i z a t i o n o f t h e c o n n e c t i v e tissue i n t h e legs t h e r e f o r e n e e d s t o b e d i f f e r e n t f r o m t h a t o f t h e a r m . Because t h e body is c o n s t a n t l y m o v i n g . t h e i n t e r o s seous m e m b r a n e needs to be elastic so that the b o n e s can rotate with the multidirectional u s e o f t h e h a n d . and coccyx) and t h e viscera. T h e r e is t h e n e e d for t h e leg to go forward a n d b a c k a n d for t h e joints of t h e leg t o m o v e w i t h o u t excess r o t a t i o n . we c a n elaborate h o w parts of t h e b o d y t h a t are a n a l o g o u s structurally (arms a n d legs) a r e f u n c t i o n a l l y d i f f e r e n t . T h e c o n c e p t is.m o v e m e n t s t h a t c r e a t e s f u n c t i o n a l vert i c a l i t y i n t h e m o v i n g b o d y .

T h e literal c e n t r a l a x i s o f t h e b o d y t r a v e l s through t h e viscera. T h e s u p p o r t f o r t h e h e a d i s t h e forward foot. T h e sacrum remains relatively stable as t h e two hip bones rock with each m o v e m e n t of the leg. also h a v e a spring action that helps to organize m o v e m e n t in t h e b o d y as a w h o l e . a s t h m a — a l l deflect t h e b o d y from verticality as m u c h as or m o r e t h a n a m u s c l e s p a s m or a r o t a t e d v e r t e b r a . Since the head weighs somewhere between ten and fifteen p o u n d s . 9-3). this forward foot is directly under the h e a d (Fig. the a b d o m e n is in line w i t h t h e pelvis.) W h e n w e a r e s t a n d i n g m o r e o r less still. a h e a r t s p a s m . T h i s i s a n e x a g geration. T h e m o v e m e n t i s a l m o s t like a figure eight.MOVEMENT AND GRAVITY 37 dissection a n d is visible in behavior. t h e n . t h e c o n c e p t o f weight is a g o o d w a y of analyzing structure. it b e c o m e s f u n c t i o n a l l y lighter. A s t o m a c h a c h e . 9-4). As soon as the head is m o v e d b a c k i n t o a p o s i t i o n w h e r e it is centered on and supported by the neck. ( T h i n k o f M a r i l y n M o n r o e o n h e r w a y a c r o s s t h e floor. n o t t h r o u g h t h e spine (Fig. Figure 9-3 Central axis of the body. such as walking across an u n i m p e d e d floor. w e m u s t t h e n use t h e large m u s c l e s in t h e back of t h e shoulders a n d n e c k literally to hold o n t o our heads. i f t h e c h i n o r f o r e h e a d i s l e a d i n g t h e rest o f t h e b o d y — t h e n i t i s n o t s u p p o r t e d b y the neck. T h e clearest e x a m p l e of this (and t h e largest rotation in walking in a straight line) is in t h e connection between the sacrum (the base of t h e spine) and t h e two b o n e s o f t h e hip. Even w h e n the primary m o v e m e n t is straight forward. t h e j o i n t s o f s u p p o r t i n t h e b o d y still n e e d t o b e f r e e t o r o t a t e s l i g h t l y . o u r w e i g h t i s c o m f o r t a b l e a n d w e n e e d less e f f o r t t o k e e p o u r s e l v e s u p r i g h t . t h e shoulders are i n line with the a b d o m e n . i f w e are i n a l i g n m e n t . I f t h e h e a d i s t o o far f o r w a r d — t h a t is. T h e muscles o f the back of the neck and the shoulders can t h e n start t o r e l a x . T h e classic e x a m p l e h a s t o d o w i t h t h e posit i o n o f t h e h e a d . . It is cantilevered. hemorrhoids. absorbing a n d a c c o m m o d a t i n g t h e swivel a c t i o n a s o n e leg a n d t h e n t h e n e x t r e a c h e s t h e floor. T h e c o n c e p t of gravity is particularly appropriate to a m o v i n g body. a broad base b e t w e e n t h e t w o feet. t h e pelvis is in line w i t h t h e k n e e s — n o m a t t e r h o w far o r i n w h a t d i r e c tion the body leans. b u t it is graphic. T h e exception is the o n e leg t h a t i s forward t o p r e v e n t t h e b o d y f r o m falling. T h e viscera themselves. I n s t a n d i n g still. The b o d y i n m o t i o n i s still a l i g n e d — t h e h e a d i s i n l i n e w i t h t h e shoulders. W h e n t h e leaning b o d y is in alignm e n t . t h e v i s c e r a are i n c l u d e d i n t h e c o r e s t r u c t u r e a n d are a d e t e r m i n a n t o f verticality. F u n c t i o n a l l y . Gravity t h e n acts t h r o u g h the b o d y in the w h o l e space that it occupies. t h e n .

T r o u b l e — p a i n . B u t t h e y a r e actually heavier b a n d s of c o n n e c t i v e tissue. W h a t g e t s i n t h e w a y o f t h i s i d e a l s t r u c t u r e ? For Ida Rolf. In l o o k i n g at t h e c o n n e c t i v e tissue arrangem e n t in dissections of h u m a n bodies. In the pelvic region. Yet g o o d t o n e is s o m e t h i n g we all r e c o g n i z e . t h e contour. This is the relationship of the deep to t h e m o r e superficial structures. Seen from the front. t h e b a l a n c e o f t h e p e l v i s w a s p a r a m o u n t . Fascial crisscrosses seen in dissection s e e m to relate to t h e n o r m a l rotations in a m o v i n g body. T h e y are n e c e s s a r y for n o r m a l m o v e m e n t . All t h e w o r d s w e u s e t o d e s c r i b e t i s s u e t o n e are s u b j e c t i v e — t h e y have to do w i t h personal experie n c e r a t h e r t h a n o b j e c t i v e s t a n d a r d s . the sacrum. there is this kind of surface-todeep tissue i m b a l a n c e . i t i s p o s s i b l e t o v i s u a l i z e h o r i zontal lines through the body. Vertical integrity a n d g o o d t o n e are our measures of a properly aligned body. t h e h i p b o n e c a n b e r o t a t e d i n its r e l a t i o n t o t h e s a c r u m o r t h e leg b o n e . . b u t w e are n e v e r entirely s y m m e t r i c a l . These relations are n o t s i m p l e . this is t h e excessive response of a b o d y that is n o t in alignment. stiffness. heaviness—is a product of misalignm e n t (rotation) of any one of these elements with respect to another. usually a response to a b n o r m a l rotation of the b o d y in m o v e m e n t . T h e y are u s u a l l y f o l d s . W h e n i n n e r a n d o u t e r s t r u c t u r e s are i n b a l a n c e . it seems possible that differences in brain function engender asymmetrical movem e n t preferences resulting in structural asymm e t r y . W h e r e there is excessive knotting or flabbiness. awkwardness. t h e b a l a n c e b e t w e e n surface tissue a n d tissue t h a t is close to t h e b o n e .38 THE ENDLESS WEB placement of the organs is asymmetrical. In an aligned body. o b l i q u e fascial structures are n o t r a n d o m . T h e r e is a further m e a s u r e of proper alignm e n t . For o n e t h i n g . For i n s t a n c e . This is visible in t h e surface Figure 9-4 Walking. f r e q u e n t l y f o l d s t h a t p e o p l e refer t o a s fat t h a t t h e y c a n ' t g e t rid o f . T h e sacrum c a n be rotated with respect to the lumbar spine or the tailbone or the hip bone. we n o t e d t h a t there was s e l d o m a linear (vertical or horizontal) arrangement of connective t i s s u e fibers o n t h e s u r f a c e o r d e e p w i t h i n the body. ideally. W h e n crisscrosses h a v e h e a v y c o n c e n t r a t i o n s of fat a n d gristle. t h e tissue h a s w h a t we call proper t o n e . T h e o b l i q u e s o n t h e f r o n t o f t h e b o d y are in balance with those on the back. T h e s e n o r m a l d i f f e r e n c e s are s l i g h t a n d . m u c h t h e way a violin string that is i n p e r f e c t t e n s i o n h a s p e r f e c t p i t c h . Further. a well-aligned person s h o u l d a p p r o a c h s y m m e t r y . There may be further rotations between individual lumbar vertebrae. T h e fibers tended to run diagonally across t h e b o d y . This has to do with t h e relations of the hip b o n e (ilium). S h e f e l t t h a t e v e r y s e s s i o n i n R o l f i n g h a s a s its ultimate goal the creation of better balance in t h e pelvis. and the lower back (lumbar) vertebrae. It is a springiness to t h e t o u c h and suppleness in movement. we saw a h e a v y c o n c e n t r a t i o n o f f i b e r s g o i n g f r o m o n e side o f t h e c h e s t a c r o s s t o t h e o p p o s i t e side o f the a b d o m e n and down to the opposite hip. M a n y of these padded oblique angles can be s e e n o n t h e s u r f a c e o f t h e b o d y .

h e a d . c o n n e c t i v e tissue. This is the position that the b o n e returns to w h e n i t i s a t rest. I n m o v e m e n t t e r m s . Adequate width and depth of t h e body. kyphosis). Images are t w o .s h a p e d b e n d in the spine. but u n f o r t u n a t e l y t h e y t e n d to confuse t h e situation for m o s t of us. t h e body is three-dimensional. The h u m a n body is obviously an enclosed system. T h e h e a d is t h e opposite e n d of a t e n s i o n line f r o m t h e feet. All o f t h e s e i m b a l a n c e s b e t w e e n b o n e s are m a i n t a i n e d b y t h e s o f t t i s s u e — m u s cle. t h e s p i n e starts t o u n w i n d . a n d rib c a g e are all p a r t o f t h e a b e r r a t i o n . Rotation is a c o m b i n a t i o n of tilting a n d swiveling of b o d y parts. a spiral t w i s t . Seen in profile. Proper length and extension within that circumfere n c e allows for adequate t o n e t h r o u g h o u t . we speak as t h o u g h t h e i m b a l a n c e were solely or m o s t l y c o n f i n e d to t h e spine. t h e y d o n ' t stay p u t . A r m s . C o n v e r s e l y . T h e t w o legs a r e f u n c t i o n a l l y a unit. So we prefer to speak of curvatures of t h e b o d y as a w h o l e rather t h a n curvatures of the spine. W h a t we n o t i c e so o f t e n is t h a t rotations are n o t static. w e are t a l k i n g about the " h o m e " position of the b o n e . creating i m b a l a n c e s in the vertical a n d horizontal planes. T h e d i s c o m f o r t w e feel arises f r o m o u r a w a r e n e s s o f s o f t tissue t e n s i o n r a t h e r t h a n b o n e i m b a l a n c e . are all a p a r t o f e v a l u a t i o n o f s t r u c t u r e . If his feet are slightly farther apart. W h a t are t h e s e t e c h n i c a l t e r m s . e x c e s s i v e p e l v i c tilt t h r o w s o f f t h e v e r t i c a l l i n e . a base for e v e r y t h i n g above t h e m . locking his knees. t h e y c a n b a l a n c e t h e b r o a d p e l v i s . p e l v i s . W e c a n ' t e v e n say t h a t t h e spine is w h a t is h o l d ing the body in the scoliotic posture. l i g a m e n t . This leads us b a c k to t h e circular c o n c e p t that we have talked about in reference to other aspects of balance. He'll have to t i g h t e n s o m e part of his body to keep himself upright—grabbing with t h e toes. . Here we e n c o u n t e r an interesting difficulty in translating f r o m t h e visual to t h e verbal. and/or contracting the shoulders. w h i c h should be m o r e or less s t r a i g h t i n t h i s v i e w . a p e l v i c tilt t h r o w s o f f t h e h o r i z o n t a l l i n e a c r o s s t h e body. Our e x p e r i e n c e as Rolfers is t h a t w h e n we release t h e t i s s u e o f a r m s o r legs o r r i b c a g e . Diagnosis attempts to identify t h e m o s t p r o m i n e n t aspect of a problem. We exist w i t h i n t h e circumference of our skin a n d fascia. There is a welter of t e r m i n o l o g y used to describe t h e various types of rotation of t h e p e l v i s / s a c r u m / l u m b a r spine area. But a scoliosis is manifestly an i m b a l a n c e of t h e b o d y a s a w h o l e . Cause a n d effect in the body b e c o m e interrelated. lordosis is an exaggeration of the n o r m a l curves of the spine. Scoliosis a n d lordosis are clinical t e r m s that identify spinal exaggerations. a n d h o w do t h e y relate to our c o n c e p t of b o d y alignm e n t ? Seen f r o m t h e side. t h e r e s t r i c t i o n w o u l d b e n o t i c e a b l e a s a loss o f r a n g e o f m o v e m e n t . We a n d our d o c t o r s say.d i m e n s i o n a l . t h e s p i n e w i l l n o t u n w i n d u n t i l e x t e r n a l structures are given greater range of m o v e m e n t . F o r e x a m p l e . s c o l i o s i s is a s i d e w a y s S ." But these terms tend to lock the b o d y i n t o a static picture. tightening t h e buttocks. T h e y are precise as diagnostic tools. "I h a v e a l o r d o s i s ( s c o l i o s i s .MOVEMENT AND GRAVITY 39 W h e n w e speak o f t h e rotation o f b o n e s w i t h r e s p e c t t o e a c h o t h e r . S e e n f r o m t h e f r o n t (or t h e b a c k ) . if a p e r s o n w i t h a f a i r l y b r o a d pelvis stands w i t h his feet t o o close together. In using t h e terms. t h e d a n c e r w i t h t o o c o n c a v e a l u m b a r curve in standing will o f t e n show an exaggerated c o n v e x curve in sitting. as well as free range of m o t i o n . he's obviously n o t going to be in easy bala n c e . For e x a m p l e . e v e n t h o u g h t h i s can create a lot of mischief. (There seems to be no medical t e r m i n o l o g y f o r a b a c k t h a t i s t o o flat.) Seen f r o m t h e f r o n t or b a c k . The combination of vertical a n d horizontal tilting in t h e b o d y is w h a t we c a l l r o t a t i o n . legs. T h e r e are o t h e r f a c t o r s i n v o l v e d i n i d e a l structural vertical a n d horizontal a l i g n m e n t .

Habits lay d o w n pads. 10-2). . Figure 10-1 Body contour tells us a lot about the condition of the underlying connective tissue and its potential for movement. This is in contrast t o t h e u s u a l artist's c o n c e p t i o n o f m u s c l e anatomy as determining the outline of the body. T h e large.TEN Body Contour A p h o t o g r a p h of a b o d y s h o w s s h a d o w s a n d h i g h l i g h t s t h a t c a n be seen as hills a n d v a l l e y s (Fig. breathing. T h e r e are areas w h e r e t h e t i s s u e b u l g e s a n d areas w h e r e i t a p p e a r s t o b e h e l d d e e p . As it interacts with b o n e s a n d m u s c l e s . Intuitively we have expectations of how these bodies will move. t h e s e soft tissues are t h e p r i m a r y determinant of body shape. b o n e . B o t h o f t h e s e modifiers o f c o n t o u r reflect t h e w a y t h e b o d y i s u s e d . H i g h l i g h t s (hills) c o r r e s p o n d t o t h i c k e n e d pads of tissue b e t w e e n skin and b o n e ( a n d / o r m u s c l e ) . and digestion. T h e s e p a d s are o f t e n m a d e up of fatty tissue in association with f i b r o u s c o n n e c t i v e t i s s u e . w h i c h in t u r n supports a n d restricts the activity of muscle. T w o p a d s t h a t are p r e s e n t i n a l m o s t all b o d i e s are a v e r y h e a v y t h i c k e n i n g a t t h e b a s e o f t h e skull a n d a heavy pad at t h e base of the spine. s o m e t i m e s c o n t a i n i n g fatty accumulations. Body shape is therefore affected by the holding patterns that we have described. T h e result is a person's s h a p e . Volition. T h e position o f b o n e s w i t h i n m u s c l e a n d c o n n e c t i v e tissue controls the direction of m o v e m e n t . 10-1). a n d self-image shape the connective tissue. Here are photographs of three very different body types. T h e s h a d o w s (valleys) a p p e a r t o b e a r e a s w h e r e s k i n a l m o s t sticks to b o n e ( a n d / o r m u s c l e ) . b r o a d m u s c l e a t t h e b a s e o f t h e skull (trapezius) i s i n c o n s t a n t p a r t i a l c o n t r a c t i o n t o s u p port a forward head. The contour of the body is based on connective tissue. and other functions such as circulation. over t h e t o p o f t h e b u t t o c k s (Fig. habit. H e a v y fat a n d c o n n e c t i v e t i s s u e p a d s are v i s i b l e i n areas t h a t h a v e b e e n u n d e r t e n s i o n for a lifetime. Muscles expand and contract in response t o d e m a n d . M u s c l e s a r e o v e r u s e d i n t h e s e t w o a r e a s . W h a t is creating these adhesions seems to be a compacted b e d o f c o l l a g e n fibers m i x e d w i t h i n t e r c e l l u l a r m a t r i x i n its gel s t a t e . w e c a n see i t a s a m a p o f t h e u n d e r l y i n g structures as t h e y affect t h e c o n n e c t i v e tissue bed. T h e upper margin of the gluteus m a x i m u s habitually contracts to hold W h e n we look at the contour of the whole b o d y .

It is only w h e n it is overdeveloped and thickened t h a t it b e c o m e s a p r o b l e m . In a detailed dissection on t w o stillborn infants. However. Actually. Note the similar padding across the shoulders and up into the neck.Gluteus maximus m. where t h e c o n n e c t i v e tissue layer over b o n e is in good t o n e . There were also pads of fatty c o n n e c t i v e tissue b e t w e e n t h e legs ( b e t w e e n t h e r e g i o n o f t h e a n u s a n d t h e genitals).Trapezius m. d o w n to t h e tiniest muscle. Fat& "connective tissue pad b a b i e s w e r e i n m a n y w a y s s i m i l a r (Fig. T h e presence of this padding at birth would indicate t h a t it is a n o r m a l part of b o d y c o n t o u r . These pads were thick. There is always a c o n n e c t i v e tissue l a y e r o f g r e a t e r o r lesser c o m p l e x i t y b e n e a t h t h e skin.BODY CONTOUR 41 t h e p e l v i s rigid. In b o t h . s o m e w h a t like a diaper b e n e a t h t h e skin. the better off we are. C o n t o u r is idiosyncratic e v e n at birth. t h e b o n e lies u n d e r several layers o f t o u g h e n e d c o n n e c t i v e tissue. 10-3). T h e skin sticks to t h e leathe r y (or glassy) c o n n e c t i v e t i s s u e . C h r o n i c t e n s i o n h a s r e s u l t e d in a h e a v y pad on t h e b o d y surface. t h e patterns of c o n n e c t i v e tissue padding in t h e t w o . In one. Figure 10-2 Fat and connective tissue pads. We never actually t o u c h b o n e in palpating t h e body.connective tissue pad . t h e skin c a n m o v e freely over b o n e a n d tissue. The heavy pad of fat over the gluteal region was a thick mass of connective tissue containing fat. a n d that the more a muscle is developed. Fat& -. just u n d e r t h e skin. the musculature of the b o d y was relatively undeveloped. there was a considerable difference in m u s c l e development. crossing over a n d tying the hip bones to the sacrum. O n t h e o t h e r h a n d . I n d e n t a t i o n s are likewise visible in areas that have b e e n u n d e r t e n s i o n for a lifetime. We tend to think that heavy muscle is good Erector spinae m. while in t h e o t h e r t h e pattern was well defined a n d visible Figure 10-3 This is a photograph of a dissection of a stillborn baby at term. there was a heavy pad of fibrous c o n nective tissue across t h e upper posterior border o f t h e large h i p b o n e s . T h e b o n e appears to be right at t h e i n d e n t e d surface. Overdeveloped m u s c l e s l o o k .

This bala n c e is based on partial c o n t r a c t i o n . T o o m u c h of a g o o d t h i n g in this case causes restriction and exacerbates preexisting habitual distortions. B o t h are t h e result of habitual h o l d i n g patterns. O u r a d v i c e i s t o let pleasure be your guide.42 THE ENDLESS WEB impressive. This is where most of the mischief occurs. . From the side. I n a d d i t i o n . i t i s s o m e t i m e s p o s s i b l e to maintain adequate freedom of movement in the joints along with development of the muscle mass. Its c o n n e c t i v e t i s s u e r a m i f i c a t i o n s are e s p e c i a l l y i m p o r tant. c h a l l e n g i n g w o r k o u t s are generally associated w i t h exercising past t h e p o i n t of efficiency. w e see i m b a l a n c e w h e n o n e s h o u l d e r i s higher t h a n the other. A reasonable a m o u n t of bodybuilding is a good thing. t h e j o i n t torques (twists). resulting in compression a n d s h o r t e n i n g at t h e joints. creating t o n e and strength. This is true for p u m p i n g iron. T h e leg i s n o t able t o l e n g t h e n o u t o f t h e j o i n t a n d therefore c a n n o t m o v e straight forward a n d b a c k w a r d (Fig. it will be functional as long as t h e program of exercise is m a i n t a i n e d . Excessive d e m a n d on a b o d y part always brings out whatever c o m p e n s a t i o n s or restrictions already exist in t h e part. there will e v e n t u a l l y b e p r o b l e m s . w e h a v e already m e n t i o n e d t h e deviations f r o m vertical such as the head forward. o n e side o f t h e h i p c a n t e d u p w a r d . o n e knee tending more in or out. Unless there is modification of t h e exercise to a c c o m m o d a t e individual idiosyncrasies. r u n n i n g or jogging. a heavy muscle needs another equally heavy m u s c l e t o o f f s e t its c o n t r a c t i v e n e s s . O n e of t h e great d e t e r m i n a n t s of posture i n t h e b o d y i s t h e p s o a s m u s c l e . It is virtually impossible n o t to create chronic a n d / o r acute injury w h e n repeatedly exercisi n g i n a n e x h a u s t e d s t a t e . chest depressed. or ballet. W h e r e there has b e e n m o r e persistent effort at m u s c l e b u i l d i n g o n o n e side o f t h e j o i n t t h a n t h e other. working out on m a c h i n e s . Posture is apparent in t h e static p h o t o g r a p h as overall b o d y balance or imbalance. T h e psoas myofascia is interwoven with t h e fascia o f t h e muscles o n t h e inside o f t h e Proportionately small head Short neck Arms pulled into shoulders Shortened torso Arms go wide Legs pulled into pelvis Legs go wide Figure 10-4 The muscle development of this body looks impressive. This is because the pumped muscle is contracted. How m a n y people have you seen smiling while running? T h e c o n c e p t s o f c o n t o u r a n d posture overl a p a n d b l e n d i n t o e a c h o t h e r . b u t t h e y t e n d t o reduce free range of m o v e m e n t .g. y o g a ) . But w h e n such a person walks. W h e r e b o d y b u i l d ing is c o m b i n e d with stretching and body a w a r e n e s s (e. o n e arm longer than t h e o t h e r . A bodybuilder w h o conscientiously works o n all o f t h e m u s c l e s c a n a c h i e v e a b a l a n c e o f tightness around individual joints. but that muscle bulk is a major impediment to freedom of movement. he or she ends up with a kind of waddle. pelvis tipped forward or tucked back. shoulders up or r o u n d e d . For b a l a n c e . From t h e front. 10-4).

pulling the lumbar vertebrae forward. I n t h e g r o i n a r e a . pulls pelvis up Figure 10-5 A physically asymmetrical psoas leads to lumbar rotations and pelvic tilts. This is the origin of the typical big-bellied baby look. Lateral pelvic tilt Psoas ' longer lax Psoas shortened. all k i n d s o f p o s t u r a l a n d f u n c t i o n a l d i f f i c u l ties c a n arise. T h e p s o a s o r i g i nates along t h e upper l u m b a r spine. 10-5). This allows it to act as a k i n d of pulley. A deteriorated psoas. t h e l u m b a r v e r t e b r a e c a n n o t slip i n t o t h e compression and misalignment that is the beginning of t h e bad lower back. "If a b o d y is n o r m a l . I m m a t u r e b o d y patterns f r e q u e n t l y persist *Ida P. c h i l d r e n a r e b o r n w i t h m o r e d e v e l oped muscle in back t h a n in front. T h e y start t o s h o w w h e n t h e legs adjust to bearing weight. t h e p s o a s is a b r i d g e b e t w e e n u p p e r b o d y a n d legs. p l a c e m e n t . t o o wide. A c c o r d i n g t o Ida Rolf. T h e t w o sides a r e r a r e l y s y m m e t r i c a l i n t o n e . This prevertebral support ensures l e n g t h i n t h e l u m b a r s p i n e a s a w h o l e . t h e psoas c a n involve t h e respiratory pattern. W h e n the psoas is habitually contracted. irrespective of general b o d y position. Rolf.BODY CONTOUR 43 pelvis a s w e l l a s w i t h t h e d i a p h r a g m f a s c i a . . 1 9 7 7 ) . S t r u c t u r a l l y . e v e n t h o u g h centrally located in the body. t h r o u g h these n e i g h b o r s . It diagonally traverses t h e cavity of t h e pelvis. Moreover. t h e p s o a s i s o n e o f the most significant muscles of the body. T h e psoas tendon attaches to the femur at the top of the inner thigh and is thus c o m m o n l y bound up w i t h t h e fascia o f t h e l o n g e r m u s c l e s g o i n g d o w n t h e leg. T h e iliacus lines t h e i l i u m . in order to walk. lengthening with every m o v e m e n t of flexion. 1 1 0 . t o o flaccid. j u s t t o t h e side o f t h e p u b i c b o n e . It maintains body structure a n d b o d y relations h i p s (Fig. t o o narrow. for part o f its l e n g t h i t r u n s a l o n g t h e f r o n t s u r f a c e o f t h e l u m b a r v e r t e b r a e . O n e fairly c o m m o n s o l u t i o n i s t o o v e r u s e t h e psoas. it is a b i l a t e r a l m u s c l e . a n d i n s e r t s b y a t e n d o n s h a r e d w i t h t h e iliac u s ( t h e i l i o p s o a s t e n d o n ) i n t o t h e lesser t r o c h a n t e r of t h e femur. 10-6A and 6B). the direction of t h e psoas changes. glued d o w n as it crosses t h e pelvic b ri m. t h e psoas should e l o n g a t e d u r i n g f l e x i o n a n d fall b a c k t o w a r d the spine. chronically flexes t h e b o d y at t h e level of t h e groin.. as t h e child crawls a n d starts t o s t a n d u p . t h e large b o n e o f t h e p e l v i c b a s i n . Rolftng: The Integration of Human Structures (New York: Harper & Row. T h e p s o a s c a n b e t o o s h o r t . W i t h t h e psoas f u n c t i o n i n g in this n o r m a l pattern. so t h a t it p r e v e n t s truly erect posture. m u s c u l a r imbalances do exist in t h e n e o n a t e . Its o r i g i n i s i n c l o s e proximity to the two tabs of the diaphragm called t h e crura. Nevertheless. At about a year old. p. As we h a v e said."* T h e preferences o f t h e psoas are n o t obvio u s a t b i r t h . A physically asymmetrical psoas t h e n leads to l u m b a r r o t a t i o n s a n d p e l v i c tilts (Fig. t h e child has s o m e h o w to solve the p r o b l e m i n h e r e n t in this muscular a n d c o n n e c t i v e tissue i m b a l a n c e . a n d size.

A t its e x t r e m e . T h e s h o u l d e r b l a d e s are so h i g h t h a t it a l m o s t looks as t h o u g h t h e y are p u s h i n g t h e h e a d forward. " It is too hard to hold y o u r h e a d up. so we c a n n o t ameliorate structure by f o c u s i n g o n o n e s y m p t o m . We prefer n o t to classify physical habits in psychological terms. t h e r e are t w o typical h o l d i n g patterns reinforcing a b e l l y t h a t sticks o u t . T h e s e start t o d e v e l o p i n t h e s m a l l c h i l d . Like t h e folds of a curtain. Starting with the work of W i l h e l m Reich. no physical p r o b l e m exists in isolation. Character Analysis (New York: N o o n d a y Press. T h e y intensify to pervade the b o d y a n d t h e personality o f t h e adult.* there has b e e n t h e t e n d e n c y t o classify characteristic b o d y postures in clinical terms. physical culture experts a t t e m p t to m o d i f y structural patterns by building up muscle mass. " It is our c o n t e n t i o n that it is n o t effective to shorten t h e belly muscles to m a t c h the tight back muscles. A n o t h e r e x a m p l e of a c o m m o n postural Figure 10-6A This masterly drawing by John Lodge has been taken from Ida Rolf's book on Rolfing. A familiar example are all t h o s e e x e r c i s e s d e s i g n e d t o " t i g h t e n t h e t u m m y . T h e y t o o a r e e x a c e r b a t e d a s t h e c h i l d starts t o w a l k . O n e i s a d e p r e s s i o n o f t h e rib a r c h ( c o s t a l a r c h ) . To get t h e n e c k straight. 1 9 9 0 ) . T h e " d o w a g e r ' s h u m p " i s t h e result o f creating an excessive pad at the base of the neck. T h e o t h e r i s a n i m m o b i l i t y at the groin (inguinal) region.44 THE ENDLESS WEB the psychological pattern tends to change as t h e physical structure is able to evolve.u p s will i m p r o v e a s t r u c t u r e w h o s e k e y is a c o m p u l s i v e l y t i l t e d p e l v i s . you m u s t exert c o n s t a n t effort to pull against d e p r e s s e d ribs a n d c o l l a r b o n e . Our assumption is that *See W i i l h e l m Reich. psychotic. w h e n t h e h e a d is forward. p. Moreover. t h e h e a d i s p u s h e d v e r y far f o r w a r d . Reich classifications were hysteric. schizoid. On t h e other h a n d . y o u will stop t h e effort as s o o n as your attention is deflected from bettering your posture. A variation of this pattern is often seen in older w o m e n and m e n . There is no way this posture can be corrected by simply "holding your head u p . into adulthood. Y o u m u s t p u s h . T h e basis for these types is considered to be b o d y a r m o r i n g . set i s f o c u s e d a t t h e b a s e o f t h e n e c k ( s e v e n t h c e r v i c a l v e r t e b r a ) . Psychological treatment of character a r m o r i n g is designed to release these patterns. We believe that n o a m o u n t o f s i t . w h i c h is w h a t we call h o l d i n g patterns. B o t h of these patterns would be reinforced r a t h e r t h a n c o r r e c t e d w i t h i m p r o p e r sit-ups. cantilevering it out over t h e chest. 7 2 . It shows the iliopsoas and its associated muscles. everything in t h e b o d y appears to h a n g from the base of the neck. For e x a m p l e .

is n o t so m u c h to achieve perfect vertical a n d horizontal structure lines in a body. t h e n . T h e y evaluate the body in terms of the logic of m e c h a n i c s and draw lines t h r o u g h t h e b o d y in t h e mind's eye. squandering their energies and working against themselves. T h e s e l i n e s are m o r e a p p a r e n t i n a b o d y t h a t i s still. T h e goal. There is a concurrent loosening of the normal t o n e of the rectus abdominis. Figure 10-6B A chronically short psoas will have its greatest impact on the groin.BODY CONTOUR 45 against h u n c h e d or rounded shoulder blades. Rather it is to free t h e soft tissues so that t h e b o d y c a n m o v e freely b y b a l a n c i n g t h r o u g h planes t h a t are h o r i z o n t a l a n d vertical. b u t b o d y workers learn to evaluate t h e u n d e r l y i n g structure of a m o v i n g body. . One very common result is lordosis and a pot belly. t h e r e are f u r t h e r h o l d i n g p a t t e r n s all t h e w a y d o w n to t h e feet. Rolfers h a v e b e e n t a l k i n g a b o u t t h e way people use their structures inefficiently. muscle. forcing the pelvis down in front. H o w can an efficient b o d y b e d e s c r i b e d ? Rolfers like t o t a l k i n t e r m s o f vertical and horizontal planes. E v e n a s s u m i n g y o u c o u l d d o all t h a t . Our goal is to h a v e j o i n t s m o v e as t h o u g h they were in line. and especially c o n n e c t i v e t i s s u e — acts together to create t h e structure t h a t gives t h e s e i m a g i n a r y l i n e s . T h e total b o d y tissue—bone.

the baby again attempts to control with arms a n d k n e e s a n d b y h o l d i n g t h e s p i n e rigid. they generally hold under the armpits or by the hands. I am a f r a i d b e c a u s e I r u n .ELEVEN Emotions and the Fascial Web t h o s e early fears. l a c k o f t r u s t . it is no l o n g e r an o b j e c t to be carried a r o u n d (however lovingly). Integrated m o v e m e n t centers around the c o n c e p t of l e a n i n g forward so that gravity r a t h e r t h a n e f f o r t i n i t i a t e s a c t i o n . R e a s o n a b l e c a u t i o n and attempts at control by the infant as it learns to walk can be retained as m o v e m e n t patterns in t h e adult. "I d o n ' t r u n b e c a u s e I am afraid. c l e n c h e d j a w s . T h e m o r e w e t i g h t e n it. It's assumed that we n e e d to learn h o w to use our brains. t a k i n g c h a r g e o f its o w n l i f e . we are taught almost everything w e d o i n life. instead of creating a relaxation response. m i n d . This "natural" reaction has an outcome t h a t i s t h e r e v e r s e o f o u r i n t e n t i o n . w e c a n ' t l e n g t h e n t h e j o i n t s t o t h e Body Awareness and Response Patterns As children. W h e n a c h i l d starts to walk. even t h o u g h this would be the best time to s h o w a c h i l d h o w t o u s e its l e g s . h e l d s h o u l d e r s . W h e n t h e b a b y w a s c r a w l i n g o n all fours. h e / s h e u n c o n s c i o u s l y restimulates . 11-1). T h e adult is n o t afraid of losing b a l a n c e a n d falling. a b a b y ' s first s t e p s . a n d y e t i t i s t a k e n f o r g r a n t e d t h a t w e k n o w h o w t o u s e o u r b o d i e s . N o o n e gives us i n f o r m a t i o n on h o w to create balance or change physical problems. " M o v e m e n t patterns express personality p a t t e r n s a s w e l l a s v i c e v e r s a . but as t h e adult walks.i n ass. T h e result is a g r a b b i n g p o i n t (or several). I n W i l l i a m J a m e s ' f a m o u s d i c t u m . s u c k e d . g r a b b e d t o e s . W h e n w e a r e s m a l l a n d l e a r n i n g t o w a l k t o o early. For m a n y p e o p l e . T h e s e a r e all i n r e s p o n s e t o o u r fear o f b e i n g u n a b l e t o c o n t r o l o u r m o v e m e n t or are d o n e to avoid ridicule or embarrassment. Even in t h e case of a b o d y part t h a t h u r t s w h e n i t i s m o v e d . This again reinforces the pattern of c o n t r o l l e d shoulders to stabilize walking. accompanied by attempts at balancing with t h e a r m s . f o r a m o m e n t . T h i s persists as t h e h o l d i n g p a t t e r n of t h e adult (Fig. I t w o u l d b e g i l d i n g t h e lily t o t r y t o i n s t i l l f o r m . fear i s m o r e a p p r o p r i a t e l y a s i g n a l f o r c a u t i o n . starts a p r o c e s s o f t i g h t e n i n g i n t h e b o d y . e n e r g y . T h e r e a s o n s o m e o n e d o e s n ' t a l l o w h i m s e l f t o " f a l l " forw a r d i n t o m o v e m e n t i s t h a t h e d o e s n ' t trust his structure. This holding is unnecessary. T h e fear o f b e i n g u n s t e a d y p r e c i p i t a t e s all sorts o f unconscious modifications—locked neck. but presumably using our bodies i s d o i n g w h a t c o m e s naturally. Yet we h a b i t u a l l y m i s i n t e r p r e t it as a s i g n a l to fight or flight. Fear m a n i f e s t s as a g e n e r a l c h a r a c t e r i s t i c in all a s p e c t s of t h e individual's identity—in body. W h e n adults h o l d a child to help it walk. It s h o u l d not cause us automatically to tighten that a r e a . I m a g i n e . T h e r e i s u n s t e a d i n e s s i n t h e f e e t a n d legs. t h e m o r e i t will hurt. T h e t r u e n a t u r e o f fear (lack of t r u s t ) is t h a t it is a s i g n a l to p a y a t t e n t i o n . The whole body c a n b e i n a fluid s t a t e a t all t i m e s . J u s t t h e f a c t t h a t t h e b a b y i s u p o n t w o legs i n s t e a d o f d o w n o n all f o u r s s e e m s m i r a c l e e n o u g h . W h e n there is unsteadiness in walking. e m o t i o n . t h e s u g g e s t i o n t o l e a n o r fall f o r w a r d . O f t e n t h i s l a c k o f t r u s t starts w i t h a r a t i o n a l fear. It is b e c o m i n g independent in the w o r l d . security lay in keeping t h e back steady and pushing off with the hands and knees. M o s t h o l d i n g p a t t e r n s are related t o e m o t i o n a l fear.

t h e r e is a t e n d e n c y to b a r r e l or r o u n d o u t in t h e lower chest. T h e m o s t c o m m o n tendency of anyone frightened is to hold his or her breath. W i t h t h e initial s h o c k of t h e cold. explain t h e m . Holding t h e breath is a w a y o f s t o p p i n g t h a t p h y s i c a l flow. M a n y p e o p l e h a v e a stored reservoir of air in t h e lower part of t h e chest. The whole body tightens and is unable to adjust to t h e coldness of t h e water. This t o o is w h e n we stop our breath. Figure 11-1 Ideally. d o n o t l e a n f o r w a r d . Later. t h e s a m e k i n d o f r e a c t i o n persists. T h e y sit d o w n . In skiing. a n y p h y s i c a l s e n s a t i o n c a n b e experienced through the body the way a s h i v e r g o e s f r o m t h e f e e t all t h e w a y t o t h e crown of t h e head. There is m o r e control in the tips o f t h e skis. it is essential to lean forward. . for e x a m p l e . As a r e s u l t .EMOTIONS AND THE FASCIAL WEB 47 point where leaning forward is comfortable. r e s p o n s e p a t t e r n s t h a t are repetitive a n d u n c o n s c i o u s tend to b e c o m e c h r o n i c . M o s t b e g i n n i n g o r i n t e r m e d i a t e skiers. our t e n d e n c y is to gasp. and we're n o t taught to breathe. b u t t h e y o n l y serve t o r e t a i n p a i n . As we h a v e said. T h e r e is also m o r e m o b i l i t y because of a greater c o n t r o l in t h e knees. T h i s i s t h e r e a c t i o n we taught ourselves in c h i l d h o o d . T h e ribs j u s t u n d e r t h e collar b o n e s a n d h i g h u p inside t h e a r m p i t are u n e x p l o r e d t e r r i t o r y — m o s t o f u s d o n o t feel o r m o v e t h e s e t o p m o s t ribs. w h e n we experience physical pain. to draw the breath into the lungs and to hold it there. m o r e lift i n t u r n i n g . We're not taught to walk as children. t h e w a t e r n o l o n g e r feels a s c o l d . so we should b e able t o m o v e t h e s e ribs freely w i t h every breath. In t h e case of t h e breath. we usually try to stop things so we can think about them. S i m i l a r l y . t h e y g e n e r a l l y fall b a c k w a r d . Being restricted at t h e t o p a n d t h e b o t t o m o f t h e rib c a g e . P e r h a p s we do this because we don't want to experience the sensation or the emotion (emotions are physically e x p e r i e n c e d ) . w e r a r e l y e x p e r i e n c e a full b r e a t h . get ourselves c o m f o r t a b l e . A s e c o n d area w h e r e there is little breath activity is in t h e u p p e r t i p o f t h e l u n g s . t h e lower ribs m o v e very little or n o t at all. w h a t we see is a p a r t i a l h o l d i n g . W h e n we are in a state of fear or c a u t i o n . a n d less c h a n c e o f falling d o w n o n steep o r b u m p y slopes. T h e afterthe-fact e x p l a n a t i o n is t h a t we are afraid to fall f o r w a r d b e c a u s e w e ' r e a f r a i d w e m i g h t h i t our heads. We're m u c h m o r e likely t o fall f o r w a r d o n t o h a n d s a n d k n e e s . An e x a m p l e is j u m p ing i n t o cold water. Letting t h e breath out allows t h e b o d y to relax. gasping and h o l d i n g t h e b r e a t h are c o m m o n . Not true. we have difficulty maintaining our r h y t h m of breathing and thinking at the same time. W h e n t h e y fall. T h e tips o f t h e lungs extend up to this region. T h i s i s p a r t i c u l a r l y e v i d e n t in sports. i n t h e a d u l t . h o w e v e r . T h e c h i l d f i n d s s o m e w a y t o p u l l its b a l a n c e b a c k .

