Anda di halaman 1dari 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
Copyright © 1 9 9 6 by R. Louis Schultz and Rosemary
Feitis. All rights reserved. No portion of this book,
except for brief review, may be reproduced, stored in
a retrieval system, or transmitted in any form or by
any means—electronic, mechanical, photocopying,
recording or otherwise—without the written per-
mission of the publisher. For information contact
North Atlantic Books.

Published by
North Atlantic Books
P.O. Box 1 2 3 2 7
Berkeley, 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, a nonprofit edu-
cational corporation whose goals are to develop an
educational and crosscultural perspective linking
various scientific, social, and artistic fields; to nur-
ture a holistic view of arts, sciences, humanities,
and healing; and to publish and distribute literature
on the relationship of mind, body, and nature.

ISBN 13: 9 7 8 - 1 - 5 5 6 4 3 - 2 2 8 - 6

Library of Congress Cataloging-in-Publication Data


Schultz, R. Louis (Richard Louis), 1 9 2 7 -
The endless web : fascial anatomy and
physical reality / by R. Louis Schultz and
Rosemary Feitis; illustrations by Diana Salles ;
photographs by Ronald Thompson,
p. cm.
Includes bibliographical references and index.
ISBN 1 - 5 5 6 4 3 - 2 2 8 - 3 (paper)
1. Manipulation (Therapeutics) 2. Fascia
(Anatomy). 3. Rolfing. I. Feitis, Rosemary.
II. Title.
[DNLM: 1. Fascia. 2. Manipulation, Orthopedic.
3. Human Body. 4. Holistic Health. WE 5 0 0
S387e 1996]
RD736.M25S38 1 9 9 6
615.8'2—dc20
North Atlantic Books are available through most DNLM/DLC
bookstores. For further information, visit our web- for Library of Congress 96-31550
site at www.northatlanticbooks.com or call 8 0 0 - CIP
733-3000.
8 9 10 11 12 TRANS 12 11 10 09 08
Dedicated to Ida P. Rolf

A promise fulfilled—with love


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

Introduction vii

Part I E a r l y D e v e l o p m e n t Pre- a n d P o s t - B i r t h
1 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 3
2 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 6

3 Factors in the G r o w t h of t h e E m b r y o 11

4 D e v e l o p m e n t of M e s o d e r m a l Tissues 13
5 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 15

Part I I C o n n e c t i v e Tissue B o d y
6 T h e Effect of t h e Birth Process 21

7 Developmental Transitions in the N e w b o r n


and Young Child 23

8 Myofascial Structures: T h e Spine as an E x a m p l e


of "Living A n a t o m y " 27
9 M o v e m e n t and Gravity 34
10 Body Contour 40
11 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 46

Part III Body Retinaculae (Bands/Straps)


12 T h e C h e s t B a n d : Implications for M o v e m e n t
and Behavior 53

13 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 61

14 T h e Eye B a n d a n d C h i n B a n d 68

15 The Collar Band, Umbilical Band, and Groin Band 73

Part I V Anatomy and Function

16 Proprioception: Internal Body Awareness 83

17 Upper Body 85

18 Axial Skeleton 93

19 Pelvis a n d U p p e r Legs 98
20 T h e System of Horizontal a n d Vertical Myofascial
Structures 106
  v i       T H E  E N D L E S S  W E B  

21 Reciprocity of Movement 109 

22 Joints 114 
 
Part V              Practical Application 

23 Doing Bodywork Based on the Connective 
Tissue Concept 119 
Evaluation 119 
First Intervention 120 
How to Go Deeper 123 
How to Touch 124 
How to Make It Last 126 