I t h i n k a b o u t m y s h o u l d e r because it catches every time I m o v e my arm in a c e r t a i n w a y . a n d as J u n g says in h i s Collected Works. a r r e s t its m o m e n t u m . any more than we know when we m a k e other habitual gestures. W h e n a child must stop doing something. Put y o u r h a n d s o n y o u r l o w e r ribs j u s t a b o v e t h e a b d o m e n . W h e n s o m e t h i n g h u r t s . we try to put t h e pain out o f m i n d . As you come to t h e e n d o f y o u r u s u a l e x h a l e . a judgment. The exhale b e c o m e s t h e active part of t h e breathing cycle. But there is a problem. T h e same kind of process occurs w i t h respect to e m o tional pain. Pain is o n e way the body c o m m u n i c a t e s to us. especially t h e t o p m o s t a n d lowest ribs. perhaps doesn't include my hip. and so forth. t h i s i s life s u p p o r t i v e . This is often . stop t h a t activity. p a r t o f w h a t is. My sense of vitality is diminished. We h a v e o t h e r kinds of physical awaren e s s .i m a g e . a p o i n t of view. T h i s is a h a b i t . I ' m n o t going to get m u c h d o n e . This does n o t m e a n pushi n g t h e air o u t w i t h t h e a b d o m e n . T h e n there is the chronic pain. Evaluating bodies. i t must tighten or cringe—tense up. accidents. by conscious learning. Usually we don't k n o w that we're holding our breath.48 THE ENDLESS WEB O n e w a y t o e s t a b l i s h a full b r e a t h i s t o concentrate on the exhale. People h u n c h their shoulders or hold t h e m back in response to being told not to slump. If there is no injury. In general. I n a way. stop t h a t noise. b u t t h e y t o o are u s u a l l y n e g a t i v e — w e h a v e p o r t i o n s o f o u r b o d i e s t h a t w e d o n ' t like. Over t i m e . They're u n c o n s c i o u s . t h a t is n o t i n h e r e n t i n its o r i g i n a l p h y s i c a l d e s i g n . b u t r a t h e r allowing t h e rib cage to relax. This is a different kind of c o m m u n i c a t i o n . W e don't learn t h e m the same way we learn to read or to c o o k or to do algebra. t h e strain b e g i n s t o t e l l . Holding t h e breath is a pattern m o s t of us use to ward off u n w a n t e d feelings. I t results in a similar kind of d e a d e n i n g of awareness. a n d i t i s a l s o a w a y o f letting a physical problem work through the b o d y . the inhale occurs spontaneously. This kind of holding pattern puts the body i n t o a p o s i t i o n t h a t is strained. w e first c h e c k t o be sure t h a t n o t h i n g is injured or b r o k e n . concentrating on the exhale. its o n l y r e c o u r s e i s t o h o l d s o m e p a r t o f its b o d y — i t s b r e a t h o r b a c k or jaw. we tend to focus on the physical things that have gone w r o n g — illnesses. For o n e t h i n g . W h e n a c h i l d h a s t o s t o p its c r y i n g . w e are t a u g h t t o h i d e e m o t i o n . we tend to take notice only w h e n we're hurt. " T h e s e responses are so h a b i t u a l t h a t t h e y ' r e p a r t o f o u r s e l f . We learn by c o p y i n g our peers. a l l o w m o r e air to leave t h e lungs. I f m y a n k l e h u r t s a n d t h a t ' s all I t h i n k a b o u t . O n e is a direct message in terms of pain or sensation. Another c o m m o n message to children is to stop that feeling. an attitude that is shared by most people. N o w I h a v e a body image that doesn't include my ankle. our elders. I k n o w about my ankle because t h a t little twinge r e m i n d s me t h a t I n e e d to b e c a r e f u l o f it. w e feel all sorts o f aches and creaks. Patterns that we have absorbed unconsciously are harder t o c h a n g e . i t i s a v e r y g o o d w a y o f l e t t i n g all t h e air o u t o f t h e l u n g s . exasperated parents sometimes do almost anything to stop their children from crying. Feel t h e m o v e m e n t o f t h e s e ribs a s y o u b r e a t h e . our siblings. T h i s is t h e m o m e n t (in a c h i l d or adult) w h e n t h e e m o t i o n gets stored in t h e c o n n e c t i v e tissue. T h e y are m o r e i n g r a i n e d i n our c h a r a c t e r s t h a n t h o s e t h a t are a b s o r b e d knowingly. " T h e u n c o n s c i o u s is really u n c o n s c i o u s . A s w e a g e . To s o m e e x t e n t . People are rarely aware of t h e strain in their posture. t h e other is an emotional message. ways we got pushed out of s h a p e . T h e crying m a y b e reasonable. Constant low-level back pain is c o m m o n . If I shut off sensation in my ankle so I d o n ' t feel p a i n . I shut out o t h e r sensations f r o m my ankle as well. For example.

w h e n I was w a l k i n g up o n e of t h e s t e e p streets i n S a n F r a n c i s c o . love. I h a d b e e n h o l d i n g m y j a w c l a m p e d . The physical response to e m o t i o n is t h r o u g h t h e soft tissue. t h e body as a w h o l e is out of balance and o n e place is taking t h e brunt of t h e strain. In time it is impossible to determine w h i c h is cause a n d w h i c h is effect. For e x a m p l e . or contracts whenever we experience stress. I t i s t h i s p h y s ical p r o p r i o c e p t i o n t h a t w e i n h i b i t w h e n e m o t i o n or e n e r g y or structural e v e n t s are inconvenient. T h e cause. a p l a c e t h a t t w i n g e s . It simply gets stuck at our weak link. m y k n e e started to twinge. A v a r i a t i o n o f t h i s i s t h e d e l i g h t e d t h r i l l of terror in a h o r r o r m o v i e or on a roller coaster. I m a g i n e . N o r c o u l d I find a c o n v e n i e n t p l a c e t o sit d o w n . W h e n I let m y jaw relax. That's a metaphysical concept. muted. redirected. affection. It is expressed intellectually. T h e s e r e s t r i c t i o n s arise f r o m g e n e r a l a t t i t u d e s in t h e culture. There is an initial germ of awareness. whatever trouble we get i n t o reverberates t h r o u g h t h e o r g a n i s m as a w h o l e . A n d t h e n I s u d d e n l y realized t h a t i n t h e t e n s i o n o f t h e c l i m b a n d t r y i n g to get w h e r e I w a s g o i n g in a h u r r y . H u m a n b e i n g s s e e m t o b e feedback systems. t h e characteristic shiver t h a t is fear.a n a t o m y . It is an e x a m p l e of t h e c o m m o n phenomenon of how movement at one end of the body constrains the other end. A blow. i f y o u b r e a k a l e g o r s p r a i n a n a n k l e . And yet this response. M o s t of us h a v e a w e a k l i n k . T h e n t h e "logical" response is to try t o get rid o f t h e p a i n . a response to the actual e m o t i o n . T h e r e are also individual kinds of contraction and holding. Emotion and energy also have a physical c o m p o n e n t t h a t w e are i n c l u d i n g i n t h i s t e r m . this expression of the e m o t i o n a l impulse. t h e k n e e pain w e n t away a n d I was a b l e t o get u p t h e h i l l . even though the rationale behind the c o n n e c t i o n is n o t clear at t h e m o m e n t . this stoppage is the sensation of pain. for e x a m p l e . is often unrel a t e d . u n r e l a t e d t o t h e o r i g i n a l accident. T h e fascia is t h e e m o tional body. ) T h e sensation of pain is a signal t h a t s o m e thing is going on that isn't right. W e feel e m o t i o n s physically. T h e a r e a t h a t h u r t s i s not necessarily t h e cause of t h e pain. " A m o v e m e n t c o n n e c tion between jaw and knee seems obscure. f e e l i n g s a r e felt i n t h e t o t a l b o d y — e m o t i o n s travel t h r o u g h t h e fascial w e b . w e u s u a l l y t h i n k o f p a i n a s t h e c a u s e o f t h e problem. c o m p e n s a t i o n sets i n a t t h e h i p a n d b a c k t o f a v o r t h a t leg. aches. w e c o u l d c a l l i t m e t a . Ideally. O n e such type of inhibition is transferring awareness from o n e modality t o a n o t h e r . It is probably true that t h e physical manifestation of e m o t i o n is a secondary p h e n o m e n o n . t h e initial event. A l m o s t a n y e m o t i o n a l o r p h y s i c a l t r a u m a will g i v e rise t o p a i n i n t h i s stress site.EMOTIONS AND THE FASCIAL WEB 49 t h e result o f a p r e c e p t t a u g h t t o t h e v e r y y o u n g t h a t l i t t l e b o y s ( a n d girls) d o n ' t w i g g l e t h e i r rear e n d s . For e x a m p l e . T h e m o r e we're unaware of our bodies. for e x a m p l e . (A personal note from o n e author: " O n c e . an e m o t i o n a l upset. but there it was. t h e awareness o f r e s t r i c t i o n a n d p a i n c a n start a t a n y a g e . interest. a n d t h i s t h e n feeds b a c k i n t o t h e system t o b e e n h a n c e d . A n y f u t u r e p a i n o r p r o b l e m i n t h e leg. S o o n t h e pain was so severe t h a t I felt I w o u l d n ' t b e a b l e t o r e a c h t h e n e x t street corner. U n f o r t u n a t e ly. etc. e m o t i o n a l l y . p h y s i c a l l y . is part a n d parcel of the e m o t i o n itself. E v e n w h e n t h e h o l d i n g p a t tern has originated in t h e child. reinforces t h e initial c o m p e n s a t o r y habit. It is m o r e accurate to describe physical problems in t e r m s o f a r e a s o f a c u t e o r less a c u t e s e n s a t i o n . a n d so forth. Proprioception is t h e ability to sense one's own physical being. Physical a n d e m o t i o n a l awareness are c o n n e c t e d . p e o p l e w h o d o n o t . W e t h e n interpret t h e physiological sensation as anger. t h e m o r e we n e e d a g u i d e t o let u s k n o w h o w a n d w h e r e t h i n g s n e e d t o get b a c k t o t r u e . We react as systems to a n y situation. o r all t h r e e . even t h o u g h t h e t r a u m a is n o t to t h a t area.

It is always easier to deal w i t h a s i t u a t i o n i n its o w n m o d a l i t y . An e m o t i o n a l l y held part of t h e b o d y b e c o m e s rigid a f t e r b e i n g h e l d t i g h t l y o v e r y e a r s . I n t h e e x a m p l e o f t h e b r o k e n a r m . On the other hand. the reason your neck can't straighten and lengthen m a y be because of the shock of being continually bullied in c h i l d h o o d . W h e n w e c a n see e m o t i o n a l s i t u a t i o n s clearly. is w h a t y o u feel w h e n y o u break your arm. W e h a v e " f l e s h e d o u t " t h e c o n c e p t o f a c o n n e c t i v e tissue b o d y a n d given images a n d descriptions of h o w this concept c a m e into being and how it works itself o u t in an actual physical body. all t h a t r e m a i n s i s t o let g o o f t h e e m o t i o n a n d m o v e t h e a r m freely. as in a t e n s i o n h e a d a c h e . W h a t makes the pain seem physical is that it does include a structural c o m p o n e n t .50 THE ENDLESS WEB wish to recognize that they have an e m o tional pain frequently transform it into physical pain. I n t h e n e x t s e c t i o n . Conversely. B o t h h a v e b e c o m e a part of t h e structure a n d part of t h e physical m a k e u p of the body. P h y s i c a l p a i n . Physical and e m o t i o n a l sensations overlap and influence each other. S h o u l d e r s t h a t are h u n c h e d f r o m fear are difficult to distinguish f r o m shoulders t h a t are h u n c h e d a f t e r a b a d fall. it is hard n o t to experience a m i x t u r e of depression and anxiety w h e n a bad back o r a c h r o n i c h e a d a c h e flares u p . w e use t h a t i n f o r m e d perception to look at and analyze body contour. t h e h e a l e d break has m a d e t h e a r m s t r o n g e r . w e are t h e n in a p o s i t i o n to m o v e t h r o u g h a n d away from t h e m . In physical fact. for e x a m p l e . It is important to distinguish t h e m in terms of a choice of therapy. Physical w o r k will o n l y partially open that problem unless there is recognition that there m a y be an e m o t i o n a l origin. t h e r e is a lingering fear ( e m o t i o n ) t h a t t h e a r m is fragile. . Our goal is to clarify t h a t w h i c h is physical and to allow that w h i c h is emotional to be seen as s u c h . It is n o t appropriate to try to deal with a broken arm in terms of your resentm e n t at the person w h o pushed you. We have shown h o w a body functions and s o m e o f t h e h i s t o r y o f it's g r o w t h .

PART THREE Body Retinaculae (Bands/Straps) .

an ideal b o d y h a s a m o r e o r less s m o o t h c o n t o u r . T h e telltale sign of t h e p r e s e n c e of a s t r a p is a f l a t t e n i n g or d e pression running horizontally through the b o d y surface. It m a y be c o n t i n u o u s or interrupted—like a dotted line. h o w e v e r . this is probably an effective way o f s h o r i n g o u r s e l v e s u p . We describe t h e straps as b e i n g just u n d e r t h e skin because t h a t is w h e r e we see t h e m . just b e l o w the nipples. W h e n m u s c l e s are n o t b e i n g u s e d . As we describe these individually. T h e c o n t o u r patterns w e d i s c u s s i n t h i s s e c t i o n a r e a series o f s e v e n such bands. T h e s e straps o n t h e s u r f a c e o f t h e b o d y a r e similar in function to t h e armor of an armadillo. Aesthetic proportion is o n e way of interpreting body contour. t h e a r e a f l a t t e n s . To s o m e degree. b u t t h e y are visible soft tissue structures. S t r a p s s e e m t o arise i n m u c h t h e s a m e w a y as tendons and ligaments. i n t h e h u m a n body. evident i n a l m o s t e v e r y o n e . Seen f r o m t h e front.TWELVE The Chest Band Implications for Movement and Behavior I n o r d e r t o feel a l i v e a n d c o m f o r t a b l e . This freedom is visible physically in b o d y c o n t o u r : it is possible to infer f r o m s o m e o n e ' s shape t h e state of his or her energy a n d ease of m o v e m e n t . t h e r e a r e often a c c u m u l a t i o n s of c o n n e c t i v e tissue a n d fat t h a t h a v e b e c o m e c e m e n t e d i n t o p l a c e over t h e muscle tissue. t h e r e are a l s o p a t t e r n s t h a t are m o r e o r less c o m m o n t o all b o d i e s . a s t h e y r e l a x . t h a t a kid's legs a r e t o o s k i n n y . T h e s e g m e n t a t i o n of the armor holds e a c h p a r t rigid w i t h r e s p e c t t o its n e i g h b o r i n g section while nevertheless permitting some m o v e m e n t . Similarly. t h a t a w o m a n ' s h i p s are t o o w i d e . 12-1 & 12-2). t h e straps preserve e x t e r n a l structure. The most obvious aspect of the body is proportion. Theoretically. W h a t defines these as restrictive b a n d s is their inflexibility. this is located at the junction of the upper insertion of t h e rectus a b d o m i n i s . A silhouette outline shows t h e hills a n d valleys o f t h e body. we talk m o r e about w h a t t h e y i m p l y about b o t h m o v e m e n t and behavior. T h e s e p a t t e r n s a p p e a r a s s t r a p s — b a n d s t h a t w e see r u n n i n g h o r i z o n tally a r o u n d t h e body. An example is the balance between the top and b o t t o m halves of the body. a l m o s t like retaining b e l t s h o l d i n g in t h e s o f t t i s s u e (Figs. T h e m o s t obvious strap. t h e y s h o u l d b e able to relax a n d thus create no m a r k e d bulging. T h e y are u n e x pected a n d u n e x p l a i n e d . standards vary from o n e culture to another. t h e y s e e m . I n a n area t h a t d o e s n o t f l a t t e n . T h e s e a r e r e l a t i v e l y i n d e p e n d e n t o f t h e m u s c l e a n a t o m y o f t h e body. w e n e e d free flow. is a h o r i z o n t a l depression in m i d chest. We o f t e n say t h a t a m a n ' s h e a d is t o o small for his shoulders. Straps represent a f u n c t i o n a l c o n n e c t i n g structure t h r o u g h t h e b o d y w h e r e t h e r e are no traditional anatomical connections from f r o n t to b a c k . t o g o all t h e w a y t h r o u g h a s w e l l as a r o u n d t h e surface. Muscles contract and thicken as t h e y are u s e d . which they appear to resemble in structure. A s e n s e of p r o p o r t i o n is a m a t t e r of a e s t h e t i c judgment. Besides i n d i v i d u a l v a r i a t i o n s i n c o n t o u r . w h e t h e r we c a l l it a free f l o w of energy or of m o v e m e n t . p r e v e n t i n g too deep an infolding as the body bends. t h e y break t h e flow of m o v e m e n t . A s t h e b o d y m o v e s . T h e h i l l s refer t o b u l g e s a n d t h e v a l l e y s t o t i g h t places where surface tissue appears stuck to underlying tissue. T h e y m a y be visualized as planes through the body. I t i s a p a t t e r n w e see i n all h u m a n b e i n g s .

connecting the band downward to the region of the pubic bone. muscle and the lower insertion of the pectoralis m a j o r m u s c l e (Fig. It is usually a non-moving depressed area on the chest. It extends laterally to the tip of the shoulder. t h e q u a l i t y o f t h e t i s s u e differed as well. and ends at the junction of cervical and thoracic vertebrae. with permission. This band extends laterally along the upper margin of the large wings of the pelvic bones (ilia). 1 9 9 5 . 3. T h i s also . we have used the terms " b a n d " and "strap" interchangeably. The fourth band is in the area just below the nipples (chest band) and is visually the most apparent. 2. with some fibers fanning down into the armpit. 6. The lowest band in the torso (pubic band) extends from the pubic bone in front across the groin (which is thereby shortened). Its lower margin tends to include the inguinal ligament. ending at the lumbosacral junction. It travels backward along the lower ribs. like an inverted arch. hinging between the fifth and s i x t h (or s i x t h a n d s e v e n t h ) t h o r a c i c v e r t e b r a e . The back extension of this strap seems to be t h e dorsal h i n g e . The Journal of the Rolf Institute. ending at the junction of the thoracic and lumbar vertebrae. it extends along the lower border of the pectoralis major. Reprinted from Rolf Lines. 5. The band across the lower abdomen (inguinal band) is frequently more prominent in men. a functional division of the chest (thorax). The area below the chin (chin band) is an area of concentration of fibers and padding which includes the hyoid bone and the base of the jaw. When this strap is pronounced. and down the lateral margin of the latissimus dorsi where it begins to run parallel to the scapula toward the arm. passing just below the ear. but an inability to expand the ribs sideways in breathing. the skin seems glued down onto the ribs and muscle. travels across the eye sockets and above the ears. It may cross at the umbilicus (sometimes creating a crease in the abdominal wall extending out on either side of the umbilicus). The strap appears to tie the lower tip of the scapula to the back ribs and ends at the dorsal hinge of the spine. resembling an internal jock strap or chastity belt. I n f r o n t . and across the buttocks. The strap continues toward the back on the inside and outside of the upper border of the shoulder blade (scapula). and ending where the base of the skull joins the first cervical vertebra (atlas). 7. It connects the two bony projections of the pelvic bones in front (the anterior superior spines of the ilia). The third band crosses the abdomen (belly/umbilical band) and is perhaps the most variable in location. It usually dips slightly downward in front. In either case. T h e dorsal h i n g e is visible as a c h a n g e in m o v e m e n t pattern between upper and lower halves of the chest. ending at the junction of the sacrum and coccyx. t h e s t r a p starts a b o u t a n i n c h a b o v e t h e l o w e r t i p o f t h e s t e r n u m . NOTE: For the body retinaculae. It originates on the bridge of the nose. 4.54 THE ENDLESS WEB Figure 12-1 Body Retinaculae: The Seven Body Bands of the Torso 1. around the hip bones (the greater trochanter of the femur). Laterally. and ends at the back of the skull just above the occipital crest (the bump at the back of the skull). 12-3). T h e a n g l e o f t h e ribs c h a n g e d v i s i b l y a n d relat i v e l y a b r u p t l y . It can be felt as a pad of tissue just below and deep to the collar bone (clavicle). or it may lie midway between the umbilicus and the midcostal arch (tying t o g e t h e r the two sides of the costal arch). it will extend laterally to form an arch across the abdomen to the lower ribs on each side—particularly to the free tip of the eleventh rib. across the mid-lateral chest. The fifth strap at the shoulders (collar band) involves the clavicle and is part of the tissue gluing the clavicle to the first and second ribs in front. The top band (eye band) is the most difficult to visualize. T h e b a n d is slightly higher as it m o v e s around to t h e back b e c a u s e t h e ribs c h a r a c t e r i s t i c a l l y a r e a n g l e d downward in front. there is not only a depressed midchest. T h i s d i v i s i o n o f t h e rib c a g e i n t o t w o parts was apparent in our dissections.

THE

CHEST

BAND

55

A

B

Figure 12-2 Body Straps: (A) side view; (B) front view d e f i n e s t h e c o n n e c t i o n f r o m o n e side o f t h e body to the other. We tend to ignore this right-to-left relationship across t h e s t e r n u m , yet it is an i m p o r t a n t o n e , reinforcing a n d often c e m e n t i n g side-to-side variations in m o v e m e n t . Because there is little m u s c l e

t i s s u e o v e r t h e s t e r n u m a n d ribs, i t i s e a s i e r t o see w h e r e t h e c o n n e c t i v e t i s s u e h a s b e c o m e glued to t h e b o n y surface. T h e b a n d a t its d e e p e s t l e v e l i n v o l v e s t h e u n d e r l y i n g ribs a n d t h e intercostal m u s c l e s , r e s t r i c t i n g full e x p a n s i o n o f t h i s p a r t o f t h e rib c a g e i n b r e a t h i n g . S u p e r f i c i a l l y , t h e m u s c l e s t h a t are visibly i n h i b i t e d in t h e i r m o v e m e n t are t h e rectus a b d o m i n i s a n d t h e

56

THE

ENDLESS

WEB

pectoralis major. T h e rectus a b d o m i n i s spans f r o m t h e p u b i c b o n e t o t h e m i d d l e ribs o f t h e c h e s t . I t c r o s s e s t h e l o w e r m a r g i n o f t h e rib c a g e ( c o s t a l a r c h ) a n d o f t e n a d h e r e s t o it. In fact, there is a heavy t h i c k e n i n g on t h e underside of the rectus a b d o m i n i s at the costal arch, giving the appearance that the m u s c l e e x t e n d s o n l y f r o m t h e b o t t o m part o f t h e rib c a g e t o t h e p u b i c b o n e . By anatomical design, relaxation of the r e c t u s a b d o m i n i s a l l o w s t h e f r o n t o f t h e rib c a g e t o lift. T h e a b d o m e n t h e n l e n g t h e n s f r o m t h e p u b i c b o n e t o t h e ribs. T h e r e c t u s a b d o m i n i s also provides vertical stability to counterbalance the action of the long muscles of t h e back. W h e n it is h e l d tightly, there is a shortening between the mid-chest and the p u b i c b o n e . T h e result is a folding in of t h e A a b d o m i n a l region a n d a depression at the l o w e r m a r g i n o f t h e rib c a g e . T h i s i s t r u e w h e t h e r t h e h o l d i n g is caused by a postural h o l d i n g (sit-ups or a s u c k e d - i n b e l l y ) or a structural h o l d i n g (stuck c o n n e c t i v e tissue). Immediately contiguous with the upper a t t a c h m e n t of t h e rectus a b d o m i n i s is the lower margin of the pectoralis major muscle. T h i s a t t a c h e s a t t h e m i d d l e ribs, n e a r t h e stern u m , traveling f r o m there t o t h e upper part of the arm b o n e (humerus). W h a t we have, t h e n , a t t h i s s u p e r f i c i a l s o f t t i s s u e level o f t h e body, is a vertical pull f r o m t h e mid-ribs d o w n w a r d a n d a diagonal pull f r o m t h e m i d ribs u p w a r d . T h e o v e r l a p o f t h e s e t w o pulls i s at t h e s t e r n u m a n d includes t h e lower a n d m i d d l e p a r t o f t h e rib c a g e . Ideally, e a c h o f B Figure 12-3 Mid-chest strap: (A) front view; (B) side view. The arrows denote the major lines of force of the muscles involved in the movement between pelvis and arms. Ideally, movement flows through the muscles in sequence. This flow is interrupted by the mid-chest strap. Its location is defined by the major lines of force of the muscles. t h e s e t w o m u s c l e s i s s h e a t h e d i n its f l e x i b l e e n v e l o p e of c o n n e c t i v e tissue, allowing it t o s h i f t a s t h e b o d y m o v e s f r o m side t o side, walks, etc. T h e m u s c l e tissue of t h e rectus a b d o m i n i s a n d t h e pectoralis m a j o r is separate, b u t their c o n n e c t i v e tissue forms a continuous, segmented web, allowing the m o v e m e n t o f o n e m u s c l e t o b e reflected i n t o the other.

THE

CHEST

BAND

57

T h e s u p e r f i c i a l m u s c l e a n d c o n n e c t i v e tissue p a t t e r n h e r e m a y be i m a g e d as a Y w i t h a broad double base. M o v e m e n t is transmitted vertically a n d diagonally across t h e chest. W h e r e there is habitual restriction, t h e effect on m o v e m e n t is progressive. W h e r e c o n n e c tive tissue i s o r i g i n a l l y o n l y l i g h t l y h e l d down, bodily activity t h e n tends to drag t h e margins of the two adjacent muscles closer together, causing t h e c o n n e c t i v e tissue to thicken. A s t h e strap c o n t i n u e s a r o u n d t h e s i d e , going toward t h e back, it crosses t h e upper margin of t h e latissimus dorsi, a broad m u s c l e a r i s i n g f r o m all t h e s p i n e s o f t h e v e r t e b r a e from about T6 to the sacrum. Above, it narrows i n t o a t e n d o n t h a t r u n s a l o n g t h e l a t e r a l outside margin of t h e shoulder blade (scapula). It ends in an a t t a c h m e n t to t h e a r m bone (humerus). The attachments of the pectoralis m a j o r a n d t h e latissimus dorsi o n t h e a r m are a d j a c e n t . T h e y c o u n t e r b a l a n c e e a c h other and determine the openness of the armpit. The Y form on the front of the body (rectus a b d o m i n i s a n d pectoralis m a j o r m u s cles) is t h u s b a l a n c e d by a V f o r m ( l a t i s s i m u s dorsi m u s c l e ) on t h e b a c k (Fig. 12-4). T h e h o r i z o n t a l c o m p r e s s i o n t h a t w e are calling a strap crosses f r o m m i d - s t e r n u m a r o u n d to t h e side, overlapping t h e space where the pectoralis m a j o r and the latissimus dorsi m u s c l e s a p p r o a c h e a c h o t h e r . T h e s e m u s c l e s s h o u l d b e free t o slip v e r t i c a l l y w i t h r e s p e c t t o e a c h o t h e r , l e a v i n g t h e a r m full range o f m o v e m e n t . W h e n t h e y are c a u g h t up in a restriction, t h e a r m p i t is c o m p r e s s e d . T h e strap h e r e i s v e r y m u c h like t h e b o d i c e o f a dress w i t h a n E m p i r e w a i s t l i n e . A n o t h e r image that comes to m i n d is the scaffolding of the b o t t o m edge of a brassiere. T h e strap restricts lateral rib m o v e m e n t a s w e l l a s m o v e m e n t t o raise t h e a r m s . F r o m t h e lateral m a r g i n o f t h e p e c t o r a l i s m a j o r , t h e strap t h e n c r o s s e s t h e l o w e r t i p o f the scapula. It c o n t i n u e s across t h e b a c k of t h e ribs a n d t h e m u s c l e s o f t h e b a c k , a n d ends approximately at t h e dorsal h i n g e . W h e n t h e strap is h e a v y a n d tight, it inhibits t h e Figure 12-4 The " Y " of the front and the "V" of the back.

by t h e n e e d n o t to l o o k d i f f e r e n t f r o m e v e r y b o d y else. the scapula t h e n floats upward. This. o r b y resp i r a t o r y d i s e a s e . A m o r e e m o t i o n a l l y based way of expressing what we m e a n is that the blueprint of the s t r u c t u r a l p a t t e r n starts i n t h e b a b y . As t h e strap b e c o m e s tighter a n d m o r e f i r m l y e s t a b l i s h e d . T h e c o n n e c t i v e tissue assoc i a t e d w i t h all o f t h e s e h a s d i r e c t i o n a l p u l l s that modify the horizontal quality of the s t r a p . T h e pressure of hiding t h e a r m p i t s r e i n f o r c e s t h e t i g h t n e s s o f t h e strap a n d i n h i b i t s t h e l a t e r a l (side) e x p a n s i o n o f t h e w h o l e t o p o f t h e rib c a g e . T h e s e p a t t e r n s a r e w h a t w e see a s s t r a p s . protecting t h e armpits. The a r m s w e r e c l o s e l y p u l l e d i n t o t h e sides o f t h e body. a n d t o w a r d t h e pelvis. " This gave impetus to the h u n c h e d . P u d g y a d o l e s c e n t boys also c a n be uptight about nipples and breast tissue. he went through a period of b e i n g a "sulky c h i l d . obscuring the neck. is the physical description of t h e mid-chest strap—the nipple binder. by a desire n o t to b r e a t h e . t h e strap m a y b e caused b y a n accident. it merely allowed h i m to use w h a t was there. d o w n toward t h e lower lateral m a r g i n of t h e rib cage. T h e e f f e c t of b o d y w o r k was dramatic: his chest got four c o a t sizes bigger. his chest seemed too narrow in p r o p o r t i o n t o t h e rest o f h i s b o d y . T h e seed m a y be physical or e m o t i o n a l in origin. c o n t r o l . They a r e like s e e d s i n a p e a r l . r e s t r i c t i o n s t e n d t o set i n a s w e g o through the challenges of growing up. t h e p h y s i c a l h o l d i n g falls i n t o p a t t e r n s . T h e r e are a limited n u m b e r of ways to effect control in the body. they try to hide t h e m . T h i s b r o a d effect is probably a reason t h a t b r e a t h i n g d y s f u n c t i o n s are so widespread and influence every aspect of the body. T h i s i s p a r t i c u l a r l y t r u e a t t h e sides. by a desire to hide t h e breasts. T h e result is a t o r q u i n g t h a t p u l l s t h e s t r a p a w a y f r o m its main path around the chest. then. As t h e strap runs f r o m front to back. Armpits are sensitive a n d t h e p r o t e c t i v e g e s t u r e i s s i m i l a r i n all i n d i v i d uals. As an adult. First. As the reach continues. Ideally. As this child got to be about eight or nine. w h e n you reach the arm forward and up. We h a v e c o v e r e d its p a t h i n s o m e a n a t o m i c a l detail t o s h o w t h e m u s c l e a n d c o n n e c t i v e tissue p a t h w a y s by w h i c h it influences t h e body. All t h e s e d i f f e r e n t c a u s e s manifest in t h e b o d y as a similar pattern. C o n t r o l is really t h e m o s t descriptive term here. d i f f e r e n t parts o f t h e b o d y get drawn in. S o m e t i m e w e s u c c e s s fully incorporate t h e m with m i n i m a l c o n n e c tive tissue disturbance.u p physical pattern. T h e b o d y w o r k d i d n ' t give h i m t h e n e w chest. T h e c h e s t s t r a p ties i n w i t h t h e f a m i l i a r g e s t u r e o f h o l d i n g t h e a r m s t o t h e side t o guard t h e armpits. o n e child's shoulders were very narrow and high. A s s o m e girls first b e g i n t o d e v e l o p b r e a s t s . H o w d o straps c o m e i n t o b e i n g ? T h e reasons are generally m u l t i p l e a n d c u m u l a t i v e . W h i l e emotional rationales underlying a n y given structure vary. T h e r e are pulls u p i n t o t h e armpit. a n d t h e y h u n c h over for t h e s a m e reason. 12-5). hide. I n m i d . creating stress a t t h e d o r s a l h i n g e . neither the downward nor the upward m o v e m e n t of the scapula is possible without exertion and the recruitment of e x t r a n e o u s m u s c l e (Fig. An aberrant pattern takes h o l d i n t h e b o d y w h e r e t h e r e i s t h e desire t o h o l d d o w n . b e c o m e s . t h e s c a p u l a is suspended a n d c a n " f l o a t " freely over t h e ribs a s t h e a r m m o v e s . i n b a b y p i c t u r e s a t less t h a n a year old. F o r e x a m p l e . T h e y cave in at t h e sternum a n d h u n c h their shoulders. W h e n there is a restriction by a band.c h e s t . O t h e r times we grow successive c o n n e c t i v e tissue layers to c u s h i o n a n d protect ourselves from t h e irritation. the scapula drops. it crosses over a n u m b e r of additional deeper muscles as well as t h e superficial o n e s we h a v e described. We h a v e described several scenarios of physical origin. F o r e x a m p l e .58 THE ENDLESS WEB m o v e m e n t o f t h e s c a p u l a .

neck. The positions of the scapulae have been outlined. .T H E C H E S T B A N D 59 Figure 12-5 This array of shoulder movements provides comparison of three very different body types. and along the spine. Notice the great differences in muscle recruitment at the elbow.

we have the b e g i n n i n g s o f f i b r o u s c o n c e n t r a t i o n s . T h e restrictions inhibit our evolution to an " u p r i g h t s t a n c e . Individual variations pull it d o w n in o n e place. T h e straps are n o t e x a c t l y t h e s a m e i n all individuals. a n d t h e o t h e r s f o l l o w . these b e c o m e like a b r o a d t e n d o n . It is a l o c a l c h a n g e in the balance between fiber and matrix organization within the total connective tissue bed. if aberrant t e n s i o n s are m a i n t a i n e d . tighten it in another. J u d g i n g f r o m t h e t w o babies t h a t we dissected.60 T H E E N D L E S S W E B established as the character type.t o . It's n o t s o m u c h t h a t t h e c o n t r a c t i o n s start i n a n y o n e place a n d t h e n spread outward. T h e s t r u c t u r e s o m e t i m e s looks like t e n d o n in dissection. it certainly feels like t e n d o n u n d e r t h e skin. . and t h e n i s e m b e d d e d a s a n a t t i t u d e i n t h e a d u l t .b a c k a n d wide side-tos i d e . t h e p a t t e r n is laid d o w n in utero. There is s o m e variation in placem e n t a n d shape. T h e s e c r e a t e c h a r a c t e r i s t i c p a t t e r n s o f i n h i b i t i o n regardless of cause. O r t h e h e a d m a y c o m e f o r w a r d first. T h e b o d y has certain places where it can most e a s i l y c o n t r o l its o w n m o v e m e n t . " Shoulders get raised as t h e chest sinks d o w n a n d t h e head c o m e s f o r w a r d . But i n " n o r m a l " a n a t o m y n o t e n d o n s are described in that location. Later. As early as in t h e n e w b o r n . W e e m p h a s i z e a g a i n t h a t t h e strap i s n o t a s t r u c t u r e p e r s e . D e c i d i n g w h i c h i s first cause is difficult a n d usually n o t necessary. t h e differences i n e m p h a sis. T h e attachm e n t s o f t h e strap. T h e pattern as a w h o l e is sketched in a n d t h e n becomes reinforced and more pronounced w i t h age a n d use. m a y b e t h e d i f f e r e n c e b e t w e e n s o m e o n e w h o is barrel-chested and s o m e o n e w h o is very n a r r o w f r o n t . T h e strap is t h e structure as a w h o l e .