Illustration Index 127 

Subject Index 129 

About the Authors 131 
Introduction

T h e m u s c l e - 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 . I t s e p a r a t e s m o v e m e n t i n t o dis-
crete f u n c t i o n 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. W h e n o n e part m o v e s , t h e b o d y as a w h o l e responds. Function-
ally, 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. 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 .
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 .
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 . 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 a t t h e
t i m e she was developing her m e t h o d of working with bodies. She started in
t h e late 1 9 3 0 s . 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 , 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 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 - s e t t i n g (osteopathy, 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.
Today, 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 .
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. R o l f e s t a b l i s h e d
t h r o u g h her work. 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. This, t o o , is imple-
m 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 . I n fact, 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 .
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 . 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 . 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.
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. 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 . 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. 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.
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 . 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 . R a t h e r , it's
" M y b e l l y sticks o u t , " " I ' v e a l w a y s h a d k n o c k k n e e s , " " 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 . " 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 , 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 .
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 i l e m e n say, " T h a t c u t o f
jacket brings out t h e best in my shoulders."
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, 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 . F o r m a n y , 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 , " o r " I like m e n w i t h b i g s h o u l d e r s . " I n o u r n a t i o n a l c u l t u r e , 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, e c o n o m i c , social, a n d sexual suc-
c e s s e s a r e less i f o n e i s f a t . 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 , r u n n i n g , o r o t h e r k i n d s o f m o v e m e n t , 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 . 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 aggres-
sion and masculinity.
M o s t of i n n e r - b o d y awareness is also piecemeal, a n d generally negative:
" I h a v e a n upset s t o m a c h , " " M y k n e e h u r t s , " " M y n e c k i s stiff," " M y n o s e i s
stuffed." 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. W h e n I brag, I am c o n c e i t e d , w h i c h is
b a d . 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 , g o o d a b o u t
my body, I e n d up feeling guilty.
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, 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 w i l l d o p u s h - 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 ; 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 . 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 . 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 , 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.
This kind of connectedness is easy to understand in impact injuries.
W h e n I s t u b m y t o e , 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 , all t h e
way to my head, whether I notice it or not. The pain in the toe makes me
n o t w a n t t o s t a n d o n it, 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 . 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 , 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 . 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 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 .
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 . This is especially true if t h e toe was b r o k e n , a n d t h e pain has persisted
for a l o n g t i m e . 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.
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. E v e n a f t e r t h e
cast is r e m o v e d , there is t h e physical habit of allowing for t h e weight a n d
bulkiness of t h e cast, 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 . People t e n d to carry an arm that was o n c e broken half
b e n t , 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 .
T h e s e are straightforward responses to straightforward injuries. 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 . In our living tissue, t h e record b e c o m e s fixed w i t h c o n s t a n t replay-
ing. Like an orchestra, e a c h part relates to t h e o t h e r segments. In an orches-
tra 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 , 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 , 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.
I n t h e h u m a n b o d y , 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 . 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 , I w o u l d be in bed. I
INTRODUCTION ix

wouldn't be able to function. 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, giving us m a x i m u m operational
support for t h a t m o m e n t . 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 . 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 .
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. 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, 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 . To use
t h e orchestra analogy, 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 ; b o n e , m u s c l e , 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 . T h e c o n -
nective tissue is t h e record; it is an i n f o r m a t i o n b a n k for t h e body.
Visualize a n e t curtain or a h a m m o c k . W h e n a h o o k pulls on o n e part of
that web, the resulting distortion influences every part of t h e system to s o m e
d e g r e e . 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 , 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. By tracing c o n n e c -
t i v e tissue's o r i g i n , f u n c t i o n , a n d a p p e a r a n c e i n t h e b o d y , 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. 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. T h i c k e n i n g ,
snagging, 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 . 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.
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 ,
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 . Its
" k n e e b o n e i s c o n n e c t e d t o its . . . 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 , 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 . 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, or of h u m a n i t y .
PART ONE

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

response to m o v e m e n t , is the organizing C o n n e c t i v e tissue supports t h e organ,


factor. 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 nerve, and vascular systems. It makes up
fascia; t h e c o m b i n a t i o n is called myofascia. a high proportion of body mass, reaching
Movement is the outcome of embedded mus- 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
cle tissue a c t i o n o n t h e surrounding c o n n e c - n e t or spider w e b . This is a g o o d i m a g e
t i v e t i s s u e . (Fig. 1-1). S t r u c t u r e is t h u s t h e because it is organized but irregular—the
result o f m o v e m e n t , t h e characteristic m u s c l e 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 -
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 pletely regular p a t t e r n . A spider w e b d e p e n d s
w h o l e . C o n n e c t i v e tissue (myofascia) defines 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
t h e b o d y c o n t o u r a n d is t h e organ of structure s p u n a r o u n d — f o r its s h a p e . S i m i l a r l y , m y o f a s -
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 cia is adaptive.
body. 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 . B u t f o r c e s a l s o arise f r o m
inside, in the interconnections within the
b o d y . 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 . 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, for e x a m p l e . As a
Epimysium
r e s u l 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 , 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. Perpetuating this
i m m o b i l i t y , c o n n e c t i v e tissue t h i c k e n s a n d
Perimysium'
hardens.
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

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 . 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 . 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
Figure 1-1
from a lacelike elasticity to s o m e t h i n g m o r e
This cross section of the arm shows the way in
which muscle tissue is embedded within its con- d e n s e . If a fly g e t s c a u g h t in a s p i d e r w e b ,
nective tissue wrapping. there's a snag, a t i g h t e n i n g of t h e w e b in
EMBRYOLOGY 5

that area. Everything is pulled toward t h a t


s n a g , 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 .
Similarly, 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 , 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.
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
• B
is supported by c o n n e c t i v e tissue. 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 .
W h e n an area is compressed, t h e b l o o d sup-
p 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 t h e n affects t h e physical state
of the intercellular matrix, 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 .
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. It has certain physical
laws t h a t i t lives b y . T h e r e a r e c h e m i c a l l a w s
a s well, 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 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
C D
to a specific reaction. 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 . U n d e r
a certain kind of stimulus, s u c h as pressure,
this process can be speeded up. This is n o t Figure 1-2
This schematic shows an idealized sequence of
unusual; it is t h e n o r m a l way for a t e n d o n or
normal development of tendon from early gesta-
ligament to grow and take shape before birth.
tion to just before the baby is born. The process
As t h e e m b r y o gets bigger, t h e b o n e s get big- continues throughout life.
ger. I n g r o w i n g , t h e b o n e p u s h e s o u t , 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 (A) Early undifferentiated connective tissue near
bed between t h e two growing heads (ends) of early newly differentiated bone.

t h e b o n e (Fig. 1-2). T h i s i s t h e n o r m a l f o r m a -
(B) The growth of the bone exerts a directional
tion of ligaments and (where there is muscle pull within the connective tissue bed.
tissue) o f t e n d o n s . T h e d i r e c t i o n o f t h e liga-
m e n t or t e n d o n is determined by t h e direc- (C) Beginning of a more recognizable tendon
tional pull. T h e pattern of m u s c l e a n d t e n d o n shape; note that potential muscle tissue is devel-
oping within the tendonous bed.
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 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 . I n t h e
(D) Fully formed tendon with muscle developing
later m o n t h s , s t r u c t u r e s b e c o m e m o r e e l a b - along the line of connective tissue tension
o r a t e , m o r e set, a n d larger. between the two bones.
TWO
Early Embryological Development

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 Extraembryonic,


mesoderm
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 . T h e r e are
Amnion
t h r e e g e r m layers: Embryonic,,
Ectoderm
disc Endoderm*
• 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 epi-
Primitive
dermis (skin) yolk sac

• 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 , b o n e ,
Second week
blood, the urogenital system, and con- of pregnancy

nective tissue in general Head

By about the end of the second week of


pregnancy, 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 . 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 i c h organize i n t o layers at a b o u t t h e sec-
Amnion-
o n d week. 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 ) . Direction in Tail

the e m b r y o is established at the beginning of


Ectoderm Primitive
a b o u t t h e t h i r d w e e k (Fig. 2-1), w h e n a n a r e a streak
Endoderm-
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. Primitive^
yolk sac
At the beginning of the third week, 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 . T h e area of greater proliferation is Early third week
of pregnancy
approximately a quarter of the total surface
area. 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. T h i s is t h e tail e n d
of the embryo; it eventually becomes the anal Nolochord

region. W h e n t h e primitive streak is estab- Primitive


-"streak
lished, t h e m i d d l e layer ( m e s o d e r m ) begins to
develop. T h e process of growth in the embryo Mesoderm