T h i s c a n b e felt a s a t o u g h m a r g i n halfway between the belly button and the pubic bone.S. h o w ever. T h e r e is very little i n t e r c e l l u l a r m a t r i x i n t h i s k i n d o f t i s s u e . " N o m a t t e r h o w m u c h I d i e t . Because of this lack of intercellular matrix.Inguinal 'band Pubic tbone B . T h e fibers are c r o w d e d i n b e t w e e n t h e c e l l s . t h e fat tissue h a s b e c o m e i n f l e x i b l e . less rigid to the touch. T h e strap b r o a d e n s across t h e lower a b d o m e n . O n e o f o u r f r e q u e n t l a m e n t s is. G y m n a s t s . i t still sticks o u t .S. h a s n o t h i n g t o d o w i t h a n e e d t o d i e t . . Its cells h a v e b e c o m e e n g o r g e d w i t h a n a c c u m u l a t i o n of fat droplets. f o r m i n g a shelflike ridge in t h e lower a b d o m e n . 13-1). I t i s therefore an effective inhibitor of energy and movement.Pubic bone Inguinal ligament " 1 A Costal arch/ Rectus abdominus m.m o o n s h a p e . The rectus a b d o m i n i s m u s c l e inserts o n t h e p u b i c b o n e so t h a t t h e strap crosses t h e lower part of this muscle. The a b d o m e n immediately above t h e ridge i s n o t i c e a b l y m o r e p l i a b l e . f o r e x a m p l e . .THIRTEEN The Inguinal Band and the Structure and Function of the Vertebral Column in Relation to the Bands A n o t h e r visually o b v i o u s strap is w h a t m i g h t be called t h e chastity belt or i n g u i n a l strap w h e n s e e n f r o m t h e f r o n t (Fig. c u r v i n g downward from these protuberances.I. Sacral pad' A. I n e v e r s e e m t o g e t rid o f m y b e l l y . T h i s k i n d o f fat i s a t y p e o f c o n n e c t i v e tissue. In m a n y people it includes n o t o n l y f a s c i a l fibers b u t fat d e p o s i t s a s w e l l . It is a connection between the top front b o n y p r o t u b e r a n c e s o f t h e h i p b o n e ( t h e ASIS o r anterior superior spines of t h e ilia). T h e strap across t h e groin is particularly apparent in people w h o perform constant r e p e t i t i v e e x e r c i s e s s u c h a s sit-ups a n d l e g lifts. Figure 13-1 Inguinal band: Front and side views. " T h e b u l g e . filling the pelvic bowl. t e n d t o h a v e an almost horizontal line across t h e groin. Inguinal band i Inguinal ligament -. This c o n n e c t i o n i s like a h a l f . These c a n e x t e n d deep i n t o t h e pelvis.

This creates a t e n s i o n across the b o n e a n d pulls t h e c o n n e c t i v e tissue i n t o folds. T h e o t h e r p a t t e r n i s t h e person w h o t i g h t e n s t h e area b e t w e e n t h e l o w e r m a r g i n o f t h e rib c a g e a n d t h e b e l l y b u t t o n . of m o v e m e n t across t h e sacrum. Or t h e tightness m a y b i n d at mid-belly. In d e s i g n . t h i s t i s s u e c a n feel like c e m e n t a n d i t o f t e n b e c o m e s a filler t h r o u g h t h e w h o l e b a s i n o f t h e p e l v i s . t h e r e are t w o a b e r r a n t a b d o m i nal patterns. it r e s e m b l e s a j o c k s t r a p or d a n c e r ' s belt. and pubic bone). C h i l d r e n typically s h o w a lot It is t h e b o d y ' s w a y of e s c a p i n g t h e restrictions resulting from tightness above (chest strap) a n d t i g h t n e s s b e l o w (groin strap). In general. M o s t "lower back p a i n " appears to c o m e from this region.s h a p e d b o n y b a s e o f t h e p e l v i s . H e r e i t b l e n d s w i t h t h e fat a n d f i b r o u s tissue t h a t is t h e n o r m a l filling of t h e space b e t w e e n t h e legs ( b e t w e e n t h e c o c c y x . t h e o t h e r m u s t of necessity stick out. t h e upper a b d o m e n b e c o m e s tight a n d t h e area b e l o w t h e belly b u t t o n p r o t r u d e s (Fig. These ropes tying together t h e t h r e e b o n e s ( s a c r u m a n d t w o ilia). People breathe predominantly in the upper or lower a b d o m e n . e n e r g y .l i k e s t r u c t u r e s a c r o s s t h e l o w e r b a c k . . pulls across t h e b a c k o f t h e u p p e r p e l v i s a n d t h e s a c r u m give rise t o t e n d o n . his back t h e n b e c o m e s taut and his upper belly b u l g e s (Fig. it adds to t h e i m m o b i l i t y of t h e area. W h e n this is t o o thick. p e l v i c rami. 13-3). This m o v e m e n t o f t e n d i s a p p e a r s i n l a t e r life. T h u s straps are n o t o n l y surface p h e n o m e n a b u t traverse t h e body space. In s o m e individuals. T h e s e c a n feel l i t e r a l l y like s m a l l r o p e s or cables under t h e skin. Similarly. t y i n g left a n d r i g h t sides t o g e t h e r . T h e b o t t o m part e x t e n d s d o w n b e t w e e n t h e legs t o t h e V . we talk a b o u t a strap there in Section 15. a n d movement. I t s e e m s t o c r o s s just b e l o w t h e u p p e r e d g e o f t h e h i p b o n e (crest o f t h e ilium). 13-2). T h e b a n d thereby is continued down to the tailbone (coccyx). W e all s e e m t o w a n t / n e e d t o control pelvic m o v e m e n t . This i m m o b i l i t y across Figure 13-2 Figure 13-3 t h e sacrum is t h e m a j o r contributor to lower b a c k s y n d r o m e . T h e s e folds c o m e i n t o b e i n g m u c h t h e way pulling on a c o r n e r of a sheet creates deep pleats in t h e fabric. particul a r l y i n m e n . i t a l m o s t feels a s t h o u g h t h e s e r o p e s h a v e k n o t s i n t h e m . t h e tissue has to go someplace. W h i c h e v e r p a r t is b e i n g held. T h e y f o r m a stressed c o n n e c tion across t h e upper margin of the sacrum a n d t h e l o w e r l u m b a r v e r t e b r a e . t h e h o l d i n g interferes w i t h t h e f r e e f l o w o f b r e a t h . T h e i n g u i n a l b a n d b l e n d s i n t o t h e fascial and/or fatty pad normally present on the s a c r u m . In either case. p r o b a b l y i n t h e t e e n s . i n h i b i t sacroiliac m o v e m e n t . N o t o n l y t h e soft tissue b u t also b r e a t h needs space. O n e is the individual whose lower belly is held in.62 THE ENDLESS WEB T h e inguinal strap c o n t i n u e s a r o u n d t h e sides o f t h e h i p s . each with variations. W h e n the V of the rami is compressed and too narrow. Here.

A b a n d of strain (inguinal strap) across t h e lowest part of t h e a b d o m e n attempts to balance that internal shortness.Sacroiliac junction Fascia of -•gluteus maximus m. In walking.THE INGUINAL BAND AND THE VERTEBRAL COLUMN 63 T h e f r o n t o f t h i s b a n d i s e a s y t o see a n d feel a n d i s m u c h t h e s a m e i n all p e o p l e . T h e r e s u l t o f all t h i s i s a t e n s i o n a r o u n d t h e p u b i c b o n e . In back. often resulting in a heavy fatty c o n n e c t i v e tissue b a n d o n top o f t h e p u b i c b o n e . a l t h o u g h it varies in degree of t e n s i o n . Jlio-tibial tract Fascia of -erector spinae jlumbo-dorsal fascia) . T h e c o n n e c t i v e tissue o f t h e psoas e x t e n d s from the inside lower back to t h e inside (medial side) o f t h e t h i g h a t t h e lesser t r o c h a n t e r (Fig. W h e n t h e p e l v i s i s b o u n d tightly in back. W e w i l l discuss t h e p s o a s m u s c l e i n S e c t i o n 1 9 . It diagonally crosses t h e p u b i c b o n e a n d a t t a c h e s o n t h e i n n e r p a r t o f t h e leg a t t h e lesser t r o c h a n t e r . T h i s i s a s s o c i a t e d with t h e fascia o f t h e gluteal m u s c l e s a n d runs f r o m t h e surface to deep in t h e pelvis. In w o m e n . t h e anterior superior spines of t h e ilium w i n g out in front. Tightness in o n e will b e reflected i n t h e o t h e r w i t h every m o v e m e n t of t h e leg or pelvis. This again adds to a wide abdominal contour. M a n y m e n are t o o n a r r o w at t h e base of t h e pelvis. t h e s a m e kind of narrowness is m o r e c o m m o n in back. . b e t w e e n t h e legs. d o w n t o t h e b o n e . T h e b r i m of t h e pelvis is pulled forward and d o w n toward the pubic b o n e . In m e n . the most p r o m i n e n t l y involved muscle structure f r o m inside t h e pelvis is t h e i l i o p s o a s a n d its a s s o c i a t e d f a s c i a . b o t h sexual f u n c t i o n and feelings a b o u t castration are c o n n e c t e d t o t h i s b a n d . W h e n t h e iliacus is very short. Figure 13-4 The connective tissue of the surface muscles relates the movement of the lower back region to the outside (lateral side) of the leg. t h e t e n s i o n on t h e outside of t h e pelvis produces a corresponding tension on t h e inside. There is a c o m p l e t e set o f m u s c l e s o n t h e i n s i d e o f t h e pelvis a s w e l l a s o n t h e o u t s i d e . t h e c o n n e c t i o n across t h e front of t h e g r o i n s e e m s like a b a n d t r y i n g t o h o l d t h e lower a b d o m e n together. T h i s results i n a n a b d o m e n t h a t i s p r o p o r t i o n ally t o o w i d e i n f r o n t . I n b o t h cases. t h e r e i s o f t e n a d e e p e r set o f t e n s i o n s n e a r t h e t o p a n d side o f t h e s a c r u m . 13-5). t h e inside of t h e leg i s h e l d t o o tightly i n t o t h e h i p socket. T h e iliacus. lines t h e inside of t h e b o w l of t h e pelvis. across t h e sacrum. 13-4). t h e o t h e r part o f t h e iliopsoas c o m plex. In m e n . T h e h i p b o n e l o o k s a s t h o u g h it wings out. in addition to t h e surface ropes t h a t run parallel a c r o s s t h e u p p e r m a r g i n o f t h e p e l v i s . T h e c o n n e c t i v e tissue o f t h e o u t s i d e m u s c l e s ( s u r f a c e ) relates t h e m o v e m e n t o f t h e lower b a c k r e g i o n t o t h e o u t s i d e ( l a t e r a l side) o f t h e leg (Fig. T h e t w o f a s c i a l p l a n e s ( s u r f a c e and deep) b a l a n c e e a c h other. T h e iliacus then tightens and is too short to function with ease.

abdominal m o v e m e n t f r o m t h e b r e a t h g o e s a s far d o w n a s t h e b a n d i n g . T h i s is a l a r g e f a c t o r in p r e m e n s t r u a l s y n d r o m e a n d the reason PMS so often does n o t yield to medication. This limits sexual e n j o y m e n t to t h e penis. so that a c c o m m o d a t i o n of the necessary changes in posture caused by pregnancy is inhibited. In pregnancy. reduces t h e severity of t h e hernia or elimin a t e s it. the w e i g h t o f t h e b a b y rests d o w n i n t o t h i s shelf. 13-6). o f t e n ris- Inguinal l i g a m e n t H (inferior j u n c t i o n of internal a n d external abdominal obliques) i Figure 13-6 Inguinal band and descent of testes. Ida Rolf's book on Rolfing illustrates the psoas and iliacus muscles on the inside of the pelvis. n o t all t h e w a y d o w n t o t h e p u b i c b o n e . T h e p e l v i c s t r a p w i d e n s i n b a c k . where it m e s h e s w i t h t h e fascia o f t h e m u s c l e s a l o n g t h e spine. . t h e strap i s m o r e c o m m o n l y focused deeper in t h e lower a b d o m e n . t h e testes leave t h e protection of t h e b o d y . These seem to be centered n o t around the scrotum. particularly in m e n . We have found that lessening the tightness of the groin b a n d Figure 13-5 This drawing from Dr. ing as h i g h as t h e twelfth rib. I n w o m e n . T h e inguinal canal is t h e target of a variety of problems. w h o o f t e n h a v e a " d o n ' t t o u c h " signal there such as ticklishness. A n o t h e r e l e m e n t in sexual blocking is m e n ' s castration worries. t h e b a n d often shows up in the breathing pattern. but at a m o r e lateral region of t h e groin where. t h e t h i c k e n e d b a n d r e m a i n s . shelving u n d e r n e a t h t h e ovaries a n d funcinguinal canal (pathway of spermatic cord) Pathway of -"testes' d e s c e n t b e f o r e birth tionally separating t h e ovaries from t h e geni t a l s . For b o t h m e n a n d w o m e n . Inguinal hernias s e e m to be t h e result of excessive strain a n d postural h o l d i n g on an area that is vulnerable and unprotected. T h e g r o i n a r e a i s t i g h t i n m o s t m e n . T h e y d e s c e n d b e t w e e n t h e t h i n layers o f t h e lower a b d o m i n a l wall d o w n i n t o t h e s c r o t u m b y w a y o f t h e i n g u i n a l c a n a l (Fig. before birth.64 THE ENDLESS WEB Restriction in the groin and pubic region o f t e n serves t o b l o c k o r d a m p e n s e x u a l e n j o y m e n t . The connective tissue of these inside muscles of the pelvis connects the inner abdomen and inside lower back to the inside (medial side) of the thigh. It's a l m o s t a s t h o u g h t h e p e n i s i s h u n g through the band. so that the tightness of the b a n d c a n b l o c k t h e o r g a s m i c w a v e t o t h e rest of t h e body. After b i r t h . T h e banding tends to be deep a n d shelflike. c a u s i n g i t t o b e c o m e t h i c k e r a n d less r e s i l i e n t .

t h e y are d i f f e r e n t i n d e t a i l s o f d e s i g n a n d size. T h e s e j u n c t i o n s are b e t w e e n t h e h e a d and neck (occipito-cervical). T h e y serve m u c h t h e same function as a busy t e l e p h o n e e x c h a n g e . t h e y are places w h e r e n e u r a l messages c a n get t r a n s m i t t e d in diverse directions. Figure 13-7 Junctions of the spine. t h e c h a n g e i n m o v e m e n t pattern is m o s t visible in a living.THE INGUINAL BAND AND THE VERTEBRAL COLUMN 65 A s w e h a v e said.( 3 ) Cervico-dorsal (1) Junction at lambda/ sphenoid (2) Occipital-cervical . t h e structural i n h i b i t i o n created by the bands influences spinal integration a n d m o v e m e n t . T h e change in vertebral shape at t h e dorsal h i n g e i s m o r e s u b t l e . Interfere n c e in spinal f u n c t i o n leads to characteristic changes in posture and physical behavior. G e n e r a l l y s p e a k i n g . t h e ANS n e r v e p l e x i a r e l o c a t e d n e a r t h e spinal j u n c t i o n s t h a t we listed a b o v e . the b a n d s relate to j u n c t i o n s of t h e spinal colu m n . between chest and lower back (lumbo-dorsal). and between the sacrum and tailbone (sacro-coccygeal). T h e reason for this a p p a r e n t l y is that the change in function and morphology here entails t h e soft tissue a n d o u t l y i n g b o n e s as well as t h e vertebrae t h e m s e l v e s . •(6)Sacro-coccygeal . W h e n t h e r e is ease of m o v e m e n t at t h e s e junctions there can be stimulation of the nervous impulses that control metabolic activity. T h e muscles a n d fascia t h a t r u n longitudinally f r o m t h e n e c k to t h e s a c r u m are a c o m plex interweaving of layers. of course. restriction of m o v e m e n t at the junctions of the vertebral c o l u m n increases t h e tightness of t h e bands. ( 5 ) Lumbo-sacral (4)Lumbo-dorsal (7) Dorsal hinge . These differences imply differences in range and direction of m o v e m e n t . T h e additional stabilizing influe n c e f r o m t h e s h o u l d e r b l a d e a n d its s o f t tissue c o n n e c t i o n s t o t h e s e v e r t e b r a e m o d i f i e s their m o v e m e n t . lies t h e a u t o n o m i c n e r v o u s syst e m (ANS). Clearly. T h i s runs l o n g i t u d i n a l l y f r o m t h e b a s e o f t h e s p i n e u p i n t o t h e h e a d . 13-7). A l o n g its l e n g t h t h e r e are a n u m b e r o f s p i n a l p l e x i . therefore. but it is m o r e i m p o r t a n t in t h e upper chest. T h e d o r s a l h i n g e i s Ida Rolf's a d d i t i o n t o t h i s list (Fig. T h e s e are i n t e r r u p t i o n s i n t h e flow o f i n f o m a t i o n a l o n g t h e system. between the neck and chest (cervico-dorsal). T h e y stabilize t h e variety of m o v e m e n t s of t h e different b o n y vertebrae that m a k e up the spinal c o l u m n . t h e b a n d a t m i d . We t h e r e f o r e digress t o d e s c r i b e s o m e a s p e c t s o f the structure and f u n c t i o n of t h e vertebral column in relationship to the bands. m o v ing body. just in front o f t h e s p i n e . b e t w e e n lower back and sacrum (lumbo-sacral).c h e s t b l e n d s with t h e fascia of t h e dorsal h i n g e in t h e region of t h e sixth dorsal vertebra. On the inside of t h e body. It is interesting to n o t e that these places of m a x i m u m m o v e m e n t o f t h e spine are associated w i t h c e n t e r s o f m o s t c o m p l e x ANS a c t i v i t y . places where t h e vertebrae c h a n g e shape. In general. A l t h o u g h t h e vertebrae are similar in s h a p e . In turn. T h i s is s o m e w h a t true everywhere along t h e spine.

Sensing. . T h e e m b r y o n i c C curve o p e n s after birth as t h e child explores a n d learns to stretch a n d l e n g t h e n . As we h a v e said. Feeling. Figure 13-8 The embryonic C curve (A) straightens as the infant begins to walk (B) and later assumes the normal adult curves (C). Ultimately. (D) standing. (B) contralateral creeping. Massachusetts: Contact Editions. t h i s is n o t a s m o o t h c u r v e . 1 9 9 3 ) . A B C Bonnie Bainbridge Cohen's Developmental M o v e m e n t Sequences* graphically *See B o n n i e Bainbridge C o h e n . (C) crawling. creating t h e snake-like f o r m of an adult upright spinal c o l u m n . and Action: The Experiential Anatomy of Body-Mind Centering (Northampton. T h e s e b e n d s are l o c a t e d a t w h a t will b e c o m e t h e s p i n a l j u n c tures. its b a c k d e s c r i b e s a C c u r v e (Fig. there is a c h a n g e in t h e direction of s o m e of t h e angles. 13-8). it is a series o f b e n d s i n t h e b a c k . A B C D Figure 13-9 Developmental movement sequences: (A) intrauterine folding.66 THE ENDLESS WEB As the embryo is enfolded in the w o m b .

T h e resulting position as t h e child hangs head back and spine locked in a backward curve causes an acute w r e n c h i n g a n d ripping of fragile fascial c o n n e c t i o n s . b e l o w ) . (3) j u n c t i o n b e t w e e n n e c k a n d c h e s t . (6) j u n c t i o n b e t w e e n s a c r u m a n d c o c c y x . T h e n c o n t r a l a t e r a l creeping a n d rocking prepare t h e b o d y for crawling (Fig.o n . Kinesthetically. Their t e n d e n c y is to pull us forward and d o w n in front. T h e b o d y straps are a w a y o f f o s t e r i n g t h i s b e c a u s e Figure 1 3 . M o s t people u n c o n s c i o u s l y try to retain s o m e part of their fetal curve.THE INGUINAL BAND AND THE VERTEBRAL COLUMN 67 demonstrate h o w these flexures interact w i t h m o v e m e n t . (2) j u n c t i o n b e t w e e n h e a d a n d n e c k . (7) Dorsal hinge . this is sensed as resistance to the feeling of openness that comes with being upright.o n e s e l f p o s i t i o n . we feel t h a t s a f e t y lies i n t h e c u r l e d . There is often resistance to activati n g s o m e o r all o f t h e s e s p i n a l j u n c t i o n s . It isn't that t h e s p i n e ( a n d t h e b o d y ) c o n t r a c t s .(1) J u n c t i o n at lambda / sphenoid (2) Occipital-cervical -(3) Cervico-dorsal These m o v e m e n t s correspond to t h e activat i o n of b o t h t h e spinal flexures a n d t h e assoc i a t e d ANS p l e x i : (1) j u n c t i o n a t t h e s p h e n o i d (see S e c t i o n 1 4 o n t h e e y e b a n d . and that this dysfunction is correctable even in the adult as t h e missing m o v e m e n t pattern is practiced. It's r e a l l y a r e m e m b e r e d safety. O n e o f t h e m o s t j o l t i n g c a n c o m e very early i n life. 13-9). in t h e first d a y s a f t e r b i r t h t h e n e w b o r n e x t e n d s its h e a d . T h e straps c r e a t e a s y s t e m o f t r a n s v e r s e r e i n forcing structures w h e r e w e d o n ' t w a n t t o (or can't) trust t h e u n d u l a t i o n s of an upright spine. As she describes t h e sequence. T r u e a d u l t s t a b i l i t y a n d s a f e t y lie i n b e i n g u p r i g h t . a n d resilient.i n . E m o t i o n a l l y . (4)Lumbo-dorsal (5)Lumbo-sacral -(6)Sacro-coccygeal they compress the b o d y at spinal junctions. there can be dysfunction. T h e r e a s o n s r e l a t e t o m a n y life t r a u m a s .1 0 Spinal junctions. . C o h e n h a s n o t e d t h a t w h e n a part of this s e q u e n c e is o m i t t e d in childhood. S o o n i t raises t h e h e a d . D a n g l i n g a n e w b o r n b y its f e e t a t b i r t h s h o c k s t h e safety of t h e curve w i t h a l m o s t a s n a p p i n g m o v e m e n t . 13-10). (4) j u n c t i o n b e t w e e n c h e s t a n d l o w e r b a c k . T h i s is very similar in effect to a w h i p l a s h i n j u r y in an auto accident. it's t h a t it refused to o p e n u p . (5) j u n c t i o n b e t w e e n l o w e r b a c k a n d s a c r u m . Full m o b i l i t y i n c r e a s e s with homolateral m o v e m e n t s — f i s h l i k e swingi n g f r o m side t o side. t h e n p u s h e s o f f w i t h its h a n d s . (7) j u n c t i o n a t d o r s a l h i n g e (Fig. flexible.

B e c a u s e o f t h e t e n s i o n t h a t these straps spread t h r o u g h t h e h e a d . T h e e y e s t r a p lies r o u g h l y a c r o s s t h e e y e s a n d a b o v e t h e ears (Fig. Mandible Ethmoid Sphenoid Zygomatic Lacrimal Frontal FOURTEEN Figure 14-1 Eye strap. m o s t o f u s a r e n ' t a b l e t o s e n s e t h e b a l a n c e o f t h e cran i u m a s a w h o l e . t h e u p p e r m u s c l e s t h a t let y o u w i g g l e y o u r e a r s . the circular muscles ringing t h e eye sockets. Laterally there is the zygomatic bone. Medially. T h e u p p e r p o r tion is the frontal b o n e . which continues a s a b o n y a r c h t o w a r d t h e ear.The Eye Band and Chin Band T h e r e are t w o straps t h a t restrict m o v e m e n t o f t h e h e a d — a c h i n strap a t t a c h e d at t h e j u n c t i o n b e t w e e n t h e atlas a n d t h e o c c i p u t a n d a n o t h e r strap t h a t seems to go right across t h e e y e s like a m a s k . 14-2). Starting at t h e f r o n t m i d l i n e . T h e eye socket is c o m p o s e d of a fusion of a n u m b e r o f b o n e s (Fig. T h e lower part of t h e orbit is a c o n t i n u a t i o n of t h e maxilla (upper jaw). P o s t e r i o r l y ( t h e back of the orbit) there is the sphenoid b o n e . a n d t h e t e m p o r a l i s m u s c l e a n d its f a s c i a a t t a c h i n g t o t h e jaw. T h e areas indirectly affected include the brain stem. 14-1). t h e r e are lacrimal a n d e t h m o i d b o n e s . and the pituitary a n d pineal glands. w h i c h also f o r m t h e upper medial part of t h e nasal cavity. T h e s t r a p like t e n s i o n f r o m t h e surface generalizes to t h e s e b o n e s . i t is at about the main junction of bones of the skull. T h e b o n e s i n v o l v e d are n o t o n l y t h e larger e x t e r n a l b o n e s o f t h e cranial vault a n d jaw. w h i c h also forms part of a shelf below t h e b r a i n . w h i c h continues on as t h e m a j o r b o n e of t h e forehead. the limbic system. I n t h e b a c k . T h e s e b o n e s are tied t o g e t h e r b y sutures t h a t a n a t o m i s t s consider to be Figure 14-2 Bones of the eye socket. H a b i t u a l t e n s i o n i n t h e surf a c e t i s s u e o f t h e skull c h a n g e s t h e r e l a t i o n s o f t h e b o n e s . this b a n d crosses t h e muscles o n t h e bridge o f t h e nose. b u t a l s o a c o m p l e x a r r a n g e m e n t o f delicate b o n e s centering a r o u n d t h e eyes a n d b a c k t h r o u g h t h e skull a t e y e l e v e l . Maxillary .

t h e free range o f e m o t i o n a l expression is also d i m i n i s h e d . 1 9 4 8 ) . S e e n like t h i s . W h e n . William Sutherland. t o t h e s u r f a c e o f t h e h e a d i n t h e flat a r e a j u s t l a t e r a l t o t h e e y e s . . I t i s s h a p e d like a b u t t e r f l y w h o s e w i n g s r e a c h Figure 14-4 Notice the juncture between the sphenoid and occipital bones at the base of the skull. I n f a c t . c o n n e c t i v e tissue is t i g h t e n e d — l o s e s a d a p t a b i l i t y — w h e n its a s s o c i a t e d b o n e s are c o m p r e s s e d . There is chronic tension in the eye s o c k e t a n d o n t h e e y e b a l l itself. 14-3). the sphenoid can't move. t h e s p h e n o i d c a n get locked in place as a result of tensions from t h e surface. hearing. they nevertheless s i g n i f i c a n t l y a f f e c t f a c i a l e x p r e s s i v e n e s s a s well as t h e free use of t h e senses—sight. it is t h e fusion of t h e apical (topmost) b o n e s . T h i s is n o t as o b v i o u s l y a spinal flexure as are t h e vertebral flexures. w h a t h a p p e n s o n t h e i n s i d e o f t h e h e a d i s reflected on t h e surface. T h i s m a y a c c o u n t f o r a n u m b e r o f c o m m o n visual problems. w h i c h he termed the b r e a t h i n g o f t h e skull. 'Temporal •Parietal Occipital We have talked about the sphenoid b o n e in relationship to t h e eye socket. O n t h e c o v e r o f The Protean Body b y D o n J o h n s o n / there is a drawing of the sphenoid f l o a t i n g i n t h e air. In e m b r y o l o g i c a l terms. B e c a u s e o f its l o c a t i o n . 14-4). A l t h o u g h t h e s e are v e r y *See William G. Prolonged immobility and compression in the socket distort t h e shape a n d adaptability o f t h e e y e b a l l itself. t h r o u g h h a b i t u a l t e n s i o n s . e m b r y o l o g i c a l l y t h i s i s t h e site o f t h e first f l e x u r e of t h e b o d y (Fig. smell. W h e n t h e eye b a n d tightens. Idaho: The Cranial Academy.* the originator of cranial osteopathy. T h e b o n e s o f t h e o r b i t are s q u e e z e d together. realized t h a t slight interosseous m o v e m e n t s . a r e n e c e s s a r y f o r t h e h e a d t o f u n c t i o n . i t t S e e D o n J o h n s o n . A s w e s a i d . G o o d v i s i o n relies o n m i n u t e m u s c u l a r a d a p t a t i o n s f o r n e a r a n d far v i s i o n . The Protean Body (New York: Harper & Row. t h e eyes are fixed Posterolateral fontanelle Figure 14-3 Fontanelles are locations of non-fusion between bones in the fetal and infant skull. Sutherland.THE EYE BAND AND CHIN BAND 69 Anterior fontanelle Posterior fontanelle Anterolateral fontanelle tiny increments of movement. 1 9 7 7 ) . Conversely. The Cranial Bowl (Meridian. immovable joints. Frontal Ethmoid -Sphenoid i n o n e attitude. i n i s o l a t i o n f r o m t h e rest o f t h e b o n e s o f t h e c r a n i u m . The dotted line embryologically is the site of the first flexure of the body. This t o p m o s t b a n d relates t o t h e suture c a l l e d l a m b d a (at t h e p o s t e r i o r f o n t a n e l l e ) . Tension across t h e orbit of t h e eye c a n result in a n a r r o w i n g of t h e entire facial r e g i o n . This interface is the focus of most cranial manipulation. T h e sphen o i d c a n also be considered t h e h u b of t h e b o n y skull w h e n s e e n f r o m a b o v e (Fig. taste.

a s h a s been demonstrated in Sutherland's cranial osteopathic work. In either case. n o d d i n g b e c o m e s a n effort a n d the head's gliding response to walking is bound down. t h e sliding m o t i o n is limited a n d m a y d i s a p p e a r . There is s o m e controversy about whether this m o v e m e n t is t h e result of an i n h e r e n t b o d y r h y t h m or a response to the r h y t h m of the breathing. W h e n o n e o f the endpoints of this flow can no longer there is habitual t e n s i o n . It is t h e keystone of the bridge b e t w e e n breastbone ( s t e r n u m ) a n d t h e a n g l e o f t h e jaw. This similarity is m o r e t h a n visual. atlas. W h e n this h a p p e n s . or immobilized. t h e h y o i d is a focus of tissue buildup w h e n Figure 14-5 Chin and collar straps. W h e n t h e b a n d is particularly tight. Cranial osteopaths have m a d e the observation that the sphenoid rocks. As we see it. 14-5). This U-shaped b o n e defines the angle between the chin and the throat. t h e o t h e r e n d p o i n t i s a l s o restricted. T h e strap just under a n d including t h e c h i n (Fig. T h e p i t u i t a r y g l a n d lies i n an indentation at the center of the sphenoid. The band continues from the hyoid and u n d e r t h e c h i n i n a n upward p a t h across t h e a n g l e o f t h e jaw. t h i s is a m a j o r factor underlying temporo-mandibular joint (TMJ) problems.70 THE ENDLESS WEB r e s p o n d freely. I t f r e q u e n t l y f o r m s a p a d o n t h e a n g l e o f t h e jaw. The gonads develop within the protection of t h e b o n y pelvis. The continuation of the band thickens around the mastoid process b e h i n d and below t h e e a r a n d g o e s o n t o restrict t h e j u n c t i o n b e t w e e n t h e occiput. inhibited. 14-5) is r e l a t e d to t h e j u n c t u r e of t h e h e a d w i t h t h e first t w o v e r t e b r a e o f t h e n e c k . In fluid b o d y m o v e m e n t . It is tugged downw a r d w h e n t h e s t r a p m u s c l e s o f t h e t h r o a t are o v e r l y t e n s e (Fig. j u s t b e l o w t h e ear. s p h e n o i d a n d pelvis m o v e i n concert and reciprocally If one doesn't move.t i m e f a s h i o n m a g a z i n e . a n d axis. A further relationship b e t w e e n s p h e n o i d a n d t h e b o n y p e l v i s lies i n t h e fact t h a t t h e y b o t h h o u s e i m p o r t a n t e n d o c r i n e g l a n d s . T h i s is s e e n as a d o u ble c h i n . t h e o t h e r i s i n h i b i t e d i n its m o v e m e n t . T h e j a w i s b o t h a sliding a n d a hinged joint. This is the juncture of the occiput with the a t l a s a n d a x i s . It surrounds and binds d o w n a floating b o n e on the front of the neck called the hyoid. d e s i g n e d t o lift sagging or double chins. T h e a c t u a l j u n c t i o n o f t h e skull w i t h t h e t o p t w o v e r t e b r a e i s c o v e r e d b y a h e a v y fascial p a d . I t i s v e r y m u c h like t h e k i n d o f c h i n strap advertised in t h e b a c k pages of an o l d . the m o v e m e n t is observable and palpable. We have seen this rocking reflected b e t w e e n pelvis a n d s p h e n o i d . Like a n y o t h e r place o f m u s c l e a t t a c h m e n t . an increasingly d e n s e a n d d e e p p a d o f tissue v i r t u a l l y i m m o b i l i z e s t h e a n g l e o f t h e jaw. W h e n the jaw is strapped back. The hyoid anchors many of the so-called strap m u s c l e s of t h e throat. is easily m i s t a k e n for t h e b o n y pelvis.

learn to release these t e n s i o n s a n d c o n t r o l t h e s e tissues w i t h m i n u t e awareness. A s t h e b a n d c o n tracts a n d distorts t h e p o s i t i o n o f t h e h y o i d . . This is o n e example where a natural p a d d i n g in t h e b o d y c a n serve a s p a r t o f a s u r f a c e b a n d s u c h a s w e are d e s c r i b i n g . Voice students. the condition of the esophagus and trachea is under the influence of these tensions. giving the appearance of a v e r y flat b a c k o f t h e h e a d . We don't think of the tongue being tense. Moreover. this generalizes tension into t h e back of t h e tongue.I II I 1 YI HAND AND C H I N HAND 71 about an inch thick. Extreme tension at the back of the head p u s h e s t h e skull b o n e s t o o far f o r w a r d o v e r the neck bones.6 . Visualization of the upper body bands on p h o t o g r a p h s i s s h o w n i n Figure 1 4 . T h e d i f f i c u l t y arises w h e n t h e t e n s i o n i s excessive a n d b e c o m e s a tight surface strap. but it can be. for e x a m p l e . Figure 14-6 Upper body bands.