Figure 2-1 Ectodernr

A three-dimensional view of the embryo at the Endodemv

beginning of the third week of pregnancy, show-


ing the initial differentiation of ectoderm and
endoderm and the first indication of directionality,
as well as the notochord, which marks the location
Late third week
of the future spine. of pregnancy
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, 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.
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.
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 ,
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. 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.
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.
Logically, 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 ; or, 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 ) , t h i s e n d d e v e l o p s first
(initially tail, t h e n t h e pelvis, t h e n chest,
neck, a n d finally t h e head). In fact, neither
is the case. Nature doesn't share our sense of
logic.
T h e primitive streak r e m a i n s primitive
(undifferentiated). 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 .
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 .
T h e top e n d is pushed farther a n d farther
away from the source.
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, not only at the
source, a l t h o u g h t h e greatest generation is
there. The embryo is growing geometrically:
lengthwise, sideways, a n d internally. 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 ,
body-like s h a p e . 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, showing the changes from
early germ layer pattern to recognizable
structures.
8 THE ENDLESS WEB

wise. As longitudinal pressure increases, t h e t h e oldest part of t h e digestive system is t h e


edges b e g i n to curve inward, closing to f o r m m o u t h . T h e b a c k o f t h e m o u t h i s older t h a n
a m o r e t u b u l a r s h a p e (Figs. 2-2, 2-3). T h e t h e esophagus, the s t o m a c h is older t h a n the
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 small intestine, and so forth. T h e sigmoid
ectoderm. T h e inside (originally t h e b o t t o m c o l o n just in front of t h e anus is the " n e w e s t "
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 part of t h e body.
is t h e filling b e t w e e n t h e s e t w o layers. At birth, t h e m o s t differentiated part of t h 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 " e m b r y o i s t h e h e a d . T h e least differentiated
differentiated from the general mass of the (the least m a t u r e ) is t h e pelvis. Differentiation
primitive e m b r y o . It later b e c o m e s the anal 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
region, so t h a t we m a y say t h a t this r e g i o n is long enough to have multiplied and elabo-
t h e " o l d e s t " part o f t h e body. After t h e anus, rated. T h e primitive local structures mature.
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; 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 struc-
t u r e s , a n d s o f o r t h . E v e n t u a l l y , 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 , a liver c e l l , a b r a i n
Endoderm^ Notochord'"
cell.
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 , 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. A cell s o m e w h e r e in t h e
h e a d , for e x a m p l e , w h e n it divides i n t o two,
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. W h e n these in turn divide, t h e y
m a y b e c o m e structures in front a n d back. As
Heart,
primordium cells c o n t i n u e t o d i v i d e , t h e y split t h e i r
potentiality, b e c o m i n g more and more
focused toward a purpose.
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 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 ,
o n e o r g a n . T h e s u r r o u n d i n g cells m a k e u p t h e
Heade
fold
e n v i r o n m e n t o f t h a t o r g a n , c o n t r i b u t i n g t o its
s t r u c t u r e , its s h a p e . I f t h e c e n t r a l c e l l i s p u t i n
Heart, a n o t h e r part of t h e b o d y early e n o u g h , it c a n
primordium' Tail
-•fold b e c o m e a d i f f e r e n t o r g a n . Yet a t s o m e p o i n t
i n t i m e , its e n v i r o n m e n t h a s s h a p e d i t suffi-
c 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.
F o r e x a m p l e , p o t e n t i a l liver at first is j u s t a
Figure 2-3
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
This mid-sagittal (lengthwise) sequence shows the
rest o f t h e g u t . A s l o n g a s t h e s e cells stay
folding of the body during the third week of ges-
tation. The same structures are present as in Fig- i n s i d e t h e t u b e , t h i s e n v i r o n m e n t will d e t e r -
ure 2-2. m i n e t h a t t h e y b e c o m e liver. I f o n e c o u l d
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 integrity of the growing vertebral c o l u m n .