I t involves primarily t h e base of the throat. W h e n there is a heavy pad on top of the acromion. medially a n d laterally. are evidence of t e n s i o n w h e n this strap h a s b e c o m e too tight. w h e t h e r o p e r a o r s h o w e r s i n g e r s . r e s p e c t i v e l y . Umbilical Band. T h e m o s t c o m m o n result i s compression around the base of the neck. like t h e o t h e r straps. It ends b y spreading o u t over t h e area o f t h e dowager's h u m p — f r o m t h e upper medial tip of the scapula to the cervicothoracic j u n c t i o n . • Clavicle Coracoid process •Sternum FIFTEEN a c r o m i o n just in front of t h e shoulder joint. in a w h e e l w i t h ball bearings. c a n be c o m p a r e d to a p i e c e of c l o t h in w h i c h part of t h e weaving is very tight a n d part of it is very loose. T h i s s m a l l m u s c l e i s active in respiration w h e n t h e c o l l a r b o n e m o v e s i n relation t o t h e ribs. T h i s p r o j e c t s like a b o n y s h e l f o v e r the t o p m o s t part of t h e arm b o n e (humerus). and Groin Band Like t h e c h i n s t r a p . t h e subclavius is i m m o b i l i z e d b e t w e e n t h e t w o bones. T h e tightest area b i n d s t h e clavicle a n d t h e u p p e r part of t h e s c a p u l a . Acromion Scapula Fascia of _ scalene m Hyoid bone Collar strap . In front. just b e h i n d t h e c o l l a r b o n e s . W h e n t h e fascial c o v e r i n g o f t h e m u s c l e i s t h i c k e n e d . 15-1)—is of g r e a t i m p o r t a n c e to singers. its m o s t s t r i k i n g f e a t u r e is a t i g h t n e s s underneath the Adam's apple where the two clavicles (collarbones) m e e t t h e s t e r n u m (breastbone). It includes a small m u s c l e called the subclavius. T h i s s t r a p a t t h e b a s e o f t h e t h r o a t . T h e c o l l a r b o n e s are t i g h t l y g l u e d d o w n t o t h e u p p e r ribs i n f r o n t a n d t i g h t l y h e l d t o t h e upper margins of t h e shoulder blades (scapulae) i n t h e b a c k . w h i c h can be a misleading c o n c e p t . t h e ball bearings m o v e o n l y slightly.The Collar Band. pulling the arm in closer to the b o d y and . t h e upper tip of t h e lungs. D e e p h o l l o w s a t t h e b a s e o f t h e n e c k . For e x a m p l e . T h e clavicle articulates with t h e Figure 15-1 The collar strap. This c o n n e c t s the m i d dle s e c t i o n o f e a c h c o l l a r b o n e t o t h e first a n d s e c o n d ribs a n d c o n t i n u e s a s l i g a m e n t s t o t h e sternum and coracoid process. t h e n e x t s t r a p — t h e c o l l a r strap (Fig. t h e strap seems to e n c l o s e t h e w h o l e length of t h e c o l l a r b o n e as well as t h e two u p p e r m o s t ribs.Fascia of strap m. T h i s is t r a d i t i o n a l l y d e s i g n a t e d as a s l i g h t l y movable joint. any m o v e m e n t is inhibited b e t w e e n clavicle a n d scapula a n d acts as a brake o n t h e lateral (sideways) m o v e m e n t of the arm. T h e l o o s e r e x t e n s i o n s b r o a d e n its influence out i n t o the upper part of t h e arm. But if o n e is stuck. a n d t h e upper m a r g i n of t h e shoulders. T h e collar strap c o n t i n u e s a l o n g t h e clavicle t o t h e t i p o f t h e s h o u l d e r b l a d e ( a c r o m i o n ) . t h e larger m o v e m e n t of t h e wheel stops or eccentrically grinds d o w n its c o m p o n e n t s . W h e n this strap is very t i g h t . T h e strap c o n t i n u e s t o w a r d t h e b a c k a l o n g the inner and outer margin of the scapula.

W h e n a n g r y . t h e shelf c a n be seen on t h e surface of t h e body. W h e n b o t h pulls are unusually s t r o n g .d o r s a l hinge in the back tends to make the body look as t h o u g h it were divided into an upper a n d a l o w e r h a l f . Two characteristic m o v e m e n t patterns reinforce t h e tightness of this strap—compressing the armpits and h u n c h i n g the shoulders. In t h e collar strap. Any stressful s i t u a t i o n c a n s e r v e t o t i g h t e n t h e t h r o a t a r e a . crossing t h e b o d y like a shelf. T h e strap associated with t h e u m b i l i c u s (Fig. I n grief w e g e t " a l l c h o k e d u p . It is v a r i a b l e in its p o s i t i o n r e l a t i v e t o t h e u m b i l i c u s . and marked c h a n g e s i n c o l o r a r e all i n d i c a t i o n s o f c h a n g e in c o n n e c t i v e tissue fluidity a n d b o d y flexibility. a few i n c h e s . c l o s i n g t h e a r m p i t a n d c o m p r e s s i n g t h e upper ribs. O t h e r fibers e x t e n d i n t o t h e a r m p i t . This k i n d of i n t e r a c t i o n also occurs b e t w e e n t h e c h i n strap a n d t h e collar strap. C h r o n i c t e n s i o n i n t h e fascia surrounding these muscles brings the front p a r t o f t h e t w o straps c l o s e r t o g e t h e r . T h e s e c o n c e n t r a t i o n s o f fibers w e c a l l s t r a p s n o t o n l y c i r c l e t h e b o d y o n its s u r f a c e b u t h a v e a third dimension going deep inside. Tightness f r o m b o t h o f t h e s e straps i n t o t h e a r m p i t inhibits freedom of m o v e m e n t of the arm at t h e shoulder joint f r o m above and below. habitual anxiety. T h e u n d e r s i d e o f t h e s c a l e n e s c a n a n d o f t e n does h a v e a fascial c o n n e c t i o n to t h e upper tip of t h e lungs. this c a n cause a vertical c o m p r e s s i o n on t h e upper chest. I t c a n r u n just u n d e r t h e s m a l l c a r t i l a g e a t t h e b o t t o m o f t h e stern u m (the x i p h o i d process). Armpit c o m p r e s s i o n is a k i n d of guarding. Reduced r a n g e o f m o t i o n i n t h e s h o u l d e r ( c o l l a r strap) correlates with lack of m o v e m e n t in the upper ribs a n d shortness of breath. Like t h e o t h e r s . B o t h r e s u l t i n l a c k o f m o b i l i t y i n t h e u p p e r ribs a n d a kind of breathless feeling. etc." T e n s i o n i n t h i s area a f f e c t s s p e e c h a s well as m o r e c o m p l e x vocalizations such as singing or playing a wind instrument. t h e eye strap a n d t h e c h i n strap pull o n e a c h o t h e r i n t h e r e g i o n j u s t b e h i n d t h e ear. protecting t h e breasts. For e x a m ple. protecting the body because of ticklishness. areas t h a t are ticklish or painful to t h e touch. W h e r e strong vertical m u s c u l a r a n d fascial pulls cross t h e b a n d s . Very d e e p h o l l o w s in t h e body. or it can be carrying the weight of the world on your shoulders. and it strongly influences the front of the throat. T h e c h e s t s t r a p (see S e c t i o n 1 2 ) i n t e r a c t s w i t h t h e c o l l a r s t r a p v i a t h e c o n n e c t i v e tissue of t h e pectoralis m a j o r . Shoulders pulled up c a n also be a response to perpetual anxiety.74 THE ENDLESS WEB r o t a t i n g i t s l i g h t l y o u t o f its s o c k e t . a s c a n be seen in people w h o "lead with their chins. t h e collar strap is present i n all b o d i e s t o o n e d e g r e e o r a n o t h e r . It crosses over t h e o f t e n . " T h i s i s a t least p a r t o f t h e m e c h a n i s m t h a t u n d e r l i e s fear o f p u b l i c speaking. 15-1). a n d a m i n i s c u l e n u m b e r of us m a k e use of this upper tip of our respiratory capacity. Four muscles ( c o m m o n l y termed the strap muscles) a t t a c h t h e h y o i d b o n e t o t h e u p p e r t i p o f t h e b r e a s t b o n e . t h e straps overlap. Both act on t h e m o v e m e n t of t h e jaw a n d t h e tipping of t h e head. 15-2) i n t h e f r o n t a n d t h e l u m b o . S o m e t i m e s i t i s less v i s i b l e b u t c a n b e felt as a very tight b a n d a l m o s t at b o n e level. Mindset v e r y q u i c k l y b e c o m e s b o d y s e t . t h e s t r a p t h e n b e c o m e s l o c a l l y d e n s e r b o t h i n its h o r i z o n t a l direction a n d in t h e vertical crossb a n d i n g s .h o l l o w spot in t h e base of the neck containing the scalene musc l e s (Fig. Functionally. Very few of us are aware t h a t lungs e x t e n d so h i g h up in t h e body. S o m e times it is visible as a light b a n d i n g on t h e s u r f a c e . T h e larger stern o c l e i d o m a s t o i d overlies these a n d provides a direct vertical c o n n e c t i o n between t h e t w o s t r a p s . t h e w h o l e area b e c o m e s a t h i c k e n e d mass of tissue. o n e ' s v o i c e m a y rise o r w o r d s m a y n o t c o m e o u t .

Or it m a y e x t e n d across t h e a b d o m e n an i n c h or so b e l o w t h e u m b i l i c u s (Fig. T h e pubic or groin strap is t h e lowest strap i n t h e a b d o m e n (Fig. 15-3). a n d t w e l f t h —are attached to the diaphragm and establish its w i d t h a n d r a n g e o f m o v e m e n t . 15-4). T h e r e s u l t o f t i g h t n e s s in t h e strap is a d i a p h r a g m t h a t is f u n c t i o n ally a n d s t r u c t u r a l l y t o o n a r r o w a n d c o n s e quently overworked. T h e free r i b s — t e n t h . Breathing capacity is more labored and the diaphragm begins to a c t like a r e t a i n i n g s h e l f a c r o s s t h e b o d y . At t h e sides. i t i s a c o m p o n e n t o f t h e v e r y c o m m o n t e n s i o n c e n t e r e d o n t h e free m a r g i n s o f t h e l o w e r r i b s . H o w deeply it is pulled into t h e b o d y seems to influence t h e position of t h e strap (and vice v e r s a ) . ribs •Umbilicus •Umbilical strap Figure 15-2 Note that the area of the eleventh and twelfth ribs is the lumbo-dorsal junction. i n m o s t cases a little b e l o w t h e arch of t h e ribs. UMBILICAL BAND. A n e x t r e m e version of this is k n o w n as a pigeon breast. f o r m i n g a deep i n d e n tation e x t e n d i n g o u t to either side. o f t e n i m m o b i l i z i n g t h e free tips o f t h e t e n t h a n d e l e v e n t h r i b s .THE COLLAR BAND. e l e v e n t h . T h e t i p o f t h e e l e v e n t h rib i s pulled deep into the b o d y in m o s t people. t h e e l e v e n t h rib c a n b e pulled d o w n toward t h e pad o n t h e crest of the hip bone. It m a y run directly across t h e u m b i l i c u s . S i m i l a r l y . i t m a y compress t h e a c t i o n of t h e lateral part of t h e d i a p h r a g m . T h e r e i s s o m e s e m b l a n c e of this strap in e v e r y o n e . T h e strap c o n t i n u e s t o t h e b a c k by way of t h e twelfth rib i n t o t h e l u m b o dorsal j u n c t i o n . Umbilicus Umbilical ^trap (variable locations) . It seems to run b o t h inside a n d outside t h e ribs. g e n e r a l l y p u l l i n g t h e free e n d s o f t h o s e ribs d e e p i n s i d e t h e b o d y . t h e e l e v e n t h rib lies j u s t b e l o w a t h i n sheath of muscle and skin and establishes the width of the lower chest in t h e back. I t i s p o s s i b l e f o r t h e t w e l f t h rib t o b e deflected d o w n almost to t h e rim of t h e p e l v i s . T h e b a n d c o n t i n u e s t o w a r d t h e sides. I n d o i n g s o . I t m a y b e s e e n o n Figure 15-3 The location of the umbilical strap is variable Costal arch 11th&12th. AND GROIN BAND 75 above the umbilicus. Ideally. T h e u m b i l ical s t r a p i s t h u s c l o s e l y a s s o c i a t e d w i t h t h e d i a p h r a g m o n t h e side.

crossing the groin. It c o n t i n u e s sideways a r o u n d t h e body. T h e p u b i c strap is a c o m p l e x weaving in a n d out of t h e b o n y structure at the base of t h e a b d o m e n . After i t crosses t h e inguinal ligament. 15-5). crosspulls o n t h e b a n d t e n d t o b e s o m e w h a t o b l i q u e . Posteriorly. s o m e o f t h e fibers o f t h e p u b i c b a n d run d e e p t o t h e h i p j o i n t r a t h e r t h a n a c r o s s its o u t e r surf a c e . This vertical retaining b a n d for t h e front of t h e b o d y is very c o m m o n l y h y p e r t o n e d (overstrong). A diagonal heavy ligament (the inguinal ligament) connects the anterior superior spines o f t h e h i p b o n e t o t h e lateral points of the pubic b o n e . a l o n g t h e p u b i c r a m u s . of the sacrum with the tailbone (coccyx). c o m i n g f r o m t h e leg. This is crossed by t h e h o r i z o n t a l p u l l o f t h e p u b i c b a n d . it runs deep to the lower border of the gluteus m a x i m u s (Fig. c o m i n g f r o m t h e crest o f t h e hip b o n e . T h e act of habitually sucking in t h e belly itself s h o r t e n s t h e front of t h e body. it c o n t r i b u t e s to (and s o m e t i m e s forms) t h e gluteal fold. It blends into t h e heavy pad f o u n d on t h e ischial tuberosities (sitting b o n e s ) . In addition. 15-6). . As t h e strap crosses t h e greater t r o c h a n t e r o f t h e f e m u r . mixing with the b u i l d u p o f fat a n d f i b r o u s t i s s u e s o o f t e n f o u n d o v e r t h a t p r o t u b e r a n c e . In the center front. a n d f r o m a b o v e . t h e b a n d c o n t i n u e s l a t e r a l l y o v e r t h e g r e a t e r t r o c h a n t e r (at the top of the thigh bone). anterior view (also showing inguinal strap and ligament). O n e arises f r o m t h e l o w e r m a r g i n of the oblique muscles of the abdomen as t h e y c o m e d o w n t o f o r m t h e i n g u i n a l ligam e n t . a l t e r i n g t h e w a y t h e f e m u r tits i n t o t h e h i p socket. parts of t h e strap exist as a V-shaped t h i c k e n i n g on t h e inside of t h e legs. As was t h e case in t h e collar strap. T h i s relates to o u r cultural preference f o r a flat b e l l y a n d t o o u r t e n d e n c y t o o v e r e x ercise. T o t h e rear. T w o internal cross-structures are l o c a t e d h e r e — t h e pelvic a n d urogenital diaphragms. there is a vertical c o n n e c t i o n b e t w e e n t h e rib c a g e a n d t h e pubic crest associated w i t h t h e rectus abdom i n i s a n d its c o n n e c t i v e t i s s u e (Fig. t h e r e are p u l l s f r o m b e l o w .76 THE ENDLESS WEB the front of the body in the dense pad of c o n n e c t i v e tissue on t h e surface of t h e pubic b o n e . e n d i n g a t t h e j u n c t i o n Figure 15-4 Groin strap. posterior view. T h e strap i s s p l i t — p a r t o f i t g o e s b e t w e e n t h e legs a n d part goes a r o u n d t h e legs. The internal extension of the p u b i c strap is c o n t i n u o u s w i t h t h e c o n n e c t i v e Figure 15-5 Groin strap. O n e i t h e r side o f t h e p u b i c b o n e . S t r o n g cross-pulls are associated w i t h this b a n d .

a n d c o n t i n u o u s with. T h e pelvic a n d p u b i c straps h a v e very h e a v y vertical i n t e r c o n n e c t i o n s in front a n d back. a n d t h e vert e b r a l c o l u m n i s t h e s h a f t . c e m e n t i n g t h e c o c c y x i n t o a fixed attitude. like t h e arrow tip. T h e Vshaped sacrum is t h e arrowhead. a t its connection with the sacrum. Unfortunately. a n d sports trainers d o n ' t t h i n k t h e c o c c y x is very i m p o r t a n t . gives a m o d i f i e d " j o c k s t r a p " or "chastity belt" under t h e skin. AND GROIN BAND 77 tissue of b o t h of t h e s e . 15-7). r o l l e r skates. W h e n the pubic strap t i g h t e n s d o w n . tailbone has no support to pull it b a c k i n t o position. I n l a t e r life. urethra. guides t h e direction of m o v e ment. UMBILICAL BAND. To us. a c c i d e n t s i n v o l v i n g b i c y c l e s . the spine compensates by flexion.THE COLLAR BAND. these diap h r a g m s are p e n e t r a t e d by. a n d m a n y t e a m sports s e e m s o m e h o w t o f o c u s o n t h e t a i l b o n e a n d its a p t i t u d e f o r getting j a m m e d . we don't consider t h i s d a m a g e — n o b o n e i s b r o k e n . . Most doctors. t h e t w o straps are c o n n e c t e d by a h e a v y pad on b o t h the inside and the outside of the sacroiliac j u n c t i o n . In the back. A w r e n c h e d Figure 15-6 Groin strap with rectus abdominis. In turn. and vagina (Fig. extension. it reduces flexibility. But this can be o n e of the longest lasting kinds of imbalance in the body. straps b e t w e e n . no o n e has ever seen a plaster cast on a tailbone. It has sideways ramifications that thicken the inguinal ligament. I t i s a l s o . bodyworkers. the endpoint of t h e p u b i c strap. This configuration. and the Figure 15-7 The pelvic and urogenital diaphragms. Children repeate d l y fall b a c k w a r d o n t o t h e i r t a i l b o n e s . The location of the tailbone is important because it is o n e e n d of support for t h e h a m m o c k c a l l e d t h e p e l v i c f l o o r . with the connections in front and back. the musculature of the rectum. In general. seen a n a t o m i c a l l y . T h e c o c c y x . In front this is partly the c o n t i n u a t i o n of t h e lower rectus a b d o m i n i s fascia as it traverses t h e a p r o n o f t h e pelvic strap t o w a r d t h e pubic strap. t h e t a i l b o n e is one of the most vulnerable and accidentprone locations in t h e body. it is r e m i n i s c e n t of t h e tip of an arrow. and rotation. i t i s n ' t serious.

78 THE ENDLESS WEB Figure 15-8 .

BODY

RETINACULAE

(B A N D S / S T R A P S)

79

Figure 1 5 - 9

PART

FOUR

Anatomy and Function

SIXTEEN

Proprioception
o k a y t o zip y o u r fly a n d b r a g a b o u t t h a t . It's okay as a teenager to be athletic and to show o f f y o u r p h y s i c a l p r o w e s s . It's n o t o k a y t o swank your hips or push out your breasts. W h e n w e g i v e u p t h e f r e e d o m t o feel o u r bodies in this way, it is n o t a f r e e d o m easily regained. T h e teenager w h o chooses n o t to feel m o v e m e n t i n h i s o r h e r h i p s m a y f i n d a s an adult t h a t t h e r e is a loss of sexual feeling. Pelvic m o v e m e n t , sexual identity, a n d t h e like a r e l o a d e d a r e a s o f a w a r e n e s s . E v e n i f w e turn to s o m e t h i n g neutral, such as throwing a ball, p r o p r i o c e p t i o n o f t h e m o v e m e n t will b e defined by body image, m o v e m e n t image, accidents, and physical structure. Proprioception is the summation of our physical history into the m o m e n t of present a c t i v i t y . As I t h r o w a b a l l , I m a y f e e l my w r i s t s n a p p i n g a s t h e b a l l i s r e l e a s e d b u t h a v e less awareness of h o w my elbow extends. I m a y feel m y a r m a s I t h r o w , b u t n o t h o w m y a r m c o n n e c t s to my back or h o w my back is supp o r t e d t h r o u g h m y pelvis a n d legs. I n t h e Midwest, t h e t e r m for this kind of w h o l e b o d y e n g a g e m e n t is " b o d y English." Every physical act reverberates t h r o u g h t h e w h o l e body, a n d t h i s c a n b e c o n s c i o u s l y felt. P r o p r i o c e p t i o n , then, is sensing the mechanics of m o v e m e n t . W h e r e there is a gap in proprioception, there is a habitual i n h i b i t i o n of m o v e m e n t . This is a n c h o r e d i n t h e f l e s h b y loss o f e l a s t i c i t y i n t h e c o n n e c t i v e t i s s u e , a r e d u c t i o n i n its a b i l i t y t o s t r e t c h a n d t h e n r e t u r n t o its o r i g i n a l shape. Releasing these contractions in the c o n n e c t i v e tissues is a m a t t e r of physical or mental awareness. T h e straps i n h i b i t p h y s i c a l r e s p o n s i v e n e s s a n d proprioception. An i m a g e of h o w a strap w o u l d feel p r o p r i o c e p t i v e l y i s a w o m a n i n t h e

Internal Body Awareness
M o v e m e n t can be evaluated from the outside by a trained observer. It is evaluated f r o m t h e inside by proprioception. This is t h e internal physical sensation of position in three-dimensional space. Most of us c a n sense our bodies to s o m e degree. W h e n we t u n e in, however, it is surprising h o w m a n y parts of our bodies we d o n ' t f e e l . For e x a m p l e , m o s t p e o p l e w a l k around with one shoulder higher than the other, o n e eyebrow higher t h a n t h e other, etc. Yet w e are rarely a w a r e o f t h i s . W e a r e s t a r t l e d w h e n s o m e o n e points it out, and usually find it difficult to sense e v e n t h e n . W i t h s o m e effort, w e m a y feel o u r f e e t , b u t f i n d i t i m p o s sible t o s e n s e o u r a n k l e s . W e m a y b e a b l e t o r e a c h o u r l o w e r legs, b u t s o m e h o w c a n ' t g e t a sense of our i n n e r thighs. T h e older w e get, t h e m o r e w e t e n d t o limit our body sense to w h a t hurts. Children often seem to have a pleasurable sense of their b o d ies. T h r o u g h t r a i n i n g , a c c i d e n t s , a n d u n w e l c o m e sensations, adults learn n o t to take pleasure in their bodies. Everything f r o m cultural taboos t o u n w a n t e d e m o t i o n s a n d painful memories (physical a n d e m o t i o n a l ) t e a c h a d u l t s t o b e less a w a r e o f t h e i r b o d i e s . Proprioception is the conscious part of body awareness. There is also an u n c o n s c i o u s aspect of t h e body, and it is here that cultural b o d y i m a g e s are t h e m o s t p r o f o u n d l y i n f l u e n t i a l . V i c t o r i a n i d e a s o f " n i c e n e s s " still e x i s t i n t h e m o d e r n g u i s e o f o k a y - n e s s . It's o k a y t o feel m y s h o u l d e r s ; it's less o k a y t o feel m y b r e a s t s , a l t h o u g h it's m o r e o k a y t o feel m y breasts w h e n I'm a l o n e t h a n w h e n I ' m i n public, and this is again different from breast s e l f - e x a m i n a t i o n . Little c h i l d r e n are t a u g h t t h a t it's o k a y , e v e n w o n d e r f u l , t o t i e y o u r s h o e l a c e s a n d b r a g a b o u t it. It's m u c h less

or eating at a t a b l e all s h o w c h a r a c t e r i s t i c b o d y h a b i t s .84 THE ENDLESS WEB early part of this c e n t u r y wearing a corset. Normally. T h e y don't use their full c h e s t ." We are apt to a s s u m e a " b e t t e r " posture. M o v e m e n t s s u c h a s w a l k ing d o w n t h e street or up steps. o r o u r legs. are s i g n s o f t h e c o n n e c t i v e tissue pattern u n d e r t h e skin. Auditory types c o m pare what t h e y perceive physically to verbal d e s c r i p t i o n s a n d are m o r e o f t e n aware o f internal structure and imbalances. W h e n the body moves." W e are r a r e l y a t rest i n f r o n t o f a m i r r o r . p u l l t h e legs i n t o t h e h i p . We usually feel our arms to be shorter t h a n t h e i r l e n g t h . as shorter t h a n t h e y are. t h a t w e are a " d o i n g " s o c i ety. S h e h a s little o r n o articulation o f m o v e m e n t between the top and b o t t o m halves of her b o d y . it must move around t h e h e l d place. t h e o n l y t h i n g a Rolfer c a n do is allow the person to b e c o m e m o r e precisely aware of t h e area of h o l d i n g . s h o r t e n t h e n e c k . o r a full p e l v i s . W h e n p e o p l e b e c o m e aware o f these gaps in proprioception and the accompanying h a b i t u a l attitudes. a n d shelves through the body. P r o p o r t i o n a n d b a l a n c e are t h e keys t o m o v e m e n t . M e n o f t e n h a v e t h i n legs. b u t feel surprise a t o u r p r o f i l e a n d e v e n m o r e a t o u r s h a p e i n b a c k . t h e y s h o r t e n the body. We m a y be a c c u s t o m e d to our frontal i m a g e . whether seen from the outside or s e n s e d i n t e r n a l l y . vertical holdings. t h e y are surprised. effort has to be e x p e n d e d to hold it rigid w h i l e w a l k i n g . . A s w e see o u r s e l v e s i n a m i r r o r . t h e full p o t e n t i a l o f t h e i r rib c a g e . It is n o t always possible to release structures like this b y physical m e a n s a l o n e . O n e indicator of the difference between reality a n d internal image is t h e sense of unfamiliarity w h e n we're faced by a three-way mirror. a similar structure under t h e skin occurs. Struct u r a l a b e r r a t i o n s a n d p r e f e r e n c e s are f u n d a m e n t a l l y a m a t t e r o f h o l d i n g s o m e p a r t rigid. t h e skull b o n e s c o m p r e s s . T h e r e a r e p e o p l e w h o are p r e d o m i n a n t l y visual a n d t h o s e w h o are auditory. people sense their h e a d as being m u c h smaller t h a n t h e actual physical structure. Anomalies in physical proportion or balance. for e x a m p l e . w e are i n m o v e ment. t o o . P r o p r i o c e p t i o n is filtered t h r o u g h percept u a l s t y l e . If we did. It's w o r t h n o t i n g h e r e . U n c o n s c i o u s l y . and in m o v e m e n t the limitations of a structure b e c o m e m u c h m o r e apparent. W o m e n often have thin arms. b u t u n t i l t h e individual is ready to feel m o v e m e n t t h r o u g h t h e area. W e t e n d n o t t o f e e l this as a restriction. V i s u a l i z e r s t e n d t o see a n d k n o w a b o u t t h e i r external physical image. Possibly this reflects p s y c h o l o g i c a l a s s u m p t i o n s about o u r c a p a c i t y . A Rolfer c a n set t h e stage for t h e release. reflecting t h e c o n n e c t i v e t i s s u e s t r u c t u r e w e h a v e b e e n talki n g a b o u t — t h e surface b o d y straps. O f t e n p e o p l e a r e u n w i l l i n g t o o c c u p y all of their potential space. C o n n e c t i v e tissue c a n h a r d e n t o t h e p o i n t w h e r e i t a c t s like a c o r s e t . W h e n w e d o n o t f e e l m o v e m e n t in t h e waist or at t h e t o p of t h e pelvis. Static proprioception b e c o m e s more c o m p l e x i n m o v e m e n t . This shows as a narrowness at t h e temples. p e r h a p s a t i g h t e n i n g o f t h e legs i n r e s p o n s e t o a t i g h t e n i n g of t h e pelvis. it w o u l d be irritating. T h e r e is a l s o a p h y s i c a l result o f this kind o f attitude. p a r t i c u l a r l y t h e t h i g h b o n e s . stand up "straighter. there m a y be an unwillingness to demonstrate the potential or power that is available in arms and should e r s . A s s h e w a l k s . i t i s c o m m o n t o m a k e automatic adjustments to "look better. T h e letting go is done by the client. develop curvatures of the spine. diaphragms. Instead. A l m o s t invariably. pull our shoulders back. creating a head that is too long and too deep. W h e n I'm n o t aware o f t h e full s p a c e i n m y h e a d . w e simply feel t h e c o m forting familiarity of n o t being able to m o v e our waists. W h e n t h e h i p i s restricted. u n d u l a t i o n f r o m h e r legs t h r o u g h her waist i n t o h e r chest a n d shoulders i s i n h i b i t e d . o r i e n t e d t o w a r d w h a t i s i n f r o n t o f u s .

The typical b o d y configuration that a c c o m p a n i e s d e p r e s s i o n o f t h e u p p e r ribs i n c l u d e s a sunken and flattened upper chest. It is a l a r g e f a n . although normally there is always s o m e slight angle. In fact. T h e fan converges across the shoulder in front. physiatrists. t h e w e i g h t l i f t e r ' s " s t r a p s " (Fig. elevated shoulders. A m o r e d e t a i l e d a n a t o m y of the chest and upper back is needed to flesh o u t o u r p o i n t . there is t h e trapezius. and s h o u l d e r s i s n o t s e p a r a t e f r o m t h e rest o f t h e b o d y . the major muscle of t h e outer layer is t h e pectoralis major. 17-2). It is t h e soft tissue c o n f i g u r a t i o n s t h a t give rise t o t h e s e s i l h o u e t t e s . it is necessary to allow m o r e space for t h e b r e a t h t o c o m e u p i n t o t h e u p p e r ribs. T h e straps w e h a v e d e s c r i b e d g i v e a s e n s e of h o w c o n n e c t i v e tissue c a n create structures that overlap and interconnect. In the back. T h i s o r i g i n a t e s f r o m t h e b a c k o f t h e skull a n d r u n s . i n w h i c h t h e l o w e r r i b s flare o u t w a r d w h i l e t h e u p p e r ribs are so c o m p r e s s e d t h a t t h e shoulders are d r a w n t o g e t h e r a n d narrow. upper chest. 17-1). Our purpose is to give an image of p h y s i o g n o m y t h a t is m o r e inclusive. Osteopaths. The position of the head. t h e initial c h a n g e is different. if t h e focus is on bringing the head back.SEVENTEEN Upper Body T h e r e are m a n y ways t o analyze h u m a n structure. Likewise. it would be m o r e a c c u r a t e t o s a y t h a t t h e c o n n e c t i v e tissue guides t h e m u s c l e pathways. h o w well t h e a l i g n m e n t s t a c k s u p f r o m h e e l t o ear. m o r e directly related to t h e experience of structure a n d to m o v e m e n t . a n d c h i r o p r a c t o r s see p e o p l e i n t e r m s o f b o n e p l a c e m e n t — h o w s t r a i g h t t h e s p i n e is. i n t e r n a l o r g a n s . O r i f t h e s h o u l d e r s r e l a x . But for o n e of these habits to be modified. a n d a head thrust forward. T h e direction of t h e c o n n e c t i v e tissue is n o t d e t e r m i n e d by any one muscle or muscle group. W e are p r o p o s i n g a n o t h e r perspective—evalua t i o n o f t h e c o n n e c t i v e tissue b e d o f t h e b o d y . e x t e n d i n g f r o m t h e m i d d l e ribs u p a l o n g t h e side o f t h e b r e a s t b o n e a n d t h e m i d dle half of t h e c o l l a r b o n e . it is c o n v e n i e n t to say t h a t m u s c l e a t t a c h e s to b o n e . The extreme of this is the pear-shaped body. the other two m u s t c h a n g e as well. I f t h e u p p e r ribs w e r e raised in front. the shoulders would automatically drop and the head c o m e back to a m o r e upright position. T h e c o n n e c t i v e tissue c o n f o r m s to t h e muscle. General medical practitioners generally evaluate h e a l t h in terms of t h e soft t i s s u e s — m u s cles. T h e c o n n e c tive tissue e x t e n s i o n s a r o u n d m u s c l e s (tendons. orthopedists. W h e n t h e u p p e r ribs a r e c o m p r e s s e d . T h e easiest w a y t o b e g i n talking a b o u t the upper body is to look at the position of t h e ribs. aponeuroses) continue on as the c o n n e c t i v e tissue covering of b o n e (periost e u m ) . These t h r e e g o t o g e t h e r . t h e " p e c s " that muscle builders attempt to d e v e l o p (Fig.s h a p e d muscle covering the majority of the upper c h e s t . I n m o s t p e o p l e . In order to discuss structure. This includes the conformation of muscle and b o n e but is not limited to these. F u r t h e r m o r e . v e r y o f t e n t h e l o w e r ribs a r e o v e r e x p a n d e d . In the front of the chest. b l o o d a n d n e r v e s u p p l y . a n d ends by attaching to the humerus an inch or two below the shoulder joint. b u t this is n o t strictly true. B o n e a n d m u s c l e lie e m b e d d e d w i t h i n t h e c o n n e c t i v e tissue w e b . space i s m a d e for t h e h e a d t o c o m e b a c k a n d t h e ribs i n f r o n t t o c o m e u p w a r d . we analyze t h e b o d y r o u g h l y i n t e r m s o f its u p p e r a n d l o w e r halves. F o r e a c h person. t h e ribs a n g l e t o o s h a r p l y d o w n w a r d i n f r o n t . I d e a l l y t h e ribs would hang more horizontally.

called t h e a c r o m i o n . T h i s is a n a r row small muscle that attaches to the middle Scapula Septum (dotted line) Fascia of latissimus dorsi m. t o o . Acromion stabilize t h e position of t h e shoulder blade. T h e c o r a c o i d p r o c e s s i s v e r y m u c h like Figure 17-2 Posterior arm and shoulder fascia. In t h e b a c k .s h a p e d . Fascia of trapezius m. . T h e p e c t o r a l i s m i n o r a c t s like a l e v e r o n t h e coracoid process. c o n v e r g i n g on an a t t a c h m e n t to t h e tip of the shoulder Fascia of sternocleidomastoid m. a n o t h e r large fan-shaped muscle flows up f r o m below. relating t h e chest to t h e shoulder and arm. T h e point of this fan converges upward. a s i t crosses t h e shoulder blade (scapula). It. i s f a n . T h i s h o o k . It t h e n runs along the lateral m a r g i n of t h e shoulder blade a n d ends b y a t t a c h i n g t o t h e h u m e r u s (arm b o n e ) just b e h i n d the a t t a c h m e n t of the pectoralis major. and to the l o w e r b a c k . a h o o k on a suspended metal plate (the scapula). 17-3). called t h e latissimus dorsi—the weightlifter's "lats. m o v i n g t h e shoulder b l a d e . In t h e f r o n t . to the head. Fascia of deltoid m. is m o r e d i f f i c u l t to v i s u a l i z e as a layer." It attaches to t h e s p i n e s o f t h e l o w e r c h e s t v e r t e b r a e a s well as to t h e spines of the lumbar vertebrae down to t h e sacrum.l i k e p r o j e c t i o n forward from t h e inside of the shoulder blade c a n b e felt just u n d e r n e a t h t h e collar b o n e .86 THE ENDLESS WEB a l o n g t h e b a c k o f t h e s p i n e s o f all t h e n e c k vertebrae and the upper seven or eight chest v e r t e b r a e . T h e a c r o m i o n is a b o n y shelf that can be palpated at the corner of the junction between the shoulder and the arm. W h e n the h o o k is tugged near the top. u n d e r n e a t h t h e p e c t o r a l i s m a j o r . w h i c h serves t o Fascia of • latissimus dorsi m. Fascia of trapezius m. obliquely crossing over the lower tip of t h e shoulder blade. ribs a n d a n g l e s u p w a r d t o a t t a c h o n t h e c o r a c o i d p r o c e s s . Fascia of pectoralis major m. Figure 17-1 Anterior arm and shoulder fascia. lies t h e p e c t o r a l i s m i n o r (Fig. T h e l o w e r p a r t o f t h e t r a p e z i u s . i n t h e d e p r e s s i o n b e t w e e n t h e larger a r m m u s c l e s a n d t h e sides o f t h e ribs. These three muscles make up what we c a l l t h e e x t e r n a l m u s c l e a n d c o n n e c t i v e tissue layer of t h e chest. also attaches to t h e a c r o m i o n as well as to t h e scapular spine. T h e n e x t layer.