nearby e n v i r o n m e n t , it could b e c o m e a pan- 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
creas. As described in m a n y standard e m b r y - 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
ology texts, it has b e e n s h o w n that potential differentiated ligaments that c o n n e c t the
pancreas does n o t differentiate into mature bones (Fig. 2-4).
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 - In a d d i t i o n to a grid-like support f r o m
dermal e n v i r o n m e n t (potential fascia). Rela- b o n e , t e n d o n , a n d l i g a m e n t , t h e b o d y gets a
t i o n s h i p to t h e surrounding fascial tissue is "packing material" support from connective
i m p o r t a n t ; 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 t i s s u e . Fat is a p a r t of t h i s m a t e r i a l . It is
that makes t h e difference for this tissue. a n o t h e r kind of c o n n e c t i v e tissue. D e p e n d i n g
About the end of the fourth week, the o n its d e n s i t y , i t a c t s t o c u s h i o n , p r o t e c t , a n d
embryo has developed primitive arms and pad the b o d y or to provide support a n d spac-
legs as w e l l as a p r i m i t i v e b r a i n , p r i m i t i v e i n g w h e r e it's m o r e d e n s e . I n a d i p o s e (fat)
spinal c o l u m n , a n d t h e b e g i n n i n g s of verte- tissue, cells enlarge by a c c u m u l a t i n g droplets
brae to protect t h e central nervous system. o f i n t r a c e l l u l a r fat; fibers a n d m a t r i x a r e
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 p u s h e d aside by t h e engorged cells. This tissue
bigger, p a r t i c u l a r l y a t t h e h e a d e n d . Its s h a p e 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
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 structures. Fat is o n e of t h e body's ways of
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 i m m o b i l i z i n g or wedging an area.
outside e n v i r o n m e n t .
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 . "
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 , fibers, a n d i n t e r c e l l -
ular m a t r i x . Its t e x t u r e i s like glass w o o l o r
a n g e l hair, t h e k i n d o f s t r i n g y , fluffy s t u f f
t h a t sticks t o y o u r f i n g e r s . T h e m a t r i x i s s t i c k y A B
a n d s o m e w h a t like J e l l - O i n t e x t u r e . I n m o s t
p l a c e s i n t h e b o d y , i t stays s o f t u n t i l b i r t h .
In o t h e r places, pressures a n d t e n s i o n s , b o t h
internal and external, cause it to respond by
getting hard and directional—ligaments and
t e n d o n s begin to form. Hardness a n d direc-
t 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.
I n t h e places w h e r e b o n e will f o r m , t h e
soft m a t r i x b e c o m e s m o r e rigid, e s t a b l i s h i n g
a directional pull. This internal tension,
together with external pressures f r o m t h e D
C
c o n f i n i n g walls of t h e uterus, stimulates cells
locally to increase p r o d u c t i o n of fibers. 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 . As it g r o w s ,
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 Figure 2-4
a stress l i n 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 Tendon/ligament formation.
1 0       T H E  E N D L E S S W E B  

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

This overview of early embryological develop- 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 -


m e n t has b e e n necessarily sketchy a n d gen- tionally b o t h m o r e discrete a n d m o r e stable
eral. H o w e v e r , it p r o v i d e s a f r a m e w o r k f o r i n f o r m . Yet c o n n e c t i v e t i s s u e b e c o m e s
discussion of embryological concepts as t h e y increasingly important, establishing the
predispose a n d influence t h e shape a n d char- arrangement of structures as t h e e m b r y o
acteristic m o v e m e n t of t h e individual. g r o w s i n size. T h e r e h a v e b e e n f e w t i s s u e
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 studies of late p r e g n a n c y t h a t detail w h a t
story. 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 goes on u n d e r n e a t h t h e skin of t h e develop-
growth. Minor variations in this developmen- ing infant. It is reasonable to suppose that the
tal 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 great spurts in g r o w t h t h a t take place toward
future structure a n d behavior. 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
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 increase in t h e v o l u m e of c o n n e c t i v e tissue.
factor over a n o t h e r as t h e e m b r y o grows. At T h e b o d y grows organically, solving prob-
o n e p o i n t , t h e size l i m i t a t i o n s o f t h e w o m b l 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, rather
may be the most important. At another time, 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 -
internal growth and differentiation m a y m i n e d p l a n . G e n e t i c p r e d e t e r m i n a t i o n sets
take precedence. As described in Section 1, t h e stage; v a r i a t i o n s are a k i n d of p r o b l e m
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 - solving. N o t w o o f u s are t h e s a m e . N o t w o
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 sur- sides o f t h e b o d y a r e t h e s a m e . T h e s e v a r i a -
r o u n d i n g tissue. Every g r o w t h stage t h u s tions relate to differences in e n v i r o n m e n t ,
creates n e w d e m a n d s a n d challenges i n t h e both internal and external, of the kind we
internal environment of the embryo. In gen- have b e e n describing. As b o d y structures
eral, 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 - develop, they change the internal environ-
cialization of function. m e n t o f t h e i m m e d i a t e area, creating c h a n g e s
The external environment becomes a t t h e a n a t o m i c a l level. T h e r e are m a n y slight
increasingly i m p o r t a n t as t h e e m b r y o gets differences in t h e rate of d e v e l o p m e n t inside
larger. W i t h i n t h e w o m b , t h e r e m a y b e s o m e t h e e m b r y o . T h e o r c h e s t r a t i o n o f t h e s e vari-
insufficiency of t h e p l a c e n t a (there are chil- ables makes up t h e physical c o m p o n e n t s of
d 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 ) . I f t h e individuality. This is true long before birth,
m o t h e r ' s diet is i n a d e q u a t e , t h e e m b r y o will even before the embryo is recognizably
be affected. If t h e m o t h e r takes m e d i c a t i o n or human.
drugs, t h i s will h a v e a g r e a t e r or lesser i n f l u - O n e factor in this kind of problem solving
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 s t a g e o f ges- is t h a t cells h a v e a m u c h wider ability to
tation, and dosage and/or frequency. If she is respond to changing environment than is
constipated during m u c h of the pregnancy, generally believed. M e s o d e r m is a p r i m e
this exerts pressure on t h e uterus. e x a m p l e . It h a s types of n o n s p e c i f i c cells t h a t
As t h e e m b r y o develops, in terms of struc- 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 -
tural organization, c o n n e c t i v e tissue is t h e cialized cells as n e e d e d . T h e s e cells are p r e s e n t
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 . M e s o - in the embryo, the child, and in the mature
derm remains relatively a m o r p h o u s . adult. We have termed this the " e m b r y o n i c
12 THE ENDLESS WEB