Two other attachments to the coracoid p r o c e s s are c o n n e c t e d d o w n i n t o t h e a r m . Biceps m. 17-3). If the pectoralis m i n o r in front is habitually tight. t h i s is n o t a l i g a m e n t . T h e c o r a cobrachialis is a shorter m u s c l e t h a t spans from the coracoid process to t h e inside of t h e humerus about halfway d o w n the arm. b u t a t e n d o n t h r o u g h w h i c h the subclavius muscle is attached to the coracoid process. T o us. T h e short head of the biceps brachii (comm o n l y called simply t h e biceps) crosses b o t h the shoulder and the elbow joints. 17-5). 17-3). process Coracobrachialis m. . The focus here is on the coracoid process of the scapula and therefore includes lines of force of the relevant arm muscles. a small muscle w h o s e function is traditionally considered m i n i m a l . Figure 17-4 In this pose. T h e r e i s a n a n a l o g o u s s t r u c t u r e i n t h e leg. its f u n c t i o n is p r o b a b l y a f a c t o r in t h e n o r m a l p o s i t i o n i n g o f t h e s c a p u l a . (short head) Coracoid. C a l l e d t h e c o r a c o c l a v i c u l a r l i g a m e n t (Fig. Coracoclavicular ligament & Subclavius m. A ligament from the coracoid process to the underside of t h e clavicle contains t h e subclavius muscle.Pectoralis minor m. Figure 17-3 The deeper layer of the chest muscles. reinforcing t h e action of t h e biceps on the scapula (Fig. t h e pull on t h e c o r a c o i d p r o c e s s results i n w h a t w e c a l l " w i n g e d " s c a p u l a e i n t h e b a c k (Fig. the result is a "winged" scapula.UPPER BODY 87 t h e l o w e r b o r d e r o f t h e p l a t e i s raised like a drawbridge. the pectoralis minor is contracted. Its i m p o r t a n c e lies i n t h e w a y i t s t a b i l i z e s t h e fascial s h e a t h o f t h e c h e s t a s a w h o l e . The action of t h e comparatively small tensor m u s c l e serves t o s t a b i l i z e t h e w h o l e o f t h e thigh (Fig. T h e action of t h e subclavius t h r o u g h this c o n n e c t i v e tissue a t t a c h m e n t i s n o t g r e a t i n t e r m s o f m o v e m e n t . T h e b a n d i s a lateral t h i c k e n i n g o f t h e f a s c i a c o v ering t h e t h i g h as a w h o l e (the fascia lata). Thus. the arrows indicate the line of force of these muscles. T h e m e d i a l margin of t h e shoulder blade will project outward. . tightness in this muscle on the front of the a r m will a l s o r e p o s i t i o n t h e s c a p u l a . 17-4). T h i s i s t h e m u s c l e a n d a t t a c h e d fascial bridge called t h e t e n s o r f a s c i a lata a n d i l i o t i b i a l b a n d .

we c a n visualize t h e fascial i n v o l v e m e n t s . a n d from t h e upper a r m b y w a y o f t h e teres. teres muscles. Tension on any or all o f t h e s e w i l l r e s u l t i n a d e g r e e o f i m m o b i lization between the upper chest and the arm a n d the position of t h e scapula in the back. t h e s h o u l d e r b l a d e i s susp e n d e d i n t h r e e p l a c e s . Trapezius m. M o v e m e n t t h r o u g h a fascial p l a n e is always Ilio-tibial tract broader t h a n m o v e m e n t by an individual muscle. W h e n the arm m o v e s sideways. t o t h e r a d i u s a n d u l n a o f t h e forearm. Figure 17-6 Scapular suspension. the upper back. Its m o v e m e n t is stabilized by t h e elasticity of t h e Rhomboids. T h e s c a p u l a i s t h u s s u s p e n d e d f r o m all o f its s i d e s : f r o m t h e h e a d b y w a y o f t h e t r a p e z ius. to the humerus of the upper arm. T h i s . v Trapezius m. Teres major m. t h e t e r e s m u s t t h e n a l s o t r y t o stabilize . A l s o i n t h i s d e e p e r layer. c o n n e c t t h e s c a p u l a r t r i a n g l e t o t h e u p p e r a r m (Fig. O n its s u r f a c e . O n t h e b a c k . t h e r e are strong c o n n e c t i o n s to t h e Tensor fasciae latae m i d d l e ribs. and the arm. Gluteus maximus and to t h e middle clavicle. If the shoulder blade is winged o u t . m. will reduce t h e flexibility of the neck and head. t h e r h o m b o i d s a n d t h e levator scapulae form a b r o a d s h e e t o f a t t a c h m e n t t o t h e m e d i a l ridge o f t h e s p i n e . T h e elasticity o f t h e c o n n e c t i v e tissue of e a c h of these allows t h e s h o u l d e r t o f l o a t o n t o p o f t h e rib c a g e . A t a d e e p e r layer. F r o m t h e coracoid process. . Supraspinal Teres minor/ infraspinatus t i g h t n e s s of a n y of t h e s e will e n g e n d e r tightn e s s i n t h e o t h e r s a n d will fix t h e s h o u l d e r blade. prim a r i l y a t t h e a c r o m i o n . t h e t w o Figure 17-5 Connections between knee and hip. R h o m b o i d s a n d teres b e t w e e n t h e m form a sling t h a t stabilizes t h e m o v e m e n t of t h e lower part of t h e scapula. t h e s h o u l d e r b l a d e will start t o m o v e s i d e w a y s . . t h e distance b e t w e e n t h e arm b o n e a n d t h e scapula widens and the teres s h o u l d b e able t o l e n g t h e n . 17-6). in turn. f r o m t h e t h o r a c i c s p i n e b y w a y o f t h e r h o m b o i d s a n d levator. W h e n the m u s c l e s r e a c h t h e limit of their elasticity. m a j o r a n d m i n o r . T h e Levator scapula m.88 THE ENDLESS WEB By identifying the muscles that connect to t h e c o r a c o i d process. t h e t r a p e z i u s c o n n e c t s t o its m o s t l a t e r a l t i p . r h o m b o i d s .

w i t h its fibers c o n v e r g i n g t o w a r d t h e f i b r o u s capsule of the shoulder joint. above a n d below t h e scapular spine. Two small muscles on t h e outer surface of the scapula. We have been talking about h o w the Figure 17-8 The deltoid fascia interweaves with the septum dividing the anterior (biceps) and posterior (triceps) areas of the arm. " O h . T h e s e lie o n t h e s u r f a c e o f t h e s c a p u l a . t h e levator scapulae b e c o m e s extremely tight. These f o r m a n o t h e r r e c i p r o c a l set o f s l i n g s . iSerratus anterior m. Clavicle Rhomboid m. T h e a t t a c h m e n t of the levator on the upper middle corner of the scapula is that p l a c e w h e r e . Figure 17-7 The subscapularis (not shown) lines the undersurface of the scapula. Its f a s c i a often glues t h e m u s c l e t o t h e p e r i o s t e u m a n d fascia o f t h e ribs a n d i n t e r c o s t a l m u s c l e s . W h e n t h e teres lose elasticity. t h e y o f t e n f e e l like b o n e w h e n t h e shoulder blade is in trouble. M a n y people's teres are m u c h t o o s h o r t and tight. i f y o u press i t o n a l m o s t a n y o n e . In palp a t i o n . Its direction of pull is roughly perpendicular to that of the serratus anterior. h e o r s h e will s i g h . . a t t a c h i n g just a d j a c e n t to t h e attachment of the rhomboids. t h a t h u r t s s o g o o d ! " A n o t h e r m u s c l e o f t h e m i d d l e layer. T h e surrounding c o n n e c t i v e tissue b e c o m e s overtense. t h e serratus a n t e r i o r . Septum Fascia of trapezius m.'s External abdominal oblique m. t h e s h o u l d e r b l a d e i s d r a g g e d a l o n g with every arm m o v e m e n t . a n d so t h e y shorten. The subscapularis l i n e s t h e u n d e r s i d e o f t h e s h o u l d e r b l a d e . T h e t e r e s w e r e n o t designed for this purpose. f o r m i n g a heavy pad. c o n n e c t s t h e l o w e r r i b s t o t h e u n d e r s i d e o f t h e s c a p u l a (Fig. T h e serratus a t t a c h e s o n t h e l o w e r ribs a n d angles upward toward the medial border of t h e scapula. t h e f u n c t i o n of t h e serratus anterior seems to be to stabilize t h e shoulder b l a d e a s t h e a r m s w i n g s o v e r h e a d . t h e r h o m b o i d s . 17-7). Normally. Higher up. B o t h serratus a n t e r i o r a n d s u b s c a p u l a r i s lie b e t w e e n t h e rib c a g e a n d t h e s h o u l d e r b l a d e . t h e n a r e less u s e d and b e c o m e flaccid. 17-6) f u r t h e r r e f i n e t h e m o v e m e n t of the shoulder blade in relation to the shoulder j o i n t .UPPER BODY 89 the lower margin of t h e shoulder blade to p r e v e n t i t f r o m m o v i n g t o o far o u t . Acromion Fascia of deltoid m. T h e o t h e r half of t h e sling for t h e s c a p u l a . a w a y f r o m t h e flat o f t h e r i b s . the supraspinatus a n d infraspinatus (Fig. f l o a t i n g t h e s h o u l d e r b l a d e b e t w e e n t h e ribs a n d s h o u l d e r joint.

T o simplify. T h e r e are t w o m a j o r factors to consider in arm m o v e m e n t — t h e m o v e m e n t of muscles over t h e tip of the shoulder blade and m o v e m e n t i n t h e a r m p i t . W e are i n h i b i t i n g w h a t w e w o u l d like t o d o w i t h o u r a r m s : w a r d i n g o f f a n g e r . T h e s e a r e t h e m u s c l e s t h a t raise t h e a r m . 17-9 A). . This muscle acts like a c o n t i n u a t i o n of t h e trapezius. c o n n e c t i n g t h e a r m a n d trunk. W h e n we reach up. 17-8). H a n g i n g d o w n . It e x t e n d s muscular a c t i o n of t h e trapezius f r o m t h e h e a d a n d n e c k across t h e shoulder and down into the middle of the upper arm. W e h a v e all sorts o f r e a s o n s w h y w e d o n ' t w a n t to be. e t c . s u c h a s w h e n stretching your arms wide and up toward the ceiling in t h e relaxing stretch that goes with a yawn. t h e b i c e p s b r a c h i i a n d the coracobrachialis b o t h suspend the arm from the coracoid process of the shoulder blade. In addition. w h i c h covers the shoulder joint. These three muscles govern the lengthening out of the arm from the shoulder blade. Ideally. r e s e n t m e n t . t h a t o p e n . T h e latissimus dorsi a n d pectoralis Figure 17-9 Shoulder and arm movement depends on the continuity of fascia—(A) lateral shoulder. we c a n t h i n k of t h e trapezius a n d deltoid as a single. O f its t h r e e a t t a c h m e n t s . pectoralis major. a n g r y g e s t u r e s all f o c u s o n t i g h t e n i n g t h e a r m s d o w n t o t h e r i b s . functionally c o n t i n u o u s structure (Fig.90 THE ENDLESS WEB s h o u l d e r b l a d e i s s u s p e n d e d i n its r e c i p r o c a t ing m u s c u l a r slings. there is the triceps brachii. t w o c o n n e c t t o t h e h u m e r u s itself a n d o n e — c a l l e d t h e l o n g h e a d — c o n n e c t s to the outside margin of t h e shoulder blade just b e l o w t h e shoulder joint. the shoulder blade is suspended from the arms. fearful gestures. (B) anterior shoulder. In addition. yet armpits are t h e focus of a wide variety of e m o t i o n a l c o n c e r n s . fear. T h e r e is no way t h a t we c a n freely use an arm without opening the armpit. w h i c h drops as a c o u n t e r b a l a n c e . Trapezius. deltoid. T h e arm should be able to lengthen as it is raised u p w a r d a n d t o t h e side. Note that in this kind of stretch. a c r o m i u m . in effect. Protective gestures. t h e a r m c a n b e raised w i t h o u t elevating t h e shoulder blade. h o l d i n g one's b r e a t h . A t a d e e p e r layer. t h e reverse is t r u e — t h e shoulder blades h a n g from the arm. a n d latissimus dorsi are c o m m o n l y called t h e extrinsic (outer) m u s c l e s of t h e shoulder area. a n d s c a p u l a r s p i n e (Fig. t h e a r m m u s t b e able t o freely m o v e away f r o m b o t h t h e rib c a g e a n d t h e s h o u l d e r blade. T h e m a j o r surface c o n n e c t i o n b e t w e e n shoulder and arm is the deltoid muscle. T h e a r m a n d shoulders also relate in this way. t h e arm swings from t h e shoulder blade. T h e s e are g e s t u r e s r e p r e s s i n g r e s p o n s e t o e m o t i o n . (C) posterior shoulder. e m b r a c i n g its a t t a c h m e n t o n t h e c l a v i c l e .

T h e s e m u s c l e s of t h e o u t e r (extrinsic) layer c o u n t e r b a l a n c e e a c h other. For e x a m p l e . t h e antagonist muscle lengthens sequentially. This is as true of very small m u s c l e s as of larger sheetlike o n e s . For e x a m p l e . Part o f t h e w a y h e a v y i m m o b i l e t i s s u e p a d s are c r e a t e d i s b y o u r i n s i s t e n c e o n trying to use t h e muscle as a w h o l e instead of sequencing through the muscle as b o d y position d e m a n d s . In t h e front. It acts as a brake to m o d u l a t e t h e m o v e m e n t . 17-9 B & C). t h e pectoralis m i n o r attaches to the coracoid Figure 1 7 . t h e o p p o s i n g m u s c l e s s i m p l y let g o a n d t h e c o n n e c t i v e tissue b e d e l a s t i c a l l y s t r e t c h e s . T w o kinds o f m o v e m e n t are possible h e r e — d r o p p i n g t h e a r m . T h e c o n n e c t i v e tissue b e d provides c o n n e c t i o n s b e t w e e n m u s cle layers as well as b e t w e e n a d j a c e n t muscles. I n t h e shoulder. W h e n a m o v e m e n t is slow and controlled. A t t h e deeper layer of fascia a n d m u s c l e . t h e first m u s c l e a c t i v i t y starts a t t h e portion of t h e trapezius b e t w e e n n e c k a n d shoulder and continues down the deltoid. W h e n t h e m o v e m e n t i s fast. W h a t w e call s e q u e n c i n g i n m u s c l e m o v e m e n t i s a f a c t o r i n h o w t h e large flat s u r f a c e m u s c l e s are u s e d .UPPER BODY 91 major. d e l t o i d a n d t r a p e z i u s c o n t r a c t a s p e c toralis m a j o r a n d latissimus dorsi relax. o n e set o f m u s c l e s c o n tracts. I n b o t h m o v e m e n t s . o r s e q u e n tially letting t h e a r m d o w n . Elasticity of t h e c o n n e c t i v e tissue b e t w e e n structures is essential for an effective relationship b e t w e e n deep a n d superficial (intrinsic a n d extrinsic) m u s c l e layers. s e q u e n c i n g m o v e s t h r o u g h a series o f m u s c l e s r a t h e r t h a n through the plane of one muscle. w h i c h i s faster. a n d s h o r t e n i n g . Anatomical nomenclature occasionally reflects t h i s s t e p w i s e u s e o f t h e s u r f a c e m u s cles b y d i v i d i n g t h e m i n t o s p e c i f i c a l l y n a m e d sections." . Ideally. T h e continuing upward m o v e m e n t of the arm is supported by the vertebrae because of the a c t i o n of different parts of t h e trapezius. acting together. w h e n t h e a r m i s r a i s e d t o t h e side. i n n o m o v e m e n t d o w e u s e all fibers o f a m u s c l e s i m u l t a n e o u s l y . p e c t o r a l i s m i n o r lies u n d e r p e c t o r a l i s m a j o r . a s t h e a r m i s raised. b o t h muscles affect t h e a c t i o n o f t h e ribs. As the arm comes further up. I n e i t h e r fast o r s l o w m o v e m e n t s . T h e difference b e t w e e n t h e two m o v e m e n t s i s i n t h e c o u n t e r b a l a n c i n g set o f m u s c l e s . A m a j o r source of c o n f u s i o n in the practical application of kinesiology is that no muscle exists in isolation. t h i c k e n i n g . As t h e a r m returns t o t h e side. Toward t h e center front. muscle activity concentrates further d o w n t h e trapezius. allowing the arm to extend away from the body. bring the arm down (Fig.1 0 Common "knots. pectoralis a n d latissimus contract as trapezius a n d deltoid lengthen. w h i c h is slower. t h e u l t i m a t e limit o n t h e m o v e m e n t will b e t h e limit of elasticity of t h e c o n n e c t i v e tissue bed. These interfaces have t h e greatest potential for adhesion.

T h i s i s i n t h e area t h a t w e h a v e b e e n calling t h e dorsal h i n g e . A s a r e s u l t . Our a n a t o m i c a l illustrations in this section attempt to depict the interactions of muscle. biceps brachii. I n t h e b a c k . T h e latissimus c o n n e c t s the arm b o n e t o t h e lower b a c k a n d t h e pelvis. 17-10). T h e i n t e r a c t i o n s w i t h t h e d e l t o i d are t o o c o m p l e x t o s h o w i n t w o d i m e n s i o n s (Fig. This muscle overlies a t t a c h m e n t s o f t h e teres m a j o r a n d m i n o r . all attach to t h e vertebrae. t h e r e are t w o places w h e r e this k i n d of c o n f u s i o n is likely to occur. T h e y are u n a b l e t o slide o n e a c h o t h e r . T h e trapezius overlies t h e r h o m b o i d s a n d levator s c a p u l a e . 17-11). W h e n t h e c o n n e c t i v e tissue b e d b e t w e e n these m u s c l e s loses elasticity. a n d ribs. coracobrachialis. For a m o r e c o m p l e t e a n d c o m p l e x view. a l t h o u g h h e r e t h e m u s c l e fibers r u n c r o s s w i s e t o e a c h o t h e r . and infraspinatus. b o n e . T h e p a r t o f t h e latissimus toward the h u m e r u s lies i m m e d i ately adjacent to the Figure 17-11 process while the pectoralis m a j o r attaches to t h e h u m e r u s . . w i t h t h e result t h a t t h e lower tip of t h e scapula is i m m o b i l i z e d . w e r e c o m m e n d considerat i o n o f t h e e f f e c t o f c o n n e c t i v e tissue o n t h e underside of t h e deltoid. s h o u l d e r blade. pectoralis major and minor. W h e n t h e fascial p a d b e t w e e n t h e t w o b e c o m e s less p l i a b l e . while the r h o m b o i d s and levator scapulae attach medially to the medial border of t h e scapula. Another mid-back place on the spine that is c o m m o n l y painful is w h e r e t h e lower tip o f t h e t r a p e z i u s crosses the uppermost attachm e n t of the latissimus to t h e v e r t e b r a . Its o n l y o p t i o n is to be shrugged u p . This is a factor in t h a t teres m a j o r . (Fig. W e f r e q u e n t l y see l a t i s s i m u s a n d t e r e s m a j o r b o u n d together. t h e m u s c l e s n o longer operate individually. This spot a l m o s t always c o n t a i n s a s e n s i t i v e k n o t of tiss u e .92 THE ENDLESS WEB mid-back place under t h e lower tip of t h e shoulder blade that is so often painful. a n d c o n n e c t i v e tissue i n m o v e m e n t . T h e trapezius attaches laterally to t h e tip of t h e shoulder blade (acrom i o n ) . A t t h e c e n t e r b a c k . T h e teres m a j o r is a b r i d g e b e t w e e n t h e lower tip of the scapula and the a r m b o n e . These intera c t i o n s are c o n c e p t u a l l y s t r a i g h t f o r w a r d a n d give a partial picture of t h e effect of t h e c o n n e c t i v e tissue o n m o v e m e n t b e t w e e n arm. t h e s h o u l d e r b l a d e c a n n o t r o t a t e . t h e s h o u l der b l a d e a n d t h e a r m are activated t o g e t h e r in a n y gesture involving t h e front of t h e chest.

The most superficial muscle groups are the longest. T h e muscles closer to t h e outer surface of t h e b o d y are longer. while the deepest are very short. i t lies u n d e r t h e m i d d l e m u s cle layer ( r h o m b o i d s a n d levator scapulae). t h e l u m b o . 18-1). EIGHTEEN Figure 18-1 In these schematics of the erector spinae. T h e h e a v y f a s c i a l s h e a t h c o v e r i n g all o f t h e erector spinae is called t h e lumbo-dorsal f a s c i a (Fig. A b o v e . C o l l e c tively. Below. it acts as an aponeurosis (broad a t t a c h m e n t ) . t h e s e are c a l l e d t h e e r e c t o r s p i n a e . T h e deepest muscular layer c o n n e c t s o n e vertebra t o t h e v e r t e b r a i m m e d i a t e l y a b o v e it. .Axial Skeleton We have n o t yet talked about t h e long muscles o f t h e s p i n e . a n d t h e y travel t h e l e n g t h o f t h e spine f r o m t h e skull t o t h e s a c r u m (Fig. t h e fasc i a i s less h e a v y . T h i s fascia is very heavy. w h i c h a r e a l s o a p a r t o f t h e soft tissue layers o f t h e u p p e r b o d y . I n b o t h a p p e a r a n c e a n d s t r u c t u r e .d o r s a l fascia is c o n t i n u o u s with t h e sacral pad a n d e n d s o n t h e c o c c y x . t h e y are m u c h l i k e a multistrand rope. the arrows indicate the direction and length of muscle groups. c o n n e c t i n g t h e latissimus dorsi t o t h e l o w e r h a l f o f t h e s p i n e . m u s cle segments b e c o m e shorter a n d shorter. It c o n t i n u e s u p w a r d to t h e n e c k a n d to t h e occipital ridge. 18-2). as we go progressively deeper t h r o u g h t h e layers.

18-3). It connects the underside of t h e sternum (breastbone) to the vertebrae of the chest region. T h e c o n n e c t i v e tissue o n t h e i n n e r surface o f t h e ribs a n d i n t e r c o s t a l m u s c l e s i s c o n t i n u o u s w i t h a v e r t i c a l c o n n e c t i v e tissue s e p t u m t h a t d i v i d e s t h e r i g h t a n d left sides o f t h e c h e s t c a v i t y (Fig. not only surrounding t h e o r g a n b u t p e n e t r a t i n g t h r o u g h it. In the lower back. restriction in the l u m b o dorsal fascia will s h o w as a l o n g i t u d i n a l ropel i k e rigidity. The diaphragms of the body cavity: one at the clavicles. the respiratory diaphragm. T h i s is c a l l e d t h e mediastinum. this layer c o n t i n u e s b o t h i n s i d e a n d o u t s i d e t h e rib c a g e a n d c o n t a i n s t h e intercostal muscles b e t w e e n t h e ribs. Furthermore. t h e r e is a c o n n e c t i v e tissue c o n t i n u i t y t h a t includes t h e j o i n t capsules a n d t h e p e r i o s t e u m t h a t e n s h e a t h s e a c h b o n e . In t h e chest. the two pelvic diaphragms. where c o n n e c t i v e tissue surrounds t h e b r a n c h i n g system of trachea. w h i c h feels like a glass p l a t e w h e n it is in t r o u b l e . T h i s is particularly apparent in the lungs. This fascia is c o n t i n u o u s with t h e fascia positioning the internal organs. bronchioles. bronchi.94 THE ENDLESS WEB U p p e r b a c k a n d s h o u l d e r p r o b l e m s are usually i n t e r c o n n e c t e d t h r o u g h this fascia. W h e n there is t e n s i o n a n d vertical shortening of the Figure 18-2 Continuity of fascia of erector spinae and gluteals. and even alveoli. this c o n n e c t i o n between front and back of the chest must also b e able t o adjust with e a c h breath. At t h e deepest level. . The mediastinum contains t h e heart. s o m e t i m e s m o d i f i e d b y a cross-pull f r o m t h e latissimus dorsi. It should be elastic e n o u g h that heart m o v e m e n t can be accomplished without inhibition. Figure 18-3 Continuity of fascia within the body cavity.

Ideally. In order for this to h a p p e n . This is a learned pattern. M o v e m e n t s t h a t are m e n t a l l y controlled lack adaptive flexibility. t e n s i o n in t h e m e d i a s t i n u m is visible as a c h e s t t h a t is t o o thick from front to b a c k — a barrel chest. In this case. t h e m e d i a s t i n u m is c o n t i n u o u s with t h e c o n n e c t i v e tissue of the diaphragm. In a chest that is t o o narrow from front to back—a concave chest—the mediastinum and h e a r t are p u s h e d o f f t o t h e left. a d j a c e n t ribs a n d Figure 18-4 The action of the respiratory diaphragm. A s t h e ribs lift a n d e x p a n d t h e c h e s t . Air i s p u s h e d o u t o f t h e l u n g s . a n d twelfth. W e w o u l d like t o e m p h a s i z e t h e n e e d f o r e a c h rib t o m o v e s e p a r a t e l y a n d freely. Rib a c t i o n during b r e a t h i n g involves three separate types of rib m o v e m e n t . It crosses t h e t i p o f t h e v e r y s h o r t t w e l f t h rib a n d t h e n blends into the oblique muscles of the abdomen. eleventh. Exhaling involves the c o m b i n e d action of t h e d i a p h r a g m a n d o n e layer of t h e intercostal m u s c l e s b e t w e e n t h e ribs. T h e a c t i o n o f t h e d i a p h r a g m i s like a sail t h a t b e l l i e s in t h e w i n d (Fig. muscle action originates in the diaphragm and continues to the abdomin a l o b l i q u e s . The diaphragm attaches to the inner m a r g i n o f t h e rib c a g e ( t h e c o s t a l a r c h ) a n d extends sideways to t h e tips of t h e free ribs. The diaphragm is thus not quite horizontal across t h e b o d y . Abdominal breathing is often depicted as a pattern in which the a b d o m e n protrudes in front with each inhale. the t e n t h . both heart function and b r e a t h i n g are h i n d e r e d . t h e a b d o m e n is m o v e d i n p r e f e r e n c e t o t h e ribs. i t m u s t s h o r t e n w h e n inhaling. D i s p l a c i n g the heart t h e n constricts t h e lung and restricts b r e a t h i n g . Even people with only o n e lung can achieve n o r m a l c h e s t m o v e m e n t o n b o t h sides. T h e s e are well described in m o s t a n a t o m y a n d physio l o g y texts. 18-4). T h e tendency is to over-focus on what has b e e n learned. T h i s b r i n g s t h e rib d o w n a n d a l l o w s t h e d i a p h r a g m t o r e c o i l t o its n o r m a l d o m e shape up i n t o t h e pleural (lung) cavity. The diaphragm is an approximately horizontal curved layer of m u s c l e t h a t divides t h e c h e s t c a v i t y f r o m t h e a b d o m i n a l cavity. it flattens with every inhale (2). A t its l o w e r m a r g i n . unforced exhale. M a n y disciplines teach a type of a b d o m i n a l breathing that is a n a t o m i c a l l y q u e s t i o n a b l e . For t h e a b d o m e n t o p r o t r u d e i n t h i s way. it has an o b l i q u e angle downward to the back.AXIAL SKELETON 95 mediastinum. t h e d i a p h r a g m i s l i f t e d a t its m a r g i n s a s t h e ribs rise a n d e x p a n d s i d e w a y s w i t h inhalation. Its m i d d l e bellies u p i n t o t h e c h e s t c a v i t y w i t h e a c h exhale (1). W i t h e x h a l a t i o n e a c h rib i s raised b y r o t a t i n g i n its j o i n t s w i t h t h e v e r t e b r a e . I t i s m a d e u p o f a h e a v y c i r c u l a r c e n tral t e n d o n s u r r o u n d e d b y a r i n g o f m u s c l e . air e n t e r s t h e l u n g s . w h i c h a g a i n will c r e a t e t e n s i o n o n t h e h e a r t . T h e s y s t e m is n o t dependent on the presence of a lung. t h e abdomen must lengthen when inhaling. o n e that is m e n t a l l y c o n t r o l l e d . In a n o r m a l . I f a n y o n e rib fails t o m a i n t a i n its p o r t i o n o f t h e chest c o n t o u r . E x t e r n a l l y . . T h e m u s c l e flares o u t w a r d f r o m t h i s c e n t r a l t e n d o n a n d blends into t h e muscle wall of the chest and a b d o m e n .

t h e upper trapezius b e c o m e s a primary support of the head.96 THE ENDLESS WEB scalenes serve a f u n c t i o n a n a l o g o u s to t h a t of t h e respiratory diaphragm. tension in the n e c k restricts b r e a t h i n g i n t h e u p p e r m o s t part of the lungs. T h e neck can be seen as a continuation of t h e c o n n e c t i v e tissue structures of t h e chest. T h e outerm o s t surface layer consists of t h e trapezius and the sternocleidomastoid. Since the scalenes attach to the processes of the n e c k vertebrae. It often b e c o m e s very p r o m i n e n t in older people from Figure 18-5 Diaphragms of the body cavity. t h i s pair o f muscles o n l y stabilizes t h e m o v e m e n t s o f nodding the head and turning the head from side t o s i d e . expanding and contracting w h e n breath enters the upper tip of the lung. Filling t h e space i n t h e n o t c h b e t w e e n t h e clavicle in front a n d t h e h e a v y musculature o f t h e n e c k a n d s h o u l d e r b l a d e i n t h e b a c k are t h e s c a l e n e s (Fig. 18-6). It is used to hold the head on. The sternocleidomastoid then takes on almost t h e entire f u n c t i o n of t h e trapezius. And tension in the neck has reached endemic proportions in our overachiever culture. m u c h in t h e way a plastic bag is gathered t o g e t h e r with a twist at the t o p . T h e s e are t h e m u s c l e s i n t h e d e p r e s s i o n o n e i t h e r side a t t h e b a s e o f t h e n e c k . The sternocleidomastoid extends from the b a s e o f t h e skull j u s t b e h i n d t h e ear ( m a s t o i d process) d o w n to t h e c o n n e c t i o n between the clavicle a n d the breastbone (sternum). 18-5). All s t r u c t u r e s i n t h e n e c k h a v e a b r o a d e r c o n t i n u a t i o n below. If t h i s p r o c e s s r e a c h e s a c r i t i c a l l e v e l . as is t o o o f t e n t h e case. T h e pad over t h e angle of t h e j a w ties i n t o t h e s t e r n o c l e i d o m a s t o i d (Fig. W h e n t h e h e a d i s h a b i t u a l l y e v e n t u a l l y t h e w h o l e rib cage are distorted. T h e y a t t a c h t o t h e upper ribs. T h e p i t c h e d forward. I t c a n a c t a s a n i n h i b i t o r t o t h e freedom of m o v e m e n t in the jaw and so . o v e r u s e i n m o v i n g t h e h e a d . t h e r e is a general c o n n e c t i v e tissue response. and i t l o s e s m u c h o f its f u n c t i o n a l r o l e i n h e a d movement. T h e lungs e x t e n d u p just u n d e r n e a t h t h e m . T h e deepest layer of t h e n e c k includes the c o n t i n u a t i o n of the erector spinae. w h i c h f e e l s a l m o s t like a strait j a c k e t u n d e r t h e s k i n . Ideally. This c a n be felt as an overall rigidity in t h e c o n n e c t i v e t i s s u e o f t h e c h e s t . T h e c o n n e c t i v e tissue of t h e outer layer of the neck is continuous with the connective tissue of t h e jaw. the m i d d l e layer includes t h e scalenes.

AXIAL

SKELETON

97

indirectly affect m o v e m e n t of t h e h e a d as a whole. If you c l a m p your jaw as a habit, you will a l s o b e c l a m p i n g y o u r h e a d . I f y o u c l a m p y o u r j a w h a r d e n o u g h , i t will b e d i f f i c u l t t o shake your h e a d " n o , " a n d also difficult to shake your head " y e s . " T h e fascia o n t h e underside of the jaw is continuous with that of the tongue. T h e inside of the m o u t h and t o n g u e are t h e r e b y i n c l u d e d i n r e s t r i c t i o n s of t h e face a n d h e a d . T h e erector spinae extend up to attach to t h e b a s e o f t h e skull, m i n g l i n g w i t h t h e h e a v y pad that is found on the back base of t h e skull. O n t h e b a c k o f t h e n e c k , t h e f a s c i a o f the sternocleidomastoid and trapezius is c o n tinuous w i t h t h e skullcap of c o n n e c t i v e tissue on t h e h e a d . At t h e deepest level, a l o n g t h e spines o f t h e n e c k vertebrae a n d u p o n t o t h e b u m p o n t h e b a c k o f t h e skull, t h e r e i s a v e r y h e a v y rope of c o n n e c t i v e tissue fibers. This is k n o w n a s t h e l i g a m e n t u m n u c h a e (Fig. 18-7). It fans out over t h e projection at the back of t h e skull ( o c c i p u t ) , f o r m i n g a l m o s t a T s h a p e . I t a c t s like a s e p t u m i n t h e b a c k o f t h e n e c k , dividing right a n d left halves o f t h e n e c k i n t o s e p a r a t e c o m p a r t m e n t s . Its a c t i o n a s a s e p t u m serves t o c o n n e c t t h e s u p e r f i c i a l a n d d e e p layers o f m u s c l e t o e a c h o t h e r i n t h e b a c k . This ligament b e c o m e s especially thickened, almost bony, in people w h o habitually thrust the head forward. T h e septum of the l i g a m e n t u m n u c h a e is a normal c o n n e c t i o n between outer and deeper layers o f s o f t t i s s u e . T h e r e a r e s i m i l a r s e p t a elsewhere in t h e body. T h e y provide additional strength because a l i g a m e n t is denser a n d m o r e s t a b l e t h a n its f a s c i a l c o u n t e r p a r t . Septa also divide a n d c o m p a r t m e n t a l i z e f u n c tion by separating myofascia. Figure 18-7 The ligamentum nuchae forms a surface covering for the muscles on both sides at the base of the skull. It then dives deep to form a septum between the right and left muscle masses. Figure 18-6 The connective tissue of the outer layer of the neck.