area as a w h o l e . If this h a p p e n s at o n e time


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

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 study of tissues), t h e fascial wrapping of


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 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 . It is
t h a t will b e c o m e t h e b o n e s , l i g a m e n t s , t e n - better described as an area of greater c o n -
dons, muscle, and myofascial elements of c e n t r a t i o n of c o n n e c t i v e tissue. T h e r e is no
c o n n e c t i v e tissue. T h e s e are t h e structural 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 . Liga-
c o m p o n e n t s of mesoderm; they share a char- m 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
acteristic pattern of growth. 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 -
It is usually assumed t h a t c o n n e c t i v e tissue t e u m (a fibrous covering of t h e b o n e ) , w h i c h
(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 in turn is continuous with the next tendon
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 . It is or l i g a m e n t . (Fig. 4-2).
our belief that t h e direction of t h e c o n n e c t i v e Anatomists tend to describe the b o d y in
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. t e r m s o f its d i s s e c t i b l e p a r t s . A l i v i n g b o d y i s
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 a c o n t i n u o u s w h o l e . T h i s is especially true of
directional pull differentiates i n t o m a t u r e 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 . T h e e r r o r
muscle oriented along the line of pull. Muscle 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
itself i s s p o n g y , 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 sur-
r o u n d i n g fascial bed. 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. C o n n e c t i v e t i s s u e
gives i t s h a p e , d i r e c t i o n , a n d o r g a n i z a t i o n ,
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.
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, B
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 . For e x a m p l e , a s t h e b i c e p s m o v e , t h e
whole arm moves, including the shoulder
and neck.
T h i s i n t e r a c t i o n d e v e l o p s early, i n t h e first
or second m o n t h of pregnancy. 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 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. 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. 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 .
c D

This development m a y be stimulated by the


Figure 4-1
physical tension present in the connective
This schematic shows an idealized sequence of
tissue, 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 -
normal development of tendon/ligament from
a t e d e n e r g y field (Fig. 4-1). early gestation to just before the baby is born.
In terms of histology (the microscopic The process continues throughout life.
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 , 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 .
Periosteum^ These have one character along the bone and