NINETEEN

Pelvis and Upper Legs
tract e n d s o n t h e lateral protrusions o f t h e tibia a n d fibula, b e l o w t h e knee. In n o r m a l f u n c t i o n , t h e gluteus m a x i m u s acts between t h e b a c k p a r t o f t h e h i p a n d t h e l o w e r leg, bypassing t h e femur. Very often, however, as t h e gluteus m a x i m u s passes over t h e h i p , it sticks t o t h e g r e a t e r t r o c h a n t e r , c r e a t i n g a n aberrant drag o n t h e femur. T h e small t e n s o r fascia lata attaches on t h e anterior superior iliac spine, w h i c h is t h e uppermost b o n y protrusion on the front of the pelvic curve. T h e muscle angles d o w n and s i d e w a y s , b l e n d i n g i n t o t h e fibers o f t h e i l i o t i b i a l t r a c t . F r e q u e n t l y , t h e t e n s o r feels like b o n e . This tiny muscle balances the backward pull of t h e massive gluteus m a x i m u s on the ilio-tibial tract. By design, t h e a c t i o n of the m u s c l e i s all a l o n g t h e t r a c t , d o w n t o its

T h e r e are several ways in w h i c h t h e shoulder a n d pelvis differ f r o m o n e a n o t h e r . Initially, i n t h e first m o n t h o f e m b r y o n i c d e v e l o p m e n t , b o t h a r m s a n d legs a r e e x t e n d e d d i r e c t l y o u t t o t h e sides. A u s e f u l i m a g e i s t h a t o f f a l l i n g spread-eagled backward i n t o water. T h e arms a r e o u t t o t h e sides w i t h p a l m s f o r w a r d . T h e legs a r e s t r a i g h t o u t t o t h e sides w i t h t h e inside arch of t h e foot facing forward. (This p o s i t i o n o f t h e legs i s n o t p o s s i b l e t o a n a d u l t structure.) By t h e t i m e a b a b y is born, t h e a r m s a r e d o w n t o t h e sides, r e t a i n i n g a w i d e r a n g e o f m o t i o n . T h e legs h a v e c o m e d o w n b e n e a t h a n d in line with t h e trunk. T h e y are rotated so that the knee, w h i c h originally pointed headward, is n o w facing forward. T h i s m e a n s t h a t t h e m y o f a s c i a l w e b o f t h e leg h a s r o t a t e d , c r e a t i n g s o f t t i s s u e spirals i n t h e legs ( a n d t o a lesser d e g r e e i n t h e a r m s ) . A functional difference between shoulder a n d pelvic girdle is in t h e use of t h e l i m b s . T h e m a j o r activity of t h e pelvis is weightbearing, while in the arms and shoulders it is mobility. Pelvic m o b i l i t y has b e e n modified because t h e n e e d for support has taken precedence. O n t h e outside o f t h e pelvis t h e r e are three, possibly four muscles t h a t we classify as superficial. T h e y attach to t h e outside of t h e h i p a n d c o n t i n u e t o t h e l o w e r leg. T h e s e are t h e gluteus m a x i m u s , t h e t e n s o r fascia lata, a n d t h e sartorius. T h e rectus femoris is t h e fourth candidate for this classification (Fig. 19-1) T h e gluteus m a x i m u s has a very wide a t t a c h m e n t centrally, f r o m t h e posterior margin of t h e ilium a n d from t h e sacroiliac junction down to and including the tailbone. T h e m u s c l e angles diagonally across t h e pelvis d o w n t o w a r d t h e leg, e n d i n g i n t h e l o n g fibrous track called t h e ilio-tibial tract. This

Figure 19-1 The suspension of the knee from the hip.

PELVIS

AND

UPPER

LEGS

99

attachment below the knee. It is functionally s h o r t e n e d w h e n its u n d e r s i d e i s s t u c k t o t h e greater t r o c h a n t e r o f t h e f e m u r . W h e n t h i s h a p p e n s , its e x t r e m e r i g i d i t y is a m e a s u r e of t h e stress o n t h e m u s c l e . T h e sartorius is a t t a c h e d on t h e tip of t h e a n t e r i o r s u p e r i o r iliac s p i n e , i m m e d i a t e l y a d j a c e n t t o t h e a t t a c h m e n t o f t h e t e n s o r fascia l a t a . I t d i a g o n a l l y c r o s s e s t h e t h i g h i n a n S shape, attaching to t h e tibia below t h e knee, o n t h e i n s i d e o f t h e leg. Just deep to t h e sartorius, t h e rectus femoris attaches on t h e anterior inferior iliac s p i n e . I t d e s c e n d s t h e f r o n t o f t h e leg i n a straight line, b l e n d i n g i n t o t h e upper part of the patellar t e n d o n above t h e k n e e . T h e t e n d o n c o n t i n u e s across t h e front of t h e k n e e to the front of the tibia. T h e patella (kneecap) sits w i t h i n t h e t e n d o n like a b o n y c u s h i o n

o n t h e f r o n t o f t h e k n e e , like a p e b b l e i n a s t r e a m . T h e patella itself is n o t a stationary, w e i g h t - b e a r i n g b o n e . It is a m o d i f i c a t i o n of t h e c o n n e c t i v e t i s s u e w i t h i n t h e p a t e l l a r ligament (a sesamoid bone). O n t h e i n s i d e o f t h e legs, t h e a d d u c t o r s a r e the primary c o m p o n e n t of the V shape of the i n n e r t h i g h . T h e gracilis i s t h e o n l y a d d u c t o r t h a t crosses b o t h t h e k n e e j o i n t a n d t h e h i p j o i n t . It is t h u s c l a s s i f i e d as a s u p e r f i c i a l leg muscle. T h e other, deeper adductors cross only the hip joint; they do not extend below t h e k n e e . T h e gracilis is a b r o a d b a n d of m u s c l e t h a t , w i t h its f a s c i a , i s a t t a c h e d o n t h e pubic ramus. It continues to the knee, coming t o lie u n d e r n e a t h t h e s a r t o r i u s a n d a t t a c h i n g to t h e medial projection of t h e tibia b e l o w the knee joint. O n t h e b a c k o f t h e leg are t h e h a m s t r i n g s . T h r e e o f t h e s e m u s c l e s e x t e n d f r o m t h e sitting b o n e (ischial tuberosity), w h i c h is a b o n y projection of the hip b o n e in back and below. Two hamstrings c o n t i n u e to the inside (medial) side o f t h e k n e e ; t h e t h i r d a t t a c h e s l a t e r ally b e l o w t h e k n e e j o i n t . T h e c o m b i n e d a c t i o n o f t h e l o n g superficial m u s c l e s a f f e c t s b o t h t h e k n e e a n d t h e h i p j o i n t s . Like t h e shoulder, t h e k n e e is a s u s p e n d e d s t r u c t u r e . O n its l a t e r a l s i d e , p o s i t i o n a n d f u n c t i o n are d e t e r m i n e d b y t h e gluteus m a x i m u s , t h e t e n s o r fascia lata, a n d t h e lateral h a m s t r i n g (biceps femoris). O n t h e m e d i a l side of t h e k n e e , t h e r e is t h e interact i o n o f t h e sartorius, gracilis, a n d t h e t w o hamstrings (semitendinosus and semimembranosus). M e d i a l l y a n d l a t e r a l l y , t h i s s u p e r f i c i a l suspension of the knee resembles two inverted tripods. Medially, t h e s u s p e n s i o n s are f r o m t h e a n t e r i o r superior iliac spine, p u b i c r a m u s , a n d ischial tuberosity. Laterally, t h e y are t h e ischial tuberosity, t h e sacroiliac joint, a n d t h e

Figure 19-2 The psoas connects the lumbar spine (deep) with the lesser trochanter of the femur (superficial).

l a t e r a l side o f t h e a n t e r i o r s u p e r i o r i l i a c s p i n e . It is our professional experience that knee problems originate in the knee only w h e n

W h e n a p e l v i s i s t i l t e d sidew a y s . on an i n n e r p r o j e c t i o n o f t h e f e m u r c a l l e d t h e lesser trochanter. A b i g surprise i n o u r c l a s s i f i c a t i o n o f m u s cles as superficial or deep c o m e s w h e n we c o n s i d e r t h e p s o a s (Fig. t h e p s o a s will b e t i g h t e r o n o n e side a n d m o r e f l a c c i d o n t h e o t h e r (Fig. T h e deeper layer of muscles in t h e h i p affects only t h e hip joint. This analysis of knee injuries is borne out by m a n y b o d y w o r k e r s . w h o r e p o r t b e s t results ameliorating the knee problems of dancers or runners when working with the hip. inside of t h e pelvic b o w l . I t flows d i a g o nally over t h e p u b i c b o n e just medial to t h e a n t e r i o r s u p e r i o r i l i a c s p i n e . t h e psoas is in fact t h e m o s t superficial tissue. w h i c h t h e n modifies the tracking of the knee. It crosses t h e pelvic bowl at an angle. T h e psoas is a m a j o r factor in t h e curve of t h e lower back (lumbar) region. These muscles b a l a n c e a n d s t a b i l i z e t h e leg a s o n e m o v e s Figure 19-4 Psoas and iliacus fasciae c o m e t o g e t h e r at the groin. 19-3). . Over time. o n e m i g h t t e r m i t t h e Rolfer's m u s c l e . the obturator internus.g. 19-2). and we therefore define it as an extrinsic. It can be palpated by placing your f i n g e r o n t h e a n t e r i o r s u p e r i o r iliac s p i n e a n d t h e n m o v i n g just medially. It crosses t h e w h o l e o f t h e p e l v i s w i t h o u t a t t a c h i n g t o it. A knee that tracks straight forward implies t h a t its a t t a c h e d m u s c l e s are i n e q u a l t e n s i o n . T h e a c t i o n o f t h e p s o a s c a n b e p a l p a t e d i f y o u k i c k y o u r leg while sitting. superficial structure. Its l o w e r a t t a c h m e n t is on the inside of the thigh. It t h e r e b y indirectly determines t h e vertical tilt o f t h e p e l v i s . On t h e Figure 19-3 The tilt of the pelvis changes/is changed by the t o n e of the psoas.100 THE ENDLESS WEB Lateral pelvic tilt there has b e e n direct trauma to t h e knee. The iliacus fascia is continuous with the deep pelvic fascia. T h e upper a t t a c h m e n t of t h e psoas is on t h e lower thoracic and upper lumbar vertebrae. It is n e v e r t h e l e s s a m u s c l e t h a t crosses m o r e t h a n two joints. using a knee in a d e v i a t e d p o s i t i o n will result in a " k n e e i n j u r y " w h i c h has originated in t h e pelvis. f o r m i n g a l m o s t a n S s h a p e . U n e q u a l t e n s i o n i n t h e k n e e m u s c l e s originates in the hip. e. I t lies o n t h e i n s i d e o f t h e b o d y and attaches inferiorly deep within the leg. T h i s w a s Ida Rolf's f a v o r i t e m u s c l e . forming the iliopsoas tendon.

T h e r e i s n o t a free f l o w o f m o v e m e n t t h r o u g h t h e lower back vertebrae. The term "lower back" includes the lumbar s p i n e . . T h e iliacus is a m a j o r i n n e r d e t e r m i n a n t of t h e placem e n t of the ilium. T h e largest of t h e adductors is t h e a d d u c t o r m a g n u s . I t arises a s a l a r g e m a s s f r o m t h e w h o l e l e n g t h o f t h e p u b i c r a m u s . T h e p e c t i n e u s . B o t h iliacus a n d p s o a s are i n v o l v e d i n t h e p l a c e m e n t o f t h e pelvis a n d l u m b a r s p i n e . I t c a n b e felt a s a h e a v y c o r d j u s t t o t h e s i d e o f t h e g e n i t a l s . a n o t h e r a d d u c t o r . it almost never relaxes. On the inside of the thigh. the psoas is a m a j o r inner determinant of the placement of the lumbar spine. It l i n e s t h e i n n e r pelvic bowl. the attachment extends medially t o t h e i n n e r side o f t h e s a c r u m a n d i s thus o f t e n a factor w h e n t h e r e are sacroiliac problems. T h e iliacus f o l l o w s t h e p a t h o f t h e p s o a s t o t h e lesser t r o chanter and often joins with it to form a c o m m o n t e n d o n . Tension is transmitted from inner thigh to pelvis a n d / o r vice versa. T h e delicate rocking m o v e m e n t w i t h i n t h e p e l v i s t h a t is e s s e n t i a l f o r a fluid s t r i d e is lacking. I t c a n b e felt on palpation of t h e groin region. t h e pelvic bowl. flat. In a g e n e r a l way. b e h i n d a n d d e e p t o t h e h a m s t r i n g s (Fig. T h e muscle c o n t i n u e s d o w n across the pubic b o n e in a funnel shape. T h e i l i a c u s m u s c l e lies d e e p t o t h e p s o a s i n s i d e t h e p e l v i s (Fig. lies b e t w e e n t h e a d d u c t o r l o n g u s a n d t h e psoas. A h a b i t u a l c o n t r a c tion in this muscle creates a feeling of spasm on t h e inside of t h e pelvis. Their range of m o v e m e n t is small b u t their s h o r t n e s s gives t h e m a great m e c h a n i c a l a d v a n t a g e . Its tightness is unrelenting. T h e iliacus lines t h e entire i n n e r surface of t h e pelvic b o w l . is lost. In some people. a n d t h e t w o ilia. T h e adductor longus attaches to the inside u p p e r t h i r d o f t h e f e m u r . T h e extent of their effect is great because of their fascial c o n n e c t i o n s u p i n t o t h e t r u n k a n d d o w n i n t o t h e leg.PELVIS AND UPPER LEGS 101 through t h e m sequentially in walking. as well as of t h e m u s c l e s . T h e y c o n t i n u e d o w n to t h e upper part of t h e inside of the femur. 19-6). i n d e p e n d e n t m o v e m e n t o f t h e s e b o n e s . 19-4). gracilis. 19-5). the adductor longus is m o s t c o m m o n l y o v e r u s e d . W h e n t h e psoas is glued d o w n o n t o t h e iliacus. t h e s a c r u m . t h e s e d e e p e r m u s c l e s f o r m almost a circle of m u s c l e a n d fascia a r o u n d the upper part of t h e femur. magnus) is continuous up into the pelvic bowl and influences the urogenital and pelvic diaphragms. o f t e n f a i r l y f l a c c i d m u s c l e d e s i g n e d t o d r a w t h e leg m o r e t o w a r d t h e c e n t e r . or t h e femur. T h e adductor m a g n u s is t h e basis for t h e c h a r a c teristic shape t h a t is o f t e n seen on t h e i n n e r Figure 19-5 The fascia of the adductor group (longus. in a depression b e t w e e n t h e t w o longer muscles. I t fills t h e space d e e p t o t h e gracilis a n d e n d s b y wrapping around the back of the femur. It is a s h o r t . It attaches along t h e entire i n n e r curve of t h e ilium. j u s t b e l o w t h e a t t a c h m e n t s o f t h e iliacus a n d t h e psoas. three adductor muscles attach to the pubic ramus and the f r o n t o f t h e p u b i c b o n e (Fig. Of these. T r o u b l e c o m e s w h e n t h e superficial a n d d e e p m u s c l e l a y e r s are g l u e d together. just b e l o w t h e crest. crossing t h e hip b o n e n e x t t o t h e psoas.

It funnels downward and attaches on the top of t h e greater t r o c h a n t e r of t h e femur. This is the structural basis for the more tenacious "love handles. T h e s e m u s c l e s serve m o r e f u n c t i o n s t h a n purely l a t e r a l r o t a t i o n o f t h e leg." . t h i s is v i s i b l e as a m a r k e d d i m p l i n g b e l o w t h e pelvis. Underlying the gluteus m a x i m u s and m e d i u s t h e r e i s a g r o u p o f s e v e n m u s c l e s . 19-7). W e will d i s c u s s o n l y s o m e of t h e m in detail. yet a m o v e of purely lateral r o t a t i o n is a l m o s t never m a d e . T h e deeper muscle t h e n c a n n o t achieve its t r u e t o n e a n d f u n c t i o n . six o f w h i c h a r e c l a s s i f i e d a s lateral r o t a t o r s o f t h e l e g (Fig. w h e n t h e h a m s t r i n g s are s t u c k t o t h e a d d u c t o r m a g n u s . 19-8). t h e gracilis takes over t h e f u n c t i o n of t h e adductor magnus. t h e r e is a f a n Figure 19-6 A midthigh cross section illustrating the major compartments: flexor. i m p e d i n g t h e free s w i n g o f t h e leg. adductor. w h i c h a c c o m p a n i e s a "flat ass. extensor (hamstrings). Like t h e p e c t i n e u s . All s e v e n m u s c l e s a t t a c h like a f a n t o t h e b a c k p a r t o f t h e g r e a t e r t r o c h a n t e r o f t h e f e m u r . The relationships change higher and lower in the thigh. the head of the femur is pushed into t h e h i p s o c k e t . It forms Figure 19-7 The gluteus medius is influenced by the gluteus maximus. The fascia of the gluteus medius is continuous with that of the abdominal obliques at the iliac crest.102 THE ENDLESS WEB side o f t h e t h i g h . It attaches on the lower m a r g i n of t h e greater t r o c h a n t e r a n d continues to t h e pelvic ischial tuberosities. T h e lowest of t h e lateral rotators is t h e quadratus femoris. i t i s u s u ally u n d e r d e v e l o p e d a n d underused." a part of t h e fold or crease of t h e buttocks. t h e u s u a l r e s u l t will b e s p a s m s o r c r a m p s in t h e hamstrings that no a m o u n t of stretching c a n relieve. I n a d d i t i o n . A h a l l m a r k o f t h i s k i n d o f h o l d i n g o r s h o r t e n i n g i s t h e t h i c k e n e d t i s s u e o n t h e side o f t h e hips. o n t h e crest o f t h e ilium. W h e n t h e q u a d r a t u s f e m o r i s a n d its f a s c i a l c o v e r i n g a r e t i g h t . W h e n t h e upper border of t h e gluteus m a x i m u s is stuck to t h e gluteus medius. It is partially covered by the upper margin of the gluteus m a x i m u s . which overlaps it. At t h e i n t e r m e d i a t e l e v e l . and abductor (ilio-tibial tract). T h e t e r m " l a t e r a l r o t a t i o n " is an anatomist's term. shaped muscle called t h e gluteus medius on t h e side of t h e p e l v i s (Fig. underlying t h e posterior portion of the groin b a n d . W h e n t h e k n e e i s r o t a t e d o u t o f t r u e . Its u p p e r a t t a c h m e n t is on t h e crest of t h e ilium.

Figure 19-8 The rotators of the hip include the piriformis. t h e o b t u r a t o r intern u s . slightly above t h e obturator internus. T h e gluteus m i n i m u s is n o t included as a lateral r o t a t o r i n c l a s s i c a l a n a t o m y . Actually. also a lateral rotator. T h e piriformis. We are including the lines of force of the gluteus minimus to complete the picture of this fascial layer. and the superior and inferior gemelli. T h e piriformis crosses i n t o t h e p e l v i s t h r o u g h t h e g r e a t e r sciatic f o r a m e n . a l o n g w i t h t h e large sciatic nerve. An a t t e m p t to correct t h e situation by f o r c i n g t h e feet t o p o i n t s t r a i g h t f o r w a r d i s n o t s u c c e s s f u l b e c a u s e t h e p r o b l e m arises i n Figure 19-9 Note the relation of the fascia of the obturator internus to the deep pelvic fascia. T h r o u g h its c o n n e c t i o n w i t h t h e i n n e r tissue o f t h e p e l v i s . a t t a c h i n g a r o u n d t h e circular o p e n i n g called t h e obturator f o r a m e n . I t lies d e e p t o t h e gluteus medius a n d attaches o n t h e outside of the ilium to t h e upper part of t h e greater trochanter. 19-9). w i t h a c o r r e s p o n ding winging-out of the upper margin of the pelvis. the obturator externus is not visible from this angle. w i t h f e e t a n d legs s p l a y e d s i d e ways. its t e n d o n a t t a c h e s o n t h e o u t s i d e o f t h e h i p . m i d w a y b e t w e e n t h e ischial tuberosity a n d t h e tailb o n e . t h i s fan-shaped m u s c l e c o m p l e t e s t h e larger fan of t h e l a t e r a l r o t a t o r g r o u p . b o d i e s w i t h t h a t d i m p l e t e n d t o w a l k w i t h a w a d d l e . The muscle body is on the inside of the pelvis. T h e m u s c l e i t s e l f fills t h e l o w e r i n s i d e b o w l o f t h e p e l v i s . lies h e a d w a r d o f t h e q u a d r a t u s f e m o r i s (Fig. . t h e o b t u r a t o r i n t e r n u s i s very likely t o b e c o n n e c t e d w i t h m e n strual o r p r e m e n s t r u a l t e n s i o n a n d c r a m p s in w o m e n . internal and external obturators. quadratus femoris. i t f r e q u e n t l y g i v e s rise t o t h e pain that is called sciatica. attaches to t h e b a c k part of t h e greater trochanter. T o u s . For clarity we have omitted the lines of force of the minute gemelli. W h e n this muscle is cramped or chroni c a l l y t e n s e d . Its e x t e r n a l p a r t is a t e n d o n t h a t attaches on t h e greater t r o c h a n t e r a n d crosses t h e b a c k part o f t h e pelvic b o n e . Tightness in t h e lateral rotators as a group provides the dimple in the back of the butt o c k s t h a t l o o k s s o c u t e t o s o m e p e o p l e .P E L V I S A N D U P P E R LEGS 103 A n o t h e r lateral rotator. It angles headward to attach to t h e underside of the sacrum. A very tight obturator internus in m e n tends to show as an extreme narrowness o f t h e pelvis a t t h e b o t t o m .

About halfway d o w n t h e lower bowl. this fascial tightness in t h e h i p results in a gait t h a t is initiated in t h e lower b a c k . we described the necessary s e q u e n c i n g of muscles as t h e a r m is r a i s e d . In t h e h i p . a n d i n w o m e n t h e u t e r u s a n d . W h e n t h e h i p is tightly b o u n d . In actuality. T h e shape on t h e inside of t h e pelvic bowl ( p e l v i s a n d s a c r u m ) is like t w o b o w l s . You c a n t e s t t h i s b y s t a n d i n g s i d e w a y s o n a stair w i t h o n e leg a n d a l l o w i n g t h e o t h e r leg t o s w i n g o v e r t h e l o w e r stair. greater bowl. Muscles are h e l d in readiness (tonus) a n d c a n t h e n contract or lengthen as needed.1 0 Fascial continuity: adductors -> obturator internus -> iliacus -> internal abdominal obliques -> diaphragm. I t i s d i f f i c u l t f o r m o s t o f u s t o a l l o w t h e leg t o m o v e i n d e p e n d e n t l y i n its p e l v i c s o c k e t . is lined by t h e iliacus m u s c l e a n d its f a s c i a . All m u s c l e s s h o u l d n o t f u n c t i o n s i m u l taneously. s m a l l e r b o w l i s l i n e d o n its sides b y t h e o b t u r a t o r i n t e r n u s a n d its fasc i a . As o n e muscle or group of muscles is called into action to induce movem e n t o f t h e leg. t h e o p p o s i n g m u s c l e o r m u s cle group should relax a n d lengthen. In discussing m o v e m e n t of the arm at the shoulder (Section 17). S i n c e t h e t w o b o w l s are c o n t i n u o u s . a sling-like a r r a n g e m e n t of m u s c l e a n d fascia divides it i n t o upper a n d lower parts. This i s t h e p e l v i c floor. b y p a s s i n g t h e h i p j o i n t — a s t r u t t i n g gait. a l s o c a l l e d t h e p e l v i c diap h r a g m . 19-10). Ideally. sequencing of muscle u s e i s n e c e s s a r y f o r s t a b i l i t y i n t h e leg a s w e l l as the shoulder. T h i s allows for precise c o n t r o l c o m b i n e d w i t h flexibility in t h e shoulder joint. w e s h o u l d b e a b l e t o s w i n g t h e leg i n t h e h i p j o i n t w h i l e t h e p e l v i s r o c k s . A b o v e t h i s d i a p h r a g m lies t h e b l a d der. w h i c h is t h e i n n e r surface of t h e ilium. t h e tightness o f tissue i n t h e h i p . a larger bowl on t o p of a smaller o n e . forcing t h e feet to track straight forward puts a t o r q u e i n t o t h e leg that peaks at the knee. t h e usual c o n c e p t is t h a t t h e leg m u s t b e tightly h e l d s o t h a t m o v e m e n t will In walking. U s u a l l y t h e l e g c a n m o v e o n l y a s a u n i t w i t h t h e w h o l e side o f t h e h i p . Each must be called into action as the arm reaches the angle where that muscle ( o r p a r t o f t h e m u s c l e ) h a s its e f f e c t . i t is easy to visualize t h e fascial c o n t i n u i t y between the obturator internus and the iliacus (Fig. T h e l o w e r . Figure 1 9 . T h e upper. r e c t u m .104 THE ENDLESS WEB be stable.

t h e tilt of t h e p e l v i s will f o l l o w suit. We refer to t h e m in this text as the pelvic diaphragm. bladder. F a n n i n g o u t f r o m this m u s c l e are t h e iliococcygeus. T h e labia m a j o r a are frequently almost glued to the b o n e s of the rami. T h e s o f t t i s s u e o f t h e p e l v i c d i a p h r a g m will s h o w t h e stress. w h i c h has an effect on t h e f u n c t i o n of t h e penis. T h e margins of t h e pelvic d i a p h r a g m are c o n t i n u o u s w i t h t h e o b t u r a t o r i n t e r n u s fascia. these are o f t e n referred to a n a t o m i c a l l y as t h e levator a n i . T h e urogenital d i a p h r a g m does n o t e x t e n d t h i s far b a c k . to the inside of the second or third segment of the coccyx.PELVIS AND UPPER LEGS 105 ovaries. Below t h e pelvic diaphragm. In females. T h e t o n e of this diaphragm is a m a j o r factor in healthy reproductive and elimination systems. It connects the back of the pubic b o n e . T h e area b e t w e e n t h e ischial tuberosities a n d t h e tailbone is referred to as t h e ischiorectal fossa. behind the pubic symphysis. T h i s area i s o f t e n c o m p r e s s e d b y c l e n c h i n g the muscles of the buttocks. Collectively. This means that the opening to the v a g i n a i s r e l a t i v e l y rigid a n d l a c k s t h e resilience a n d flexibility that is i m p o r t a n t for sex and childbirth. (Fig. T h e o n l y m u s c l e c o n t a i n e d in this area is t h e e x t e r n a l s p h i n c ter of t h e anus. T h e pelvic diaphragm is c o m p o s e d of four muscles. T h e r e m a i n d e r of t h e area is filled w i t h a f a t p a d . W h e n the lumbar spine is angled t o o sharply forward or backward. In males it contains the perineal muscles. also k n o w n as t h e p e r i n e u m . T h e t o n e o f one is reciprocally determined by the t o n e of the other. 19-11). . including the muscles at the base of the penis. There is a m u t u a l b a l a n c e b e t w e e n these sphincter muscles a n d t h e sling m u s c l e s of t h e pelvic floor m e n t i o n e d above. is the urogenital diaphragm. a n d i n w o m e n t h e vagina. the ischiococcygeus. and the coccygeus. Blended into the muscles of the pelvic d i a p h r a g m are t h e s p h i n c t e r m u s c l e s o f t h e anus. T h e p u b o c o c c y g e u s is t h e largest of these. filling t h e space horizontally b e t w e e n t h e V-shaped bones of the pubic rami. Figure 19-11 The margins of the pelvic diaphragm are continous with the obturator internus fascia. the perineum is bisected by the o p e n i n g t o t h e v a g i n a .

20-2). T h e c o n n e c t i v e tissue is responsible for t h e c o n t i nuity of m o v e m e n t through the body. Acute t e n s i o n s are c o m m u n i c a t e d t h r o u g h t h e b o d y b y way o f these horizontal a n d vertical c o n n e c t i v e tissue p a t h w a y s . focusing in t h e greatest detail on the trunk a n d pelvis. a n d t h e m e d i a s t i n u m . a n d ends a s t h e fascial s e p t u m t h a t lies b e t w e e n t h e t w o h a l v e s o f the brain. t h e i n t e r n a l fascial l i n i n g o f t h e b o w l o f t h e pelvis.TWENTY The System of Horizontal and Vertical Myofascial Structures W h a t we h a v e tried to do in our consideration of the muscles of the body is to show h o w m u s c l e s a n d c o n n e c t i v e tissue interact. T h e urogenital d i a p h r a g m is below. . Figure 20-1 The connective tissue establishes the spaces of the body. we have described a vertical (core) system t h r o u g h t h e b o d y in e a r l i e r s e c t i o n s (Fig. We h a v e also m e n t i o n e d the scalene muscles at the base of the neck a s a c t i n g like a d i a p h r a g m a f f e c t i n g t h e t o p of the lungs. There is t h e respiratory diaphragm in t h e trunk separating the abdominal cavity from t h e chest cavity. In addition to this system of horizontal myofascial structures. T h i s v e r t i c a l c o n t i n u u m includes the interosseous m e m b r a n e o f t h e legs. t h e d e e p f a s c i a o f t h e t h i g h . T h e lowerm o s t t w o o f t h e s e d i a p h r a g m s are i n t h e pelvis. w i t h t h e p e l v i c d i a p h r a g m s l i g h t l y a b o v e it. We use m u s c l e a n a t o m y to orient ourselves in t h e c o n n e c t i v e tissue bed.2 The plumb line. T h i s results in a generalized tension through t h e inner aspect of the body that is characteristically Figure 2 0 . 20-1). T h e s e a r e h o r i z o n t a l m y o f a s c i a l s t r u c tures t h a t cross t h r o u g h t h e body. It c o n t i n u e s by w a y of t h e fascia a r o u n d t h e cervical viscera (esophagus and trachea) to the back of the m o u t h a n d p h a r y n x . T h e c o n n e c t i v e tissue is responsible for establishing t h e spaces of the b o d y by m e a n s o f w h a t w e h a v e c a l l e d t h e d i a p h r a g m s (Fig.

T h e fascia of t h e psoas via t h e iliacus is also c o n t i n u o u s w i t h t h a t of the obturator internus. J u s t l a t e r a l t o e a c h side o f t h e v e r t e b r a l c o l u m n . W h e n this is out of b a l a n c e . t h e r e s p i r a t o r y d i a p h r a g m blends into the transverse and oblique abdominal muscles. t h e f a s c i a o f t h e p s o a s i s c o n t i n u o u s with t h e fascia of t h e lower border of t h e d i a p h r a g m . W h e n w e refer t o s p a c e s w i t h i n t h e b o d y . continuing into the pelvic diaphragms by . For e x a m p l e . T h e y are f i l l e d w i t h organs. adjacent to the vertebral c o l u m n . In the front. I n t h i s way. O n t h e sides. T h e vertical a n d horizontal myofascial pathways we have described above exist as a n o r m a l part of t h e structure of t h e body. T h e rectus a b d o m i n i s provides a c o n n e c t i o n b e t w e e n t h e f r o n t o f t h e respiratory diaphragm and the pubic bone. t h e r e are c o n n e c t i o n s f r o m t h e respiratory diaphragm d o w n i n t o t h e p e l v i s . c o n nective tissue. t h e c o n n e c t i v e tissue of t h e psoas is continuous with that of the quadratus l u m b o r u m and the erector spinae. T h e s e are s e c o n d a r y f u n c t i o n a l structures. 20-3).HORIZONTAL AND VERTICAL MYOFASCIAL STRUCTURES 107 e x p r e s s e d as a k i n d of o v e r a l l i r r i t a b i l i t y . the d i a p h r a g m is c o n t i n u o u s with t h e fascia on t h e underside of t h e rectus a b d o m i n i s . which then blends i n t o the diaphragms in the pelvis. W h e r e t h e a b d o m i n a l d i a p h r a g m lies Figure 20-3 It is obvious from this diagram that changes in any part of the abdomen and pelvis will affect all of the abdomen and pelvis. etc. In t h e back. o b l i q u e s are a c o n t i n u a t i o n of t h e respiratory diaphragm d o w n to t h e crest of t h e ilium. it s h o u l d be r e m e m b e r e d t h a t t h e s e spaces are n o t e m p t y . The abdominal Figure 2 0 . It is a feeling of "don't t o u c h m e " or "I can't c o p e " rather t h a n an acutely debilitating pain. muscles. t h e p s o a s penetrates these crurae and extends up to attach to the lower vertebrae in the chest c a v i t y . c o n n e c t i v e tissue filling t h e interv e n i n g s p a c e s r e s p o n d s b y e s t a b l i s h i n g stress lines. T h e y are established in r e s p o n s e to need and m a y be resorbed as function is modified. it sends e x t e n s i o n s ( c r u r a e ) d o w n a s far a s t h e u p p e r p a r t o f t h e s a c r u m (Fig.4 Fascial connection between pubic bone and humerus.

e x t e n d i n g across t h e pectoralis m a j o r to t h e a r m (Fig.108 T H E E N D L E S S W E B way of t h e fascia of t h e iliacus a n d obturator internus. Fascial p a t h w a y s o n t h e b o d y surface also c o n t r i b u t e t o t h e b a l a n c e a m o n g t h e diaphragms. F a s c i a l s h e e t s o n t h e surface o f t h e obliques tie upward i n t o t h o s e o n t h e s e r r a t u s a n t e r i o r u n d e r t h e s c a p u l a (Fig. t h e f a s c i a o v e r t h e g l u t e u s m a x i m u s flows upward obliquely i n t o t h a t of t h e latissimus dorsi c o n n e c t i n g o n u p i n t o t h e Figure 2 0 . T h e o f t e n leathery covering of t h e erector spinae c a n immobilize the vertical play of a n y o r all o f t h e d i a p h r a g m s . covering more o f t h e body. These connections tend to be in broader and longer sheets. a r m . I n t h e b a c k .5 Fascial connection from front of abdomen to upper back. 20-4). . 20-5). O n e c o n n e c t i o n u p across t h e a b d o m e n i s b y w a y o f t h e superficial a b d o m inals.

T h e r e is m o r e fullness of b r e a t h w i t h less e f f o r t . Notice that w h e n t h e h e a d i s h e l d v e r y still. t h e s p i n e i s like a s p r i n g . Allow your head and shoulders to be as limber and loose as possible. Even t h e smallest m o v e m e n t creates a ripple t h r o u g h o u t t h e entire o r g a n i s m . S o m a y b e w e s h o u l d say t h a t w h e n w e are p r o p e r l y i n t o n e . W h e n c o n n e c t i v e tissue is in t o n e . We t e n d to forget t h a t we are a single v i b r a t i o n a l u n i t . I f y o u t h e n h o l d y o u r h e a d still (like s t a r t i n g t o t h i n k a b o u t s o m e t h i n g ) . t h e b r e a t h i s b o t h shallower and more labored. a n y gesture vibrates t h r o u g h o u t a living body. I f t h e l u m b a r s p i n e i s t o o flat o r s t r a i g h t . O n e of t h e t h i n g s t h a t a Slinky will do is pull itself d o w n s t a i r s . W h e t h e r t h e h o l d i n g i s o f a single m u s c l e or of a larger part. picking up t h e baby. If t h e lumbar spine is curved t o o far f o r w a r d . it transmits m o v e m e n t . H o l d i n g o n e p a r t still c o n s t i t u t e s a n interference with our resonance. T h e y a r e d e l i b e r a t e g e s t u r e s . very l o n g spring coil of steel. y o u c a n f e e l a g r e a t e r ease in b r e a t h i n g . t h e c e r v i c a l s p i n e will a l s o b e c u r v e d t o o far f o r w a r d . l e t t i n g your head and arms be very loose. w h i l e still w a l k i n g . W e c a n d e m o n s t r a t e this for ourselves b y t w o a w a r e n e s s e x e r c i s e s . I f y o u start b y p u l l i n g o n e e n d o f t h e coil d o w n o n e step.TWENTY-ONE Reciprocity of Movement restriction in your breathing. freedom of m o v e m e n t throughout the spine will b e i n h i b i t e d . d r i v i n g t h e car. T h e true diagn o s i s o f t h e s p i n e i s n o t i n its c u r v a t u r e b u t i n its q u a l i t y o f m o v e m e n t . I f o n e s e g m e n t o f t h e v e r t e b r a l c o l u m n i s b e i n g h e l d still. Another example of this can be seen in walking. T h e tissue t h r o u g h w h i c h this ripple is t r a n s m i t t e d is t h e c o n n e c t i v e tissue. this will give y o u an e x a g g e r a t i o n . It transmits vibrations. W e all have holding patterns in our bodies that are i n v o l u n t a r y . and sense your breathing. Be aware of your breathing with your b o d y relaxed as m u c h as possible. w e usually t h i n k o f large g e s t u r e s like w a l k i n g . e a c h circle in t h e coil . e x p a n d i n g a n d c o n t r a c t i n g a s t h e person m o v e s a n d b r e a t h e s . N o p a r t o f a m o v i n g s p i n e s h o u l d b e q u i e t o r still. Feel h o w y o u r b a c k l e n g t h e n s a n d m o v e s w i t h greater ease. Your step will b e c o m e m u c h softer. C o n c e n t r a t e o n a t h o u g h t . If y o u o n c e a g a i n let y o u r h e a d b e v e r y easy. T h e s e are t w o e x a m p l e s o f h o w h o l d i n g o n e p a r t o f t h e b o d y a f f e c t s t h e rest o f t h e b o d y . a g a i n let y o u r h e a d g o easy. a l o n g w i t h t h e rest o f y o u r b o d y . It is t e m p t i n g to classify t h e b a l a n c e of t h e spine by the way a person holds himself w h e n h e i s s t a n d i n g still. W h e n y o u h i t t h e side of a table. You will n o t i c e an increased heaviness on your heels as you w a l k . T h e r e is a t o y c a l l e d a S l i n k y r M S p i n a l c u r v e s are r e c i p r o c a l . Yet m o v e m e n t c a n be as subtle as slow breathing during sleep. T h e c u r v e o f t h e lumbar spine is reflected in t h e curve of t h e cervical spine. t h e c e r v i c a l s p i n e will b e t o o flat o r s t r a i g h t . t h e resonance of t h e blow vibrates t h r o u g h t h e entire table. w a s h i n g t h e d i s h e s . w e h u m — t o each person his or her characteristic t o n e . T h e n . n o d d i n g g e n t l y y e s (or n o . I n a c t u a l i t y . t h e w h o l e b o d y will b e affected. A f t e r w a l k i n g i n t h i s m o r e stressful p o s i t i o n . W h e n w e talk a b o u t m o v e m e n t . Similarly. a n d r e g i s t e r h o w t h i s h o l d i n g r e s u l t s i n rigidity in t h e w h o l e b a c k . y o u will s e n s e a . d o i n g work. Sit o r s t a n d . a highly tempered. A b o d y never stops m o v i n g . it i s m u c h like t h e c a t g u t o n a p r o p e r l y s t r u n g cello. If you can e v e n let t h e m flop a bit. i f t h a t ' s y o u r a t t i t u d e ) . h o l d y o u r h e a d still.

It starts with the continuity of the whole back with the leg. b o t h c l e n c h i n g t h e b u t t o c k s o r h o l d i n g t h e legs h a v e a c l e a r e f f e c t o n t h e b a c k all t h e w a y u p t o t h e h e a d . Usually.d o r s a l fascia. a n d to a different degree at e a c h level. 21-1) T h u s . the change in directional pull converges over a wider area. a l t e r n a t i n g f r o m o n e side to t h e other of the vertebral c o l u m n .110 T H E E N D L E S S W E B w i l l p u l l t h e n e x t o n e a f t e r it. w h i c h b l e n d s i n t o t h e h e a v y c o n n e c t i v e tissue p a d on the sacrum and coccyx. H o l d i n g at deeper levels affects smaller s e g m e n t s . .t i b i a l b a n d (Fig. Figure 21-3 Still at a superficial level. t h e l u m b o .2 As we include the fascia of the latissimus dorsi. T h i s i s a n e x ample of m o v e m e n t reverberating through a structure. The change in direction converges on the sacrum. A l t h o u g h it is n o t m a d e of steel. This kind of reciprocity of m o v e m e n t is especially apparent in the spine. Figure 2 1 . From the sacrum. p r o b l e m s i n t h e b a c k are g e n e r a l i z e d t o t h e b u t t o c k s a n d legs a s w e l l a s t o t h e h e a d . T h e e r e c t o r s p i n a e are c o v e r e d b y a h e a v y f a s c i a l s h e e t . as in scoliosis. t h e fascia c o n t i n u e s diagonally across t h e b u t t o c k s a n d o n i n t o t h e i l i o . t h e elasticity a n d organization of t h e c o n n e c t i v e tissue reverberates like a Slinky in t h e body. Because the superficial m u s c l e s are t h e longest. t h e l u m b o . are a c c o m p a n i e d by stepwise c o m p r e s s i o n of t h e soft t i s s u e o f t h e b a c k . the fascia of the trapezius adds yet another dimension.d o r s a l fascia Figure 21-1 The superficial fascia of the back is layered. T h r o u g h its c o n n e c t i o n w i t h t h e f a s c i a o f t h e l a t i s s i m u s d o r s i . C o n v e r s e l y . h o l d i n g in an area occurs at m o r e t h a n o n e level. Sideways curvatures of t h e b a c k . h o l d i n g p a t t e r n s at a s u p e r f i c i a l l e v e l a f f e c t a b r o a d e x p a n s e of t h e b a c k .

D i s t o r t i o n i n a n y o n e will distort all t o s o m e d e g r e e . r e a c h i n g — all i n c l u d e t w i s t i n g o r s p i r a l i n g . o n e h i p a n d leg h a b i t u a l l y stand slightly forward of t h e other.RECIPROCITY OF MOVEMENT 111 mediates a reciprocal effect on t h e freedom of t h e s h o u l d e r a n d a r m (Fig. T h e f a s c i a l crossover point between t h e trapezius a n d t h e latissimus dorsi (the dorsal h i n g e ) is at a b o u t t h e s i x t h a n d e i g h t h t h o r a c i c v e r t e b r a e (Fig. t h e fascial c o v e r i n g o f t h e b a c k i s c o n t i n u o u s w i t h all o t h e r p a r t s o f t h e b o d y . Fascia of psoas m. Figure 2 1 . there is the psoas. T h e fascial s h e e t s o f t h e e r e c t o r s p i n a e . In short. l e a n i n g over. 21-3). m o v e m e n t s are o b viously n o t straight forward or straight backward. The continuity of the fascia as it ensheathes the muscles and the vertebra is emphasized. q u a d ratus l u m b o r u m . .t e r m relief i n a c u t e t r a u m a . T h e b r o a d fascial c o n n e c t i o n s o n t h e s u r f a c e o f t h e b o d y allow restrictions to be generalized over t h e w h o l e structure. s h o r t e s t free rib) t o t h e u p p e r m a r g i n (crest) o f t h e i l i u m . T h e q u a d r a t u s lumborum is the connection between the inside a n d outside of t h e b o d y at t h e waist. W h a t i s desirable is a balance of the twisting on t h e t w o sides. while t h e s h o u l d e r s a n d a r m s are r e v e r s e d i n r o t a t i o n Figure 2 1 .t r u n k . T h i s c a n give s h o r t . S t a n d i n g r e l a t i v e l y still. H Fascia of quadratus lumborum m. 21-2). H o l d i n g p a t t e r n s o r p a i n i n t h e a r m s ( s u c h as f r o m a t e n n i s e l b o w ) a r e felt as a spinal restriction in this area. T h e quadratus l u m b o r u m i s a s h o r t m u s c l e t h a t lies b e t w e e n t h e p s o a s a n d t h e e r e c t o r s p i n a e (Fig. T h i s muscle is defined as c o n n e c t i n g the twelfth rib ( t h e l o w e s t .5 This diagrammatic cross section of the abdomen is in the region of the lumbar spine. Fascia of i erector spinae m. b u t u l t i m a t e l y s u c h restriction b e c o m e s c h r o n i c a n d difficult to track d o w n a n d release. w h i c h attaches to m o s t of the lumbar vertebrae. In t h e l u m b a r region. I n t h e l u m b a r r e g i o n . 21-5). T h i s f a s c i a l b l e n d i n g t r a v e l s l a t e r ally t o f o r m t h e c o n n e c t i v e t i s s u e c o v e r i n g o f the a b d o m i n a l oblique muscles a n d t h e rectus a b d o m i n i s . O n t h e inside o f t h e spine are t h e d e e p flexors of t h e trunk. 21-4). M o s t o f u s h a v e a s l i g h t r o t a t i o n t o o n e side s o m e w h e r e i n t h e m i d . a n d p s o a s a r e c o n t i n u o u s (Fig.4 The deep muscles of the lumbar region. T h e m o s t frequent m o v e m e n t s o f t h e lower b a c k — w a l k i n g .

w h i c h thickens and shortens. T h e p e a k o f t o r s i o n i n o v e r a l l b o d y spirals will be m o s t a p p a r e n t at t h e waist. Most people have no f u n c t i o n a l waistline a n d therefore few people h a v e a c o n c e p t o f it. T h e upward continuation of the erector spinae into t h e neck blends with the pad at t h e b a c k o f t h e h e a d . Figure 2 1 . w h i c h are e x t e n sors o f t h e n e c k . As t h e lower back unrotates a n d lengthens. A t t h e d e e p e s t l e v e l are t w o p a i r s o f m u s c l e s t h a t lie d i r e c t l y i n f r o n t o f .112 THE ENDLESS WEB (Fig. T h e diff e r e n c e i s p e r h a p s a h a l f a n i n c h o r less.7 For clarity. M u s cles a n d fascia on t h e inside a n d outside of t h e v e r t e b r a l c o l u m n h o l d t h e l o w e r ribs d o w n i n t o t h e tissue a c c u m u l a t i o n o n t h e b r i m of t h e pelvis. t h e y t o o will h a v e a m o r e amia b l e r e l a t i o n s h i p w i t h t h e i r tailor. The composite of the two sides make up the total myofascial complement. T h e largely vertical a c t i o n o f t h e s e m u s c l e s i s m o d i f i e d b y a latFigure 2 1 . h a v e t o w o r k h a r d e r a n d trav e r s e a g r e a t e r d i s t a n c e . eral p u l l f r o m t h e m o r e s u p e r f i c i a l t r a p e z i u s . T h e o p p o s i n g l e g a n d h i p . T h e w a i s t l i n e b e c o m e s apparent w h e n the body unrotates and the l o w e r f r e e ribs l i t e r a l l y lift o f f t h e p e l v i s . Nevertheless. I n w a l k i n g . t h e side t h a t w o r k s harder will s h o w t h e strain in t h e back. g i v i n g t h e i m p r e s s i o n o f a s h o r t e r l e g a n d a s l i g h t l i m p . w h i l e t h e t o p half goes in t h e o t h e r . T h e b o t t o m h a l f o f t h e b o d y g o e s in o n e direction. This c a n result in ecstasy a n d a n e w wardrobe for w o m e n .6 Habitual rotation of the body. U s u a l l y t h i s side m o v e s d i a g o n a l l y a n d w i t h a s w i n g . a waistline m a y miraculously appear. O n e side w i l l s h o r t e n . O v e r y e a r s o f c o n s t a n t u s e . M e n m a y experie n c e c o n s t e r n a t i o n i f t h e y b e l i e v e t h e pelvis i s n o t supposed to exist except as a small pathw a y b e t w e e n t h e l a r g e c h e s t a n d large t h i g h s . V e r y s l i g h t diff e r e n c e s i n d i s t a n c e i n t h e b o d y c r e a t e large effects. t h e l e g a n d h i p t h a t are s l i g h t l y f o r w a r d h a v e less d i s t a n c e t o t r a v e l a n d therefore t e n d t o m o v e m o r e straight f o r w a r d . T h e flexors on t h e front of t h e neck balance t h e e r e c t o r s p i n a e i n b a c k . we have depicted the deep muscles of the neck separated on the two sides. 21-6). w h i c h are s l i g h t l y b e h i n d .

W i t h every m o v e .8 Superficial fascia of the neck. 21-7). these f l e x o r s o n t h e front o f t h e n e c k (longus colli a n d longus capitis) lack t h e span to f u n c t i o n properly. T h i s i s a n a w k w a r d s i t u a t i o n a n d o n e t h a t leads t o very restricted m o v e ment of the head. 21-8). T h e ideal m y o f a s c i a l b l u e p r i n t i s t h r o w n o u t o f kilter w h e n t h e h e a d i s t h r u s t t o o far forward. T h e s e large m u s c l e s m o v e t h e h e a d w i t h r e spect to t h e n e c k as well as m o v i n g t h e n e c k vertebrae o n t h e trunk. f a n n i n g o u t t o t h e side.RECIPROCITY OF MOVEMENT 113 t h e transverse processes of t h e cervical vertebrae. o n t h e f r o n t o f t h e n e c k . Spinal curves are always c h a n g i n g . I t w a s I d a Rolf's c o n v i c t i o n t h a t s p i n a l b a l a n c e relies c h i e f l y o n s t a b i lizing t h e c o n c a v e curves of t h e spine. t h e r e a r e t h e s c a l e n e m u s c l e s . T h e upper pair (longus capitis) c o n n e c t t h e c e r v i c a l v e r t e b r a e t o t h e b a s e o f t h e skull in front of t h e spinal c o l u m n . If there is fluidity of m o v e m e n t t h r o u g h all p a r t s o f t h e v e r t e b r a l c o l u m n . t h e d o r s a l c u r v e o f t h e s p i n e i s s u p p o r t e d a l o n g its o u t s i d e s u r f a c e b y t h e rhomboids. These muscles flex t h e n e c k o n t h e t r u n k (Fig. are t h e sternocleidomastoid muscles (Fig. fascial g l u i n g c a n o c c u r b e t w e e n f l e x o r s a n d extensors as well as b e t w e e n layers. prevertebral muscles a r e n o t v e r y a p p a r e n t . m o s t h e a d movements must be controlled by the sternocleidomastoid. the longus colli a n d longus capitis t o g e t h e r stabilize t h e c o n c a v e i n n e r surface of t h e n e c k p o r t i o n of t h e spine. Their function as extensors in b a l a n c e with t h e flexors on t h e front of t h e n e c k i s r e d u c e d . and transmission of weight. t h e rest o f t h e b o d y w i l l r e a d i l y arrange itself i n t o appropriate b a l a n c e for t h e person. including breathing. I n t h e n e c k . This is an unusual view of body m e c h a n i c s . These flex t h e h e a d o n t h e t o p cervical vertebrae. Figure 2 1 . T h e erector spinae and the trapezius are t h e n used a l m o s t exclusively to hold the head on. These attach to the transverse processes of t h e cervical vertebrae a n d c o n t i n u e on to t h e s u r f a c e o f t h e first a n d s e c o n d r i b s . W h e n t h e h e a d i s t o o far forward. T h e seco n d set ( l o n g u s c o l l i ) e x t e n d s d o w n f r o m t h e transverse processes of t h e cervical vertebrae to the transverse processes of t h e upper chest (thoracic) vertebrae. T h e fascial w r a p p i n g o f all t h e s e m u s c l e s i s c o n t i n u o u s . a n d gesture. a n d o n e t h a t d e p e n d s f o r its l o g i c on questions of balance. creating problems in t h e freedom of m o v e m e n t of the neck and head. these curves undulate. At a slightly m o r e superficial level. In the chest region. movement. going f r o m m o r e curved to straighter a n d back. time. T h e psoas stabilizes t h e c o n c a v e i n n e r surface of the lumbar spine. W h e n this is t h e case. . Rolf's v i e w . A t t h e m o s t s u p e r ficial l e v e l . T h e sternocleidomastoid then becomes both the chief flexor and extensor o f t h e n e c k . T h e s e are active in b o t h flexing t h e n e c k a n d t u r n i n g t h e n e c k f r o m side t o s i d e . In Dr.

by m e a n s of t h e fibrous joint capsule. w h i c h l i t e r a l l y f l o a t with respect to o n e another.b a l a n c e d a n d h a s full r a n g e Figure 22-1 The joint capsule matures. A n o r m a l joint c o m prises a d j a c e n t b o n e s . In t h e traditional classification of joints. Conversely. irrit a t i o n of s o m e k i n d will result. O u r feeling is t h a t it also applies to those joints classified as slightly m o v a b l e or i m m o v a b l e . there is the i m p l i c a t i o n that e a c h joint f u n c t i o n s in isolation. b a t h i n g t h e e n d s of t h e b o n e s . T h e joint capsule is m a d e up of fibers that have formed in the e m b r y o in response to directional tension lines between bones. • T h e relatively nonresilient t e n d o n s and ligaments.TWENTY-TWO Joints J o i n t s are t h e m o s t c o m p l e x a n d also t h e m o s t interesting focus for t h e w a y different densities in c o n n e c t i v e tissue affect a n d determ i n e m o v e m e n t . At t h e deepest level. T h i s d e s c r i p t i o n a p p l i e s t o all j o i n t s t h a t a r e traditionally classified as freely m o v a b l e . . the periosteum of o n e b o n e is continuous with the periosteum of the next b o n e . a n d is c o n t i n u o u s w i t h t h e p e r i o s t e u m (Fig. Our attitude throughout this b o o k has b e e n t h a t n o o n e part o f t h e b o d y m o v e s w i t h o u t i n t e r a c t i o n w i t h all o t h e r b o d y p a r t s . It is very similar in c o m p o s i t i o n to the interc e l l u l a r m a t r i x o f all c o n n e c t i v e t i s s u e . W h e n t h e j o i n t i s w e l l . T h e y differ o n l y i n t h e p r o p o r t i o n o f fluid within the joint capsule. T h i s c a n be accomplished without the need to touch t h e actual distended area. If t h e ends of t h e b o n e s a r e d r a w n t o o c l o s e t o e a c h o t h e r . w h e n a joint is distended with too m u c h f l u i d (fluid o n t h e j o i n t ) . l o o s e n i n g t h e c o n n e c t i v e tissue a b o v e a n d b e l o w t h e j o i n t r e s u l t s i n a r e t u r n t o n o r m a l size. A m a t u r e j o i n t c a p s u l e a l s o lays stress l i n e s t o a c c o m m o d a t e the different rotations of m o v e m e n t . Our interest is in discovering t h e ways j o i n t s are similar t o e a c h o t h e r a n d in analyzing t h e overall f u n c t i o n of joints w i t h i n t h e c o n n e c t i v e tissue b e d . This encloses t h e fluid-filled s p a c e b e t w e e n t h e b o n e s . is j o i n t fluid. T h e result is an interweaving of fibers around the end of the bones. • T h e m o r e resilient muscular a n d c o n nective tissue c o m b i n a t i o n k n o w n as myofascia. T h e elements of a joint are: • Two or m o r e b o n e s . W i t h i n the joint capsule. 22-1) T h e r e i s a t e n d e n c y f o r c o n n e c t i v e tissue t o w r a p a j o i n t a s stress w i t h i n t h e j o i n t increasingly calls for m o r e stability. T h e differences a m o n g j o i n t s is t h o r o u g h l y described a n d classified in anatomical texts. • T h e fluid-filled j o i n t capsule.

Part o f the structural m a t u r a t i o n that c o m e s with t h e transition from baby to child occurs in the foot. W h a t h e has created is simply h e a v y tissue p a d d i n g over a contracted a n d narrowed structure. T h i s is felt as chronic joint pain. unable to lengthen out. Ankle m o v e m e n t is then limited to flexion—the front of the foot c o m i n g up and down. An a n a l o g y is t h e b a t t e n or strut in an upholstered piece of furniture. A n e x a m p l e o f w h a t w e are t a l k i n g a b o u t i s t h e t h i c k e n i n g a n d s h o r t e n i n g t h a t s o freq u e n t l y occurs i n knees.b o d y c o n dition. It is n o t possible for this to h a v e t h e resilience a n d potential of a truly flexible structure. w e see a n a c c u m u l a t i o n o f e x c e s s tissue. T h e physical e f f e c t i n t h e b o d y . I m m a t u r i t y in a j o i n t is t h e a b s e n c e of ease a n d full r a n g e o f m o v e m e n t . T h e padding can b e c o m e very tough. o n e w h e r e m o v e m e n t is expressed. These have b e c o m e stereotypes. M a n y knees are w r a p p e d i n s u c h a w a y t h a t t h e y are h e l d in a permanently bent position. Yet h i s i s n o t a truly mature structure. T h i s i s a b a l l e t d a n c e r ' s d r e a m b u t m a k e s f o r s t i l t e d w a l k i n g . t h e w o o d adds stability. i s a l w a y s c o n t r a c t i o n in t h e c o n n e c t i v e tissue structure. This also establishes t h e necessary arches of the foot. he c a n n o t fully e x p a n d h i s rib c a g e a n d s h o u l d e r s . Each b o n e floats w i t h respect to t h e other. t h e knee is tightly b o u n d . the . Likewise. t h e h e e l m u s t drop d o w n a n d back. A m a n m a y h a v e a s m a l l rib c a g e a n d t h r o u g h t h e wonders of muscle-building create massive bulk on top. B o n e s are h a r d c o n n e c t i v e t i s s u e e l e m e n t s w i t h i n t h e softer c o n n e c t i v e tissue e l e m e n t s o f t h e body. T h i s p h y s i c a l immaturity is n o t usually a w h o l e . " T h i s bandaging c a n n o t be released until we c a n learn to trust t h e stability of t h e j o i n t . For stable walking. even like b o n e . symbols of w h a t is desirable in a w o m a n or m a n . v o l u p t u o u s hips a n d a child-like top. in stepping down. T h e m a i n s u p p o r t f o r t h e u p h o l s t e r e d p i e c e i s f r o m its stuffing. R o l f r e a l i z e d t h a t t h e b o n e s o f t h e b o d y act as spacers w i t h i n t h e c o n n e c t i v e t i s s u e b e d . A baby's foot at birth is n o t y e t f u n c t i o n a l f o r w a l k i n g . In either case. This places excessive strain o n t h e m u s c l e s o f t h e s h i n . w h a t w e w o u l d c a l l " b a n d a g i n g . a n d sliding m o t i o n is lost. M o v e m e n t of the ankle includes both flexion a n d sliding. Ideally.J O I N T S 115 of m o v e m e n t . flexion in the front of the foot is counterbala n c e d by a sliding m o t i o n e x t e n d i n g t h e heel down. We c an have a well-formed a n d fully f u n c t i o n i n g rib c a g e a n d s a d l y l a c k i n g h i p s a n d legs. The f o o t p r o j e c t s m o r e o r less a s a s t r a i g h t e x t e n s i o n o f t h e l o w e r leg. W h e n a j o i n t is u n b a l a n c e d or s h o r t e n e d . A well-balanced k n e e is o n e i n w h i c h t h e j o i n t feels v e r y s l i g h t l y b e n t . M o v i n g a j o i n t t h a t is tightly b o u n d will eventually create tissue irritation. T h e strut or b a t t e n is w h a t keeps t h e c o u c h f r o m sagging w i t h age. T h i s i s a t y p e t h a t i s o f t e n s e e n i n m e n . I n m a n y people." Wrapping or thickening is o n e hallmark of w h a t we call i m m a t u r i t y in a j o i n t . T h e skeleton as a w h o l e floats w i t h i n t h e fluid c o n n e c t i v e tissue b e d . Or the knee m a y be held in a locked-back position. He can m o c k up the look of male m a t u r i t y t h a t i s c u r r e n t l y f a v o r e d . we c a n consider b o n e s as being present to prevent us from collapsing w i t h years of use a n d disuse. Dr. there is fluidity in t h e structure so t h a t t h e knee is on "go. Underdeveloped structure is c o m m o n in the foot a n d ankle. T h e reverse i s o f t e n seen i n w o m e n — fully formed. T h e h e e l (calcaneus) is drawn up into the ankle joint. A j o i n t is a m o r e o r g a n i z e d a r e a of t h i s s t r u c ture. t h e heel remains wedged forward into the ankle joint. this wrapping will be sufficient t o stabilize t h e j o i n t a n d y e t f l e x i b l e e n o u g h t o ease o f f w h e n t h e j o i n t i s n o l o n g e r i n active use. i n t h e j o i n t . T h e cause could be injury or lack of d e v e l o p m e n t or regression out of negative e m o t i o n . In addition.

B o d i e s a r e n e v e r c o m p l e t e l y still. This. and muscles. I am also aware t h a t m y feet are b o t h e r i n g m e . It d o e s n ' t m e a n t h a t I never feel g o o d a b o u t a n y t h i n g . it is i d l i n g . T h e y a r e c h a n g e s in the intensity and direction of movement. At the other extreme is the example of t h e Scarecrow.116 THE ENDLESS WEB joints of t h e foot flatten a n d t h e n spring back into t h e arch as weight is transferred. Body types s h o w different ways of using t h e c o n n e c t i v e tissue as a w h o l e . T h e consciousness m a y simply be t h a t my feet hurt. W e m a y t h i n k t h a t i n o r d e r t o m o v e we h a v e to pull ourselves o u t of a deep i m m o bility a n d inertia. T h e outside of the b o d y h a s b e e n s o t o u g h e n e d t h a t t h e j o i n t s feel rusted. W e a l m o s t m u s t add oil t o get t h e m t o w o r k . We c a n be aware t h a t gesture a n d a c t i v i t y are a s h i f t o f gear. t o o . W h e n i t i s n o t m o v i n g ." An extreme e x a m ple w o u l d be a person w h o is double-jointed. He is soft a n d structureless a n d pliable on t h e surface. Yet w i t h i n t h i s s t r u c t u r e . T h i s is w h a t Ida Rolf termed a "soft body. Immaturity of the ankles does n o t necessarily i m p l y a n i m m a t u r e i n d i v i d u a l . We can be aware of our constant m o v e m e n t and vibration. Our favorite imaginative illustration of this is to be found in The Wizard ofOz. there is a t h i n core t h a t is u n d e r e x t r e m e t e n s i o n . tendons. I n t h i s s e n s e . T h e s e deep supp o r t s i n t h e l i v i n g b o d y are s o h a r d t h e y a l m o s t s e e m like s t e e l . t h e b o d y i s m u c h like a car t h a t i s n o t t u r n e d off. O n e expression of this attitude is in the old song." . W h e n w e are q u i e t . we w o u l d like t o o f f e r a d i f f e r e n t c o n c e p t . t o o . Its m o v e m e n t is m e r e l y a s h i f t i n g i n t o gear. A n d y e t t h e r e will be a c o n s t a n t awareness of lack of support. Instead of a static image of bodies. b u t n o t a c h a n g e in state. Yet t h e y . At a level b e l o w c o n s c i o u s awareness. a t t h e d e e p e s t l e v e l . there i s t h e c o n s t a n t v i b r a t i o n o f tissue t h a t i s i n tone. is lost w h e n t h e ankle is i m m a t u r e . ready to move. T h e T i n W o o d s m a n is o n e c o m m o n type. "I w a n t to dance with a dolly with a h o l e in her stocking while her knees keep a-knocking a n d her toes keep a-rocking. T h i s is similar to t h e t h i n sticks t h a t keep t h e scarecrow upright. h a v e t h e i r origin in t h e c o n n e c t i v e tissue sleeve between and surrounding the bones. m o s t of t h e support is on t h e surface. It's a s t h o u g h t h i s p e r s o n h a s n o c o n f i dence in t h e deeper structure. b u t this is n o t t h e case. t h e fine m o v e m e n t s of breathing and balanci n g a r e r e v e r b e r a t i n g f r o m h e e l b o n e t o skull. I t does m e a n t h a t e v e n w h e n I feel w o n d e r f u l .

PART FIVE Practical Applications .

Cautious m o v e m e n t is a part of evaluation. probably the most important quest i o n is. we are actually referring to local t e n s i o n s in t h e c o n n e c t i v e tissue b e d (Fig. Y o u r a i m i s t o f i n d out what the knee can do and exactly w h e n a n d w h e r e p a i n starts. a n d back. T h e knee is composed of two bones—femur and tibia— and two outriders—the fibula and t h e patella. W e h a v e t a k e n specific c o n d i t i o n s as e x a m p l e s for t h e sake of demonstration. it is p r o b a b l y possible to w o r k d i r e c t l y o n t h e a r e a (see s e c t i o n o n f i r s t intervention). anatomical information is essential to good visualization of t h e probl e m s i n v o l v e d . s y m m e t r y . I t i s h e l p f u l to consider the a n a t o m y involved.TWENTY-THREE Doing Bodywork Based on the Connective Tissue Concept where does it hurt. T h e tibia is suspended by t h e h a m s t r i n g s posteriorly and by the quadriceps anteriorly. this m e a n s c o m p a r i n g b o t h k n e e s f r o m t h e f r o n t . Full i n i t i a l e v a l u a t i o n i s a c o m bination of these and the client's report. O f t e n k n e e p a i n arises o n l y w i t h m o v e m e n t . W h e n acute pain is n o t a p r o b l e m . t h e r e is t h e a d d u c t o r group a n d t h e ilio-tibial b a n d . a n d h o w t o m a k e c h a n g e s last. I t i s n ' t p o s s i b l e to provide a " r e c i p e " for work. point with o n e finger. This section is divided i n t o several s u b s e c t i o n s : e v a l u a t i o n . first i n t e r v e n t i o n . Ideally this c a n be allayed to get a clearer picture of t h e actual tissue p r o b l e m s . It also m e a n s considering t h e e x t e n s i o n of t h e k n e e d o w n to t h e f o o t a n d at least as far u p a s t h e h i p . 23-1). I t also h e l p f u l t o c o n s i d e r g r a v i t y / b o d y weight. W h a t can the knee do with comfort? W h a t m o v e m e n t creates t h e p a i n ? C l i e n t fear a n d a p p r e h e n s i o n are a n i n e v i t a b l e part o f acute pain. The hip and the ankle can be considered upper and lower extensions of the knee. In practical terms. For clarity we are u s i n g m u s c l e n o m e n c l a t u r e . respectively. It is n o t necessary to do an exhaustive evaluation but rather to f i n d a p l a c e t o start. or by observing m o v e m e n t . It is your best b a r o m e t e r for assessing w h e n it m a y be detrimental to do work. a n d p r o portion. " H o w p a i n f u l i s i t r i g h t n o w ? " T h i s will tell y o u w h e n a n d h o w to i n t e r v e n e . T h e c o n c e p t s u n d e r l y i n g e v a l u a t i o n are c o n t o u r . At this point. Listening to the client and asking t h e right questions at t h e outset are critical: E x a c t l y . T h e knee is the interface between the torso/hips and the ground. Evaluation— Example: knee pain Evaluation c a n be visual. t h r o u g h palpation. O b v i o u s l y it will be n e c e s s a r y t o b e g e n t l e a n d slow. h o w t o t o u c h . D o e s t h e p a i n r a d i a t e ? Are t h e r e a s s o c i a t e d pains in other b o d y parts? W h a t brings t h e pain on? W h e n is it most intense? W h a t makes it better? Was there an injury? Has there b e e n a history of repeated injury? Is the pain constant or intermittent? From the point of view of immediate intervention. M e d i a l l y a n d laterally. sides. Ideally this will lead t h e b o d y w o r k e r t o d e v e l o p a p p r o p r i a t e strategies f o r c o n d i t i o n s a s t h e y a r i s e . i f n o t f a r t h e r . w e r e a l i z e t h a t t h e c o n n e c t i v e tissue c o n c e p t c a n b e o f use i n a n y k i n d o f b o d y w o r k . T h e a b o v e are e l e m e n t s o f p r a c t i t i o n e r e v a l u a t i o n . Reassurance that pain is not the same as damage s h o u l d h e l p . h o w t o g o deeper. T h e interface b e t w e e n t h e tibia a n d fibula c a n be locked down by the popliteus behind the A s o u r i d e a s h a v e g a i n e d clarity. W h a t we c a n do in this section is o p e n a way of t h i n k i n g a n d an a p p r o a c h to tissue.

U l t i m a t e l y . it is p o t e n t i a l l y hazardous to treat t h e acutely painful area directly. A n a b s o l u t e contraindication to manipulation of the knee (except by an expert) is a tear in o n e of the c r u c i a t e l i g a m e n t s . w e n e e d t o a d d a f e w c o m ments on treatment of acute knee problems. cautious easing of the j o i n t will b e h e l p f u l . i t c a n b e confusing a n d h u m b l i n g w h e n this happens. this is because bodyworkers c o n t i n u ally evaluate as t h e y work. Thus this very small muscle controls the interosseus m e m b r a n e between these t w o b o n e s . 126). a g a i n . o n e of the oddities of bodywork tends to be that the more experienced the p r a c t i t i o n e r . I t i s i m p o r t a n t t o start w o r k w i t h t h e m o s t s u p e r f i c i a l layers o f t i s s u e . . Before we go m o r e extensively into first i n t e r v e n t i o n . t h e r e m a y h a v e t o b e surgery. Evaluation is n o t an endpoint. t h e less e x t e n s i v e t h e e v a l u a t i o n . T h e degree of tension in t h e Achilles t e n d o n is an i n d e x of severity of rotation between t h e tibia a n d calcaneus. A s i m p l e w a y t o d o t h i s i s t o r e s t r a i n t h e k n e e tissue against ever-greater k n e e flexion a n d e x t e n s i o n . This allows t h e client to feel safe b e c a u s e h e / s h e c a n c o n t r o l t h e degree of m o v e m e n t . It should be r e m e m b e r e d that o n e cause of i n t e r m i t t e n t acute pain in t h e knee is a m e n i s c a l tear. Early i n p r a c t i c e . S o m e t i m e s i t i s h e l p f u l t o w o r k f a i r l y far a f i e l d i n o t h e r parts o f t h e b o d y — a s s o c i a t e d areas o f reported p a i n or p r o b a b l e areas of dysfunct i o n (see list i n H o w t o M a k e I t Last s e c t i o n . T h i s i s n o t a n a b s o l u t e c o n t r a indication to work. S u c h a t e a r m a y b e felt a s hypermobility of the knee in the anteriorposterior direction and is obvious with even s l i g h t m o v e m e n t . E v e n t u a l l y i t will b e p o s s i b l e t o g e n t l y start t o work o n t h e fascial wrapping o f t h e k n e e itself. T h e client will o f t e n report t h a t t h e nature or l o c a t i o n (or b o t h ) o f t h e p a i n h a s c h a n g e d a n d h e / s h e c a n o f t e n b e m o r e specific about t h e pain. it is an o n g o i n g process. a n absolute contraindication to bodywork except in t h e h a n d s of an expert. Furthermore. G o i n g t o o d e e p t o o fast will a l m o s t a l w a y s Figure 23-1 Superficial muscles of the thigh. This is to be expected as a n o r m a l p a r t o f p r a c t i c e . Your knowledge of a n a t o m y a n d y o u r careful e v a l u a t i o n will t e l l y o u w h e r e t o s t a r t . As we m o v e t h e part. Evaluation is a s e q u e n c e f r o m visualization to m o v e m e n t to evaluation by touch. If t h e client is able to walk i n t o your office w i t h o u t crutches. It is almost impossible to know w h e n evaluative touch ends and treatment touch starts. h o w e v e r . If t h e p a i n is acute. w e are starting t o evaluate b y touch. A f r a c t u r e is. p. In part.120 T H E E N D L E S S W E B knee. W o r k i n g superfic i a l l y u s u a l l y will a l l o w d e e p e r tissue p r o b l e m s t o e m e r g e t h a t w e r e n o t a p p a r e n t a t first. First Intervention— Example: chronic neck ache S o m e practitioners are m o r e e x p e r i e n c e d with visual evaluation a n d s o m e with palpation. It s h o u l d be possible to ease t h e pain with educated intervention above and below. create unnecessary problems and usually creates m o r e pain. Tibial rotation is manifest at t h e ankles. it is unlikely that either of these two catastrophes has occurred.

t h e m u s c l e s a r e n o t l a y e r e d like a c a k e . C r e a t i n g order in o n e t e n d s to organize sheets above and below. It should be pointed out that f a s c i a l fibers d o n o t n e c e s s a r i l y f o l l o w t h e e x a c t p a t h o f t h e associated m u s c l e fibers.2 Fascial tensions in the neck and back. y o u r h a n d s will tell y o u w h a t t o d o . is t h e feeling of elasticity. t h e l e v a t o r s c a p u l a e suspends the shoulder blade from t h e cervical vertebrae. T h e r e c a n b e times w h e r e n o d o m i n a n t tissue directionality is apparent.DOING BODYWORK BASED ON THE CONNECTIVE TISSUE CONCEPT 121 W h a t does it m e a n to w o r k on a superficial layer o f t i s s u e ? H o w i s t h i s d o n e ? E a s i l y t h e m o s t i m p o r t a n t m a n e u v e r is to go i n t o tissue a t a n a n g l e . t h e m o s t superficial m u s c l e i s t h e t r a p e z i u s . E v e n t h i s p a r t i a l list o f t h e m u s c l e s i n volved in chronic neck ache makes it obvious t h a t t h e associated fascia is a w e b . t h e fascia superficial to t h e trapezius has m u l t i p l e fine layers in m u l t i p l e directions. O n c e again. In practical terms. F a s c i a l fibers r e s p o n d t o t h e d i r e c t i o n a l p u l l s e x e r t e d o n t h e m . G o i n g s t r a i g h t i n a l l o w s t h e tissue n o e s c a p e . t h e t i s s u e i s trapped. For e x a m p l e . the feeling you want under your h a n d s . W h a t y o u are h o p i n g t o achieve. Figure 2 3 . t h e scalenes s u s p e n d t h e ribs f r o m t h e c e r v i c a l v e r t e b r a e (Fig 23-2). In the neck and shoulder assembly. At a similar d e p t h . . I t fans out from t h e occiput. " I f t h e t i s s u e doesn't m o v e w h e n you go in o n e direction. t o w a r d a n intended endpoint. b u t t h e r e are o t h e r s . along the plane of the muscle. away from a joint. I d a R o l f w a s w o n t t o say. b u t i n t e r w o v e n like a m e s h . Direction of work m a y be toward a joint. The sternocleidomastoid musc l e i s a fairly s u p e r f i c i a l r o p e f r o m t h e m a s t o i d process to t h e sternum and t h e clavicle. As y o u work. and the upper thoracic vertebrae. t h e fiber d i r e c t i o n u n d e r y o u r h a n d s will tell y o u w h a t level o f tissue i n t h e b o d y y o u are w o r k i n g o n . a knowledge of a n a t o m y is essential. t h e cervical vertebrae. A r e a s o n a b l e w o r k i n g k n o w l e d g e o f l o c a l a n a t o m y gives a n u n d e r s t a n d i n g o f t h e tissue "layers" a n d direction of fascial fibers. m u s c l e fibers a r e o n e t y p e of pull. try g o i n g in t h e o t h e r d i r e c t i o n . " T h i s is a rule of t h u m b t h a t has stood us in g o o d stead for m a n y years. or even across t h e m u s c l e fibers. this m e a n s that tissue i s m o v e d i n a d i r e c t i o n . It is n o t necessary or possible to organize each of these fascial sheets. Posteriorly a n d d e e p e r . G o i n g straight in also often causes bruising. n o m o v e m e n t . W i t h a t t e n t i v e n e s s a n d delicacy o f t o u c h . this is c o m m o n in the most superficial s u b c u t a n e o u s layers. across the shoulder blades to the collarbones a n d the acromion.

h o w d e e p y o u w a n t to get w i t h a given m a n e u v e r . Some c l i e n t s a r e a b l e t o feel t h r o u g h t h i s m o m e n tary d i s c o m f o r t to t h e relief t h a t is h a p p e n ing. O n e m a n e u v e r t h a t c a n w o r k i s t o m a k e use of t h e body's neural wiring. It is t h e c h a r a c t e r i s t i c f e e l i n g o f c o n n e c t i v e tissue s t r e t c h i n g . A l o n g slow e x h a l e is t h e best way to ease t h e strain a n d allow t h e stretch. intangible concept of intention. It is also good to focus attention exactly where t h e stretch is occurring a n d / o r to m o v e a related b o d y part (wiggle t h e fingers). Light t o u c h and d e e p t o u c h a r e m e d i a t e d b y t w o d i f f e r e n t sets of nerve endings. a n y t w i s t o n o n e p a r t o f t h e n e c k will spread d o w n w a r d to t h e structures below. t h e y are c u m u l a t i v e a n d s o o n b e c o m e clearly apparent. it is a s i g n a l t h a t b o d y w o r k n e e d s to be d o n e . it is m o r e mental than physical. T h e s e are n o t b y a n y m e a n s t h e deepest layers. T h e concept is often apparent when watching a n o t h e r bodyworker. At s o m e point going deeper b e c o m e s a natural e x t e n s i o n of t h e work in progress. In n e c k pain. A c h a n g e i n i n t e n t i o n o r g o a l c a n r e s t o r e flow. T h e r e i s t h e tissue s e n s a t i o n . t e n s i o n b e l o w a l s o starts t o e a s e . T h e client's report of pain and your hands' report of tissue resistance will be y o u r guides o n h o w fast t o p r o g r e s s . W i t h deeper work there is always t h e potential of discomfort while working. W h a t t o d o w h e n a n area i s t o u c h y o r t i c k lish? W e h a v e f o u n d t h a t t h e tissue deep t o a t i c k l i s h s p o t is i n v a r i a b l y e x c e s s i v e l y t i g h t . A light t o u c h is generally n o t h e l p f u l . This is akin to what happens w h e n you m o v e a part t h a t has n o t m o v e d for a l o n g t i m e . t h e back of t h e ulna just above t h e e l b o w . over t i m e . which can be warm or hot or burning. B o t h a s p e c t s o f t i s s u e s e n s a t i o n will u s u a l l y b e p r e s e n t . It c a n be a useful quest i o n w h e n t h e progress of work is stalled. t h e shoulder joint. In either case. It is hard to believe t h a t i n t e n t i o n is a m a j o r factor. A n o t h e r c o m p o n e n t o f tissue p a i n is v e r y m u c h like a s t a r t l e r e s p o n s e .122 T H E E N D L E S S W E B The shoulder and neck assembly is one of t h e m o r e c o m p l e x structures in t h e body. it is useful to m a k e sure t h a t t h e client is n o t h o l d i n g his/ her breath. T h i s b r i n g s u s t o t h e difficult-to-describe. it is even harder to believe that there is any such thing as intention. m u s c l e s will shift their p l a n e o f a c t i o n . m o r e often it is the obvious n e x t step. T h e r e . O c c a s i o n a l l y this is a t h e r a p e u t i c decision. T h i s h a p p e n s gradually. Because the spasm in these muscles can be so severe that acute pain is elicited with light t o u c h . We find it impossible to give a verbal description of i n t e n t i o n . C h a n g e s are subtle at first. T h e r e f o r e as t h e superficial layers of t h e n e c k a r e e a s e d . I n t h i s i m a g e . M u c h h a p p e n s b e t w e e n b o d y w o r k sessions. h o w d e e p y o u r f o c u s is. w o r k i n g at t h e rotator cuff. B o n e s will shift their h o m e p o s i t i o n . O n e s i g n i s t h a t t h e t e n s i o n s start t o b e m o r e o b v i ously associated w i t h specific m u s c l e action. " T h e r e are at least t w o c o m p o n e n t s to t h e s e s e n s a t i o n s . Even t h o u g h ticklishness has a "don't t o u c h " a s p e c t to it. It is possible to place the w h o l e h a n d f i r m l y o v e r t h e s e n s i t i v e area while working more deeply with the other hand underneath the covering hand. O n e i m a g e t h a t gives an overview is t h a t tissue is gathered up into the neck m u c h the way a p l a s t i c b a g i s g a t h e r e d a t its c l o s u r e . E a s i n g a r o u n d t h e area c a n b e u s e f u l . o r t h e m a r g i n o f t h e o c c i p u t will b r i n g relief. Their usual c o m m e n t is that it is " g o o d p a i n . O u r struggle in this b o o k has b e e n to put into words what is so obviously happening under our hands. I t i s a l m o s t n e v e r advisable to use force to go t h r o u g h pain or t i s s u e r e s i s t a n c e . i t will n o w b e n e c e s s a r y t o e a s e t h e tissue by w o r k i n g further afield. We are w o r k i n g our w a y gradually t h r o u g h t h e layers over a n u m b e r of sessions — t h r e e or four spaced a b o u t a week apart. b u t o n e will b e m o r e p r o m i n e n t t h a n t h e other. Intention has to do with how deep your h a n d s g o .

t h e y are short a n d deep. a n a t o m i c a l k n o w l e d g e i s e s s e n t i a l t o a c c u r a c y . w h i c h is variably located near the middle o f t h e s a c r o i l i a c j u n c t i o n . O n e o f I d a R o l f ' s first principles was "take t h e part to n o r m a l a n d m a k e it m o v e . extending t o t h e t h i g h . t h e sacrum is overworked with any m o v e m e n t . 23-3). i s c h i u m . is local to the hip. T h e ischial tuberosity is the b o t t o m m o s t edge of t h e hip assembly. W o r k i n g i n layers t o e a s e t h e s e i s the answer. I n addition. I n piriformis pain. A s t h e tissue layers o f t h e h i p a s s e m b l y start t o r e l e a s e . s i t t i n g . S c i a t i c p a i n arises f r o m t e n s i o n o n t h e s c i a t i c n e r v e . t w o m o v e m e n t m a n e u v e r s will b e h e l p f u l : a s m a l l c h i n t h r u s t (like a n o d ) a n d t u r n i n g t h e h e a d . it provides an endp o i n t for t h e t e n d o n s of t h e h a m s t r i n g s . t h e y pull d o w n w a r d on t h e i s c h i u m . W h e n turning the head. leg. For t e s t i n g p u r p o s e s o n l y . A l t h o u g h t h e y are s m a l l . T h i s i s i n f a c t a sign t h a t w o r k h a s b e e n e f f e c t i v e . o r f o o t . S c i a t i c p a i n i s most c o m m o n l y a radiating pain. t h e y powerfully i n f l u e n c e t h e basic structure of t h e pelvis w h e n t h e y are i n s p a s m .DOING BODYWORK BASED ON THE CONNECTIVE TISSUE CONCEPT 123 are t h e o r e t i c a l r e a s o n s w h y t h e s e m a n e u v e r s w o r k b u t it's p r o b a b l y e n o u g h s i m p l y t o k n o w that they do work. w h i c h is a way of creating precise m o v e m e n t b e t w e e n t h e atlas a n d axis. u s u a l l y a t its outlet. the m o v e m e n t is initiated f r o m t h e a n g l e o f t h e j a w j u s t b e l o w t h e ear. t h e l o c a t i o n o f t h e s c i a t i c p a i n a n d its r a d i a t i o n o f t e n c h a n g e s . Piriformis pain. " We w a n t to evaluate t h e balanced m o v e m e n t of the j o i n t — t h e initial m o v e m e n t f r o m a n ideal h o m e p o s i t i o n . As a result. H o w to k n o w where to start? Observing n o r m a l m o v e m e n t is usually helpful—walki n g . t h e How to Go Deeper— Example: chronic sciatica A t t h e d e e p e r level. T h e nerve is not entrapped by b o n e but by the ligamentous bindings of the sacroiliac junct i o n . T h e small transverse muscles at t h e atlanto-occipital junction can be so contracted as to be barely p a l p a b l e . T h e y c a n be readily influenced by wedging the space b e h i n d the g r e a t e r t r o c h a n t e r a n d a s k i n g f o r s t r a i g h t leg external rotation (Fig. o r s a c r u m . Piriformis t e n s i o n can contribute to sciatic nerve pain. T h e rotators of the hip attach to t h e ilium. T h e piriformis runs from t h e inside of t h e lower tip of t h e sacrum to t h e greater t r o c h a n t e r of t h e femur. the deepest structures u n d e r t e n s i o n will be t h e levator scapulae a n d t h e layers of t h e cervical muscles closest to t h e vertebrae. To finish up t r e a t m e n t of n e c k pain. Release m u s t necessarily i n c l u d e work to release t h e h a m s t r i n g s . T h e y a r e a m a j o r factor in sciatic pain. W h e n t h e h a m s t r i n g s are tight. d e p e n d i n g o n t h e p o r t i o n o f t h e n e r v e t h a t i s i m p i n g e d . it is usually possible to palpate the taut rope of the muscle t h r o u g h the overlying gluteus m a x i m u s . T h e relationship of the piriformis to the sciatic nerve is variable. Figure 23-3 Rotators of the hip. does n o t radiate. a n d c a n be elicited by p u l l i n g t h e b e n t k n e e a c r o s s t h e b o d y . on t h e other h a n d . . s t a n d i n g . i n t h e h i p a n d leg.

less u n c o m f o r t a b l e . In the knee bend. the knee should c o m e straight forward over the second toe. t h e b o d y will t e n d t o return t o pattern. heels about an i n c h apart. It can m e a n a b a t c h of work every couple of years. A m o s t c o m m o n v e r s i o n arises f r o m c o m p u ter use. R o l f u s e d t o say. t h e r e will b e a n o n g o i n g n e e d for b o d y w o r k . (B) A c u t e s p a s m is a s i g n a l f o r c a u t i o n . leaning over to t o u c h the toes. a n d p r o g ress w i l l b e faster. A s e c o n d m o v e m e n t . This can be combined with other movements. W o r k c a n b e g i n o n t h e s u p e r f i c i a l layers o r o n s u r r o u n d i n g a r e a s . In this position. Generally speaking. " A m o r e long-winded way of saying the same t h i n g is t h a t w h e n tissue in an area w o n ' t s t r e t c h . e. How to Touch— Example: carpal tunnel syndrome In this s e c t i o n we are b r i n g i n g t o g e t h e r points about t o u c h from prior sections.g. renewed work w i l l b e easier. M o v e m e n t s s h o u l d b e guided for p r e c i s i o n t o give m a x i m u m assistance to tissue stretching. so does t h e position of t h e s p i n e fix t h e p e l v i s f r o m a b o v e . In t h e case of t h e hip. a n d up into the ischial tuberosity. this would be t h e spine a n d t h e bridge would be the psoas. ankles touching. a shallow knee b e n d will graphically reveal t e n s i o n s i n t h e sacrum and groin. a n d t h e a r m has l o s t its b a s e o f s u p p o r t . or repetitive use u n d e r stress. T h e client is the best judge of what he/she needs. T h e art o f a b o d y w o r k e r i s k n o w i n g w h e r e to work n e x t . (As w e have explained in t h e text. repeated injury. A guiding principle in soft tissue w o r k is " w h a t ' s d o n e i s d o n e . W o r k c a n proceed contiguously: sacroiliac j u n c t i o n — l u m b a r area—lower ribs. U n d e r stress. T h e gesture includes tensely staring at a small (usually t o o low) screen while overfocusing t h e eyes a n d thrusting t h e head f o r w a r d . W o r k c a n m o v e t o t h e o t h e r side o f t h e j o i n t . T e n s i o n a n d o v e r u s e are t h e culprits here.b a c k l o c a t i o n where shoulder m o v e m e n t a n d b o d y support intermesh. W h e n t h e r e are true physical deficits such as a s c o l i o s i s or a m i s s i n g p o r t i o n of a v e r t e bra. n e c k . For e x a m p l e . C a r p a l t u n n e l s y n d r o m e i s a c l a s s i c e x a m p l e o f r e p e t i t i v e u s e u n d e r stress. prolonged eye tension a n d head thrust c r e a t e a p r o b l e m . W o r k i n a n o t h e r a r e a h a s t o h a p p e n first.) T h e g r o i n a n d p a r t i c u l a r l y t h e i n g u i n a l ligam e n t are anterior aspects of sciatic pain. t h e hamstrings. " I f a t first y o u d o n ' t s u c c e e d . From this brief analysis it is obvious that there cannot be m u c h help for carpal t u n n e l s y n d r o m e w i t h o u t work o n t h e shoulder. tissue stretching. traction. T h e i d e a i s t o give t h e tissue u n d e r s p a s m relief before w o r k i n g on . a n d occipital ridge. o r e v e n t h e o c c i p u t . shows t h e ability of t h e hamstrings to l e n g t h e n a n d the ischial tuberosities to appropriately widen. Partly this is a m a t t e r of experie n c e . " Dr. a n d client m o v e m e n t . (A) C o n s i d e r t h e o r i g i n o f t h e p r o b l e m — accident. T h e h o l d i n g pattern can originate in the lumbar spine. Traction c a n be passive or active on t h e client's part. Just as the position of the f o o t (by w a y o f t h e leg) fixes t h e a n g l e o f t h e pelvis f r o m below. t h e dorsal h i n g e is a variable m i d . E v e n i f t h e s c r e e n i s n o t t o o low a n d t h e keyboard position is adequate. w h e t h e r t r a u m a t i c o r r e p e t i t i v e . T h i s d o e s n o t m e a n a n o f f i c e visit o n c e a week or even o n c e a m o n t h . t h e c l a v i c l e a n d a c r o m i o n are elevated. t h e back of the knees. it's b e c a u s e it's n o t r e a d y t o s t r e t c h . the b a c k is kept straight. O n e non-obvious sequence involves looking at the c o u n t e r b a l a n c i n g structure. Active traction involves stretching to t h e limit of t h e gesture. at t h e d o r s a l h i n g e .124 T H E E N D L E S S W E B ideal s t a n d i n g position is as follows: feet together. g e t t h e h e l l o u t . h e e l s t r e t c h w i t h h i p r o t a t i o n o r l e g lift. This d o e s n o t m e a n t h a t earlier b o d y w o r k w a s n o t effective. a h e e l stretch activates t h e Achilles t e n d o n . T h r e e m a i n strategies interact in this deep level of work. T h i s sets u p a n i m b a l a n c e a t t h e s h o u l d e r — t h e s c a p u l a rides u p .

t r y n o t t o c o m p r e s s it. . In normal movement. O n e specific e x a m p l e of a small muscle that seems to get particularly tight is the opponens. W e d g i n g o n t h e o p p o s i t e side o f the h a n d ( h y p o t h e n a r space) produces further opening. (F) O n e o f t h e m o r e s u b t l e a s p e c t s o f b o d y work is recognizing a n d asking for appropriate m o v e m e n t . (D) G e t t i n g t h e feel o f t i s s u e i s a n o n g o i n g study for a bodyworker. T h e u l t i m a t e goal is to m o v e t h e fascial s h e a t h s in s u c h a w a y as t o r e s t o r e e l a s t i c i t y . Normal m o v e m e n t h e r e i n o u r t e r m s i s t h e a b i l i t y t o slide t h e elbow away from the body and back without twisting at t h e elbow or elevating t h e shoulder. W e w a n t t o d e f i n e a n d u s e t h e initial gesture f r o m t h e " h o m e " p o s i t i o n . Available from t h e Rolf Institute.* W h e n lying o n t h e back. there is a lock on m o v e m e n t of t h e u l n a because of tissue tightness at the back of the elbow. t h e s c a p u l a d o e s n o t rise w i t h m o v e m e n t o f t h e a r m . this is particularly useful in o p e n i n g t h e spaces b e t w e e n t h e small b o n e s at t h e base of t h e h a n d . fiber d i r e c t i o n w i l l o f t e n i n f o r m y o u a b o u t t h e d e p t h of tissue y o u are influencing.DOING BODYWORK BASED ON THE CONNECTIVE TISSUE CONCEPT 125 i t directly. educated m o v e m e n t . l e t t h e t i s s u e rest and integrate. w h i c h adducts the t h u m b across t h e p a l m . For example. w h e n n e w s t r e t c h h a s b e e n a c h i e v e d . i t i s helpful to reduce tension in the interosseus m e m b r a n e o f t h e f o r e a r m a n d t o r e s t o r e free rotation b e t w e e n t h e radius a n d u l n a at t h e elbow. 16. In fact. (G) U s i n g m o v e m e n t allows freeing o f t h e structure at a level u n a t t a i n a b l e w i t h t h e use of m a n i p u l a t i o n alone. t h e r e is a g e s t u r e like g r a s p i n g with t h e base o f t h e h a n d t h a t will h e l p this opening. 1 9 7 3 . S o m e c u e s : Lift t h e t i s s u e . Confinia Psychiatrica. This is n o t the " a n a t o m i c a l posit i o n " described in texts. Most kinesiology texts describe range of m o t i o n . Almost always. it c a n be very helpful in the right place. this is n o t exactly what we are l o o k i n g for. However. Boulder. Colorado 80306. on t h e a r m just b e l o w t h e shoulder j o i n t (junct i o n of t h e trapezius a n d deltoid). B e sure t h a t y o u a r e taking t h e tissue in a direction rather t h a n compressing it to the bone. t h e h o m e posit i o n o f t h e s c a p u l a i s flat a g a i n s t t h e ribs. In carpal t u n n e l syndrome. the h o m e position of the elbow while lying on the back is pointing away from t h e trunk. K n o w t h a t a tense surface layer will u s u a l l y h a v e f a s c i a l fibers g o i n g i n m a n y directions. the retinaculum. W h e n lying o n t h e back. 23-4). responds well to this a p p r o a c h . B o x 1 8 6 8 . t h e h o m e p o s i t i o n o f t h e wrist a l l o w s t h e p a l m t o rest flat w i t h e l b o w p o i n t ing away from t h e trunk. pp. p a r t way down the back. (E) A s p e c i a l a p p r o a c h to t i s s u e i n v o l v e s going across t h e direction of tissue fibers. Restoring e l a s t i c i t y h e r e will start t o e a s e t h e a c u t e p a i n a t t h e wrist. Be attentive to a n a t o m y . Although the hypothenar movem e n t is s u b t l e .7 8 .it should be possible to l e n g t h e n t h r o u g h t h e p a l m b y first r a i s i n g t h e f i n g e r s a n d t h e n r a i s i n g t h e rest o f t h e p a l m i n s e c t i o n s (Fig. T h i s is not a c o m m o n maneuver. Care must be taken that there is good support under a structure being worked in this way. It is *For an excellent exposition of this c o n c e p t . It is also useful w h e r e tissue is very tight but n o t in s p a s m — b e h i n d the elbow. as we have described above in the case of the arm. see Ida P. 7 7 . In carpal t u n n e l syndrome. I n a c u t e c a r p a l t u n n e l p a i n . Vol. (C) " R e s i s t i v e m o v e m e n t " i s o u r p h r a s e f o r t h e m a n e u v e r of w e d g i n g a tissue space o p e n while t h e client m o v e s . W h e n raising t h e hand. a n d just above and below the spine of the shoulder blade. this must be precise. F l e x i o n is t h e s a m e r o l l i n g gesture in reverse. it drops slightly as a c o u n terweight as t h e a r m is raised. Rolf. W e d g i n g at t h e base of the t h u m b while asking t h e client to adduct t h e t h u m b will e v e n t u a l l y release t h i s a r e a . a thin binding s h e a t h a r o u n d t h e wrist. Try n o t t o overwork tissue.

It is just as necessary to allow t i m e for integration b e t w e e n work as it is to do t h e work. A n o t h e r aspect of t i m i n g is t h e integration t h a t h a p p e n s b e t w e e n sessions a n d after a group of sessions. T h e feel o f t h e b o d y i s t h e b e s t g u i d e . alized " c o r r e c t " p o s i t i o n has to be gradually a p p r o a c h e d . A p r i m a r y goal of such e d u c a t i o n is refining the ability to sense physical change. " W h e r e y o u t h i n k i t is. O n e or at m o s t t w o n e w t h i n g s t o f o c u s o n i s all t h a t c a n r e a s o n a b l y be incorporated. We h o p e t h a t it will e x p a n d y o u r horiz o n as well. R o l f o f t e n said. T h e m i n d learns best by comparing sensation. sleeping right? T h e o n l y w a y o u t o f t h i s d i l e m m a o f "Tightn e s s " is to h e l p increase client sensitivity. position of the a r m — t h e best time to notice these is w h e n the change is new. O n e of t h e client questions that bedevils t h e b o d y w o r k e r is " A m I d o i n g it r i g h t ? " Am I walking right. in a client w h o is pigeon-toed. W i t h s o m e m a n u a l assist. There are e x c e p t i o n s . generally n o t possible to use m o v e m e n t early in m a n i p u l a t i o n because the structure is too compressed to get accurate m o v e m e n t . o f course. We have alluded to t h e n e e d for work on compensating patterns. a n d psoas knee pain shoulder bursitis tennis elbow hip. shoulder height. This is an e x a m ple of latency in t h e learning process. A glut of n e w b o d y sensations is merely confusing. There will be c h a n g e s in stance. b r e a t h i n g right. For e x a m p l e . of preparing t h e way. b o d y a n d m i n d are in a fluid state. " W e h a v e u s e d t h e c o n n e c t i v e tissue c o n c e p t i n t h e c o n t e x t o f R o l f i n g a n d i t has been valuable to us in opening up new vistas. groin.126 THE ENDLESS WEB c h a n g e is recent. w h e n A s Dr. Keep in m i n d that in t h e period just following bodywork. dorsal hinge. no m a t t e r w h a t tradition of bodywork you practice. Client education is an essential part of bodywork. A n ideFigure 2 3 . Too m u c h information can be overwhelming.4 Wedging the muscles of the forearm in combination with m o v e m e n t of the hand. W e list a f e w b e l o w t h a t h a v e b e e n useful to us: carpal t u n n e l sprained ankle sciatic pain neck and shoulder t w e l f t h rib l u m b a r vertebrae. forcing a straight-ahead foot position before the knees a n d especially the hips can a c c o m m o d a t e the n e w position is d a m a g i n g to t h e structure as well as confusing to the client. little finger wrist How to Make It Last The element of time is important in bodywork. We have talked about n o t diving in before t h e structure is ready to o p e n . sometimes ankle ribs a n d d i a p h r a g m . . the comparison is most vivid. atlanto-occipital j u n c t i o n . Knowing where that c o m p e n s a t i o n is likely to be is o f t e n a m a t t e r o f e x p e r i e n c e . i t a i n ' t . Ideally this has b e e n h a p p e n i n g in an o n g o i n g way t h r o u g h o u t t h e sessions. c o r r e c t m o v e m e n t m a y b e p o s s i b l e early o n . s h o r t leg.

19-7. lumbo-sacral junction 13-7. 2 1 . belly band/strap 12-2 A&B. 15-1. 19-1. 12-3B. 8-8. 21-2. 2-3. scalenus posterior m. 21-7. chest band/strap 12-2 A&B. sacro-coccygeal junction 13-7. 18-7. 10-2. sternocleidomastoid m. 12-3B. 18-3. brachialis m.3 . 19-7.3 . 15-4. 17-1. semimembranosus m. umbilical band/strap 12-2 A&B. pubic band/strap 12-2 A&B. ischial tuberosity 18-3. rectus abdominis m. 17-1. groin band/strap 12-2 A&B. junctions of the spinal column 13-7. 15-1. 17-11. 14-5. notochord 2-1. 19-4. piriformis m. 2-2. 19-8. serratus anterior m. trapezius m. 15-6. pectoralis minor m. 17-2. eye band/strap 12-2 A&B. costal arch 13-1A. 7-2. 19-2. amnion 2-1. 21-3. 2 1 . 8-3. 17-8. 13-1A. quadratus lumborum m. 17-8. gluteus medius m. 19-1. 15-3. 18-7. midchest band/strap 12-2 A&B. 19-4. 18-7. scalenus medius m.6 . external abdominal oblique m. 12-3A. 19-1. 17-5. 17-2. 19-1. 8-3.3 . 21-3. semispinalis cervicis m. erector spinae m. 15-5. 15-4. chin band/strap 12-2 A&B. . 18-3. primitive streak 2-1. 2 0 .Illustration Index acromion 15-1. sartorius m. 17-5. 2-3. perichondrium 7-2. 15-6.5 . 2-2. 18-7. pelvic diaphragm 15-7. 19-4. inguinal band/strap 12-2 A&B. coracoid process 8-3. 17-11. 13-1A. coracobrachialis m. 14-5. obturator internus m. 14-4. 18-3. endoderm/endodermal 2-1. 15-1. hyoid b. 19-8. clavicle 14-5. fontanelles 14-3. 13-1B. 18-2. 19-7. 19-1. 15-7. periosteum 4-2. adductor magnus m. 17-7. urogenital diaphragm 15-7. scalenus anterior m. 17-1. 13-7. 19-6. 19-5. 15-5. 8-8. 15-6. 17-5. 19-1. mediastinum 18-3. 14-5. 19-3. inguinal ligament 5-2. 17-6. semispinalis capitis m. dorsal hinge 12-3B. 2 1 . 21-4. 13-1A. 21-4. 12-3B. 2-2. 19-5. 15-6. 12-3 A. 2 0 . semitendinosus m. 19-7. 19-10. sacro-iliac junction 18-2. 19-6. 17-2. gluteus maximus m. psoas m. 2-3. sacrospinous ligament 19-4. 19-5. ectoderm/ectodermal 2-1. 17-7. tensor fascia lata m. 17-2. 21-7. 17-6. 2-2. 10-6A. 19-8.6 . sphenoid b. ligamentum nuchae 18-7. 21-2. 12-3A. flexures (junctions of the spinal column) 13-7. 18-3. 18-2. cervical-thoracic junction 13-7. 4-2. 20-3. 5-2. 21-2. 15-2. 19-4. 5-2. 18-2. lumbo-dorsal junction 13-7. 21-2. 19-6. 17-11. 21-4. cervico-dorsal junction 13-7. collar band/strap 12-2 A&B. mesoderm/mesodermal 2-1. 2 1 . 15-1. iliotibial tract 5-2. 19-10. 15-1. 8-8. 10-2. 13-1B. 18-3. 2-3. 15-4. deltoid m. levator scapulae m. 15-1. gluteus minimus m. atlanto-occipital junction 13-7. 14-5. 15-3. 10-5. 17-8.3 . iliacus m. calcaneus 7-3. 13-6. latissimus dorsi m. 2 1 . supraspinatus m. 17-8. 17-1. 21-7. gracilis m. pectoralis major m. 17-6. 19-1.

131 sacro-coccygeal junction 6 5 . 121. 120 cervico-dorsal junction 29. 99. 67. 36. 123 primitive streak 6. 86. 126. 69. 101-102. 9 5 . 8 5 . 58. 57. 107. 115. 126 ectoderm/ectodermal 11 endoderm/endodermal 10. 67. Michel 22 pelvic diaphragm 1 0 4 .Subject Index acromion 73. 87. 68. 106. 4 2 . 121.1 0 1 . 8 3 . 123. 100. 67. 123. 67. 124. 13. Frederick 21. 66. 53. 123 umbilical band/strap 74-75 urogenital diaphragm 76. 2 3 . 15. 6 5 . 44. 68-69. 70 tendon/ligament formation 3. W. 74 Cohen.5 0 .G. 38. 75-77. 6 5 . 102 Reich. 102 inguinal band/strap 15. 103. 75-77. 113. 8 proprioception 4 9 . 67 collar band/strap 73-74. 11. 98. 77. 7. 67. 73. 22 lumbo-dorsal junction 65. 73. 111. 70. 124 adductor magnus m. 92. 111. 74 fibrocartilage 25 flexures 16. 125 pubic band/strap 62. 126 belly band/strap 74-75 calcaneus 115. 75 lumbo-sacral junction 65. 14. Bonnie Bainbridge 65.7 0 Sutherland. 1 0 0 . vii. 124 sphenoid b. 57. 99. ix. 63. 27. 75 sacro-iliac junction 34. 116.4 3 . 123. 25. 119 atlanto-occipital junction 68. 107 piriformis m. 62 chin band/strap 68. 2. 5. 124. 105. 67 cervical-thoracic junction 73 chest band/strap 58-60. 15. 6 9 . 70-71. 97. 88. 74. 65 Odent. 113. Ida P.5 8 . 103. 106 . 61-65 LeBoyer. 76 dorsal hinge 54. 101. 69 groin band/strap 62. 76.1 0 5 . 116. 124. 12 eye band/strap 67. 28.8 4 psoas m. 77. 4 3 . 58. Wilhelm 44 Rolf. 67 midchest band/strap 5 3 . 92. 4 3 .

H e h a s p r e s e n t e d w o r k s h o p s for Rolfers in m a n y states in t h e U n i t e d States as well as in Germ a n y . Brazil. . S c h u l t z r e t i r e d f r o m the University of Colorado School of Medicine and Dentistry. " a s Dr. Louis Schultz. Dr. T h e following year he established t h e a n a t o m y program for t h e Rolf Institute a n d b e c a m e a Struct u r a l P a t t e r n e r (later c a l l e d R o l f i n g M o v e m e n t T e a c h e r ) . . s h e e d i t e d Rolfing and Physical Reality.. R o l f f o r a n u m b e r o f y e a r s . O . Florida. in physiology from the University of Wisconsin in 1 9 5 5 . where his final position was Professor a n d C h a i r m a n o f t h e D e p a r t m e n t o f H u m a n Biology. a n d A u s t r a l i a . E n g l a n d . He received his Ph. I n 1 9 7 8 .D. a t t e n d e d B a r n a r d C o l l e g e a n d t h e U n i v e r s i t y o f C a l i f o r n i a a t B e r k e l e y . Ronald T h o m p s o n has b e e n a Rolfer for twenty-five years. Dr. Ph. D . He is t h e author of over forty scientific publications.D. trained as a Rolfer in 1 9 7 3 .About the Authors R. I n 1 9 7 2 .e d i t o r s of Remembering Ida Rolf. R o s e m a r y Feitis. He is currently a m e m b e r of the a n a t o m y faculty and t h e Rolfing faculty of t h e Rolf Institute a n d practices Rolfing in T a m p a . R o l f o n t h e b o o k Rolfing a n d eventually w e n t on to train as a Rolfer in 1 9 6 9 . D i a n a Salles e a r n e d h e r M a s t e r s D e g r e e i n M e d i c a l I l l u s t r a t i o n f r o m t h e U n i v e r s i t y o f M i c h i g a n . " k e e p i n g t h e i n f a n t R o l f i n g a l i v e . a c o l l e c t i o n of q u o t a t i o n s f r o m Dr. s e e i n g t h e n e e d f o r a less f o r m a l b o o k o n R o l f i n g . She worked intensively w i t h Dr. S h e i s c u r r e n t l y s e n i o r artist f o r t h e A m e r i c a n M u s e u m of Natural History in N e w York City. a c o l l e c t i o n o f s t o r i e s a b o u t t h e f o u n d e r o f R o l f i n g . a s w e l l a s e x p l o r i n g s o m e o f t h e i n t e r e s t i n g b y w a y s o f t h e h u m a n p o t e n t i a l m o v e m e n t . S h e a n d L o u i s S c h u l t z are c o . Before t h a t he did considerable work in underwater photography. R o l f o n c e said. Feitis r e c e i v e d h e r degree in o s t e o p a t h y in 1 9 9 0 a n d currently practices Rolfing a n d h o m e o p a t h y in N e w York City. Rolf's l e c t u r e s . Italy. currently he practices R o l f i n g i n N e w York C i t y . S h e i n i t i a l l y w o r k e d w i t h Dr.