Tendon'
another between the bones. 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
Fascia>- 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 , a n d
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 .
Intramuscular
Brachialis- -connective This reinforces t h e directional pull within t h e
tissue fibers
c o n n e c t i v e t i s s u e b e d , s t i m u l a t i n g m o r e fiber
production.
Tendon*
Traditional a n a t o m y describes the average
soft tissue structures of t h e body. 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. We have interpreted these
as an individual response to idiosyncratic
Figure 4-2 patterns. These patterns can include habitual
Upper arm (brachialis muscle), showing the
gestures or posture, c o m p e n s a t i o n to injuries,
connective tissue continuity. Periosteum -> tendon
-> myofascia -> tendon -> periosteum. i n d i v i d u a l rates o f g r o w t h , a n d e n v i r o n m e n -
tal stresses o f all k i n d s . T h i s k i n d o f i n d i v i d u a l
covering a r o u n d m u s c l e tissue. It is m o r e response is apparent as early as t h e third
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 o n t h o f intrauterine life.
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 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 , size
tendon. 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
Keep in m i n d that in t h e embryological m o r e stringent this limitation, t h e greater t h e
s t a g e o f d e v e l o p m e n t , all o f t h e s e s t r u c t u r e s likelihood of adaptation. In m a n y infants, for
are p o t e n t i a l . W h a t starts a s p o t e n t i a l t e n d o n e x a m p l e , 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
or ligament has potential muscle developing
w i t h i n it. 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 Figure 4-3
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 The folding of the full-
a n d b e c o m e s fascia (bedding). T h e ends of t h e term baby in the uterus
original b a n d of fibers remain as the tendo- creates normal fascial
n o u s a t t a c h m e n t s . W h e r e t h e c o n n e c t i v e tis- tensions, resulting in
localized thickenings
sue b a n d s e x t e n d across a b r o a d area of t h e
of connective tissue.
body, s u c h as t h e b a c k , t h e y are called a p o -
neuroses. T h i s is a wider, 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. o f t h e leg b e c o m e s t h i c k e n e d . T h e legs are
We h a v e isolated a particular part of m e s o - held folded within t h e uterus so that tension
dermal differentiation—that of tendons and is created between the knee cap and the hip.
ligaments a n d associated muscle within the W h e r e there is this kind of pressure, the stim-
c o n n e c t i v e tissue bed as a w h o l e . W h a t do we ulation causes a heavier c o n c e n t r a t i o n of
m e a n b y differentiation? W h a t really h a p p e n s fibers, 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 .
w h e n c o n n e c t i v e tissue structures get organ- This is n o t a response to internal need, but
ized? As cartilage ( w h i c h will be replaced by 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. 4-3).
FIVE
Embryonic Limitations and Early Structural Organization

As t h e fetus grows, e n v i r o n m e n t a l pressures w h e r e it is called t h e ilio-tibial tract. T h e ante-


begin to d o m i n a t e . At six m o n t h s , t h e fetus r 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
is really b e i n g pressed by t h e l i m i t a t i o n s of a p i e c e o f f a b r i c . T h e m u s c l e s o f t h e t h i g h lie
space. This is particularly true if t h e m o t h e r ' s w i t h i n t h e folds.
posture or structure supports t h e p r e g n a n c y A n o t h e r pull is d o w n to t h e pubic b o n e
w i t h difficulty. T h e c h i l d m o v e s a r o u n d q u i t e f r o m t h e rib region. T h e m u s c l e m o s t directly
a bit, so that it does have s o m e o n g o i n g influenced is t h e rectus a b d o m i n i s , t h e "sit-
choice. Especially toward t h e eighth m o n t h u 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
of pregnancy, however, this m o v e m e n t tends ease a n d l e n g t h s e e m to relate to t h e degree
to be restricted to t h e limbs because there is 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 .
so little space. N o w h e r e are t h e s e pulls in i s o l a t i o n . T h e r e
T h e child's position in the uterus is thus are a l w a y s c r o s s - t e n s i o n s a m o n g t h e m . W e
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 have described a line of force d o w n to the
alignment. W h e t h e r the head is to t h e right pubic b o n e and o n e up to t h e anterior supe-
o r t o t h e left o f t h e k n e e s , w h e r e t h e a r m s rior s p i n e . I n a d d i t i o n , t h e r e i s a t o r s i o n
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 between these two b o n y protuberances.
establish t h e individual pattern of t h e verte- T h e soft tissue organizes as a s h e e t across
bral c o l u m n . W e assume t h a t t h e p o s i t i o n o f t h i s area, w h i c h i s t h e groin. W i t h i n t h e s h e e t
the head on the neck is determined by these t h e r e are specific areas of c o n c e n t r a t i o n of
s p i n a l r o t a t i o n s (Fig. 5-1). It w a s I d a Rolf's c o n n e c t i v e tissue fibers. T h e m o s t a p p a r e n t is
assumption that this relationship is estab- the inguinal ligament, a rope-like b a n d from
l 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 . t h e anterior superior spine to t h e pubic b o n e .
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 W h e n this is t o o h e a v y a n d short, it restricts
compensated by intrauterine limitations
during late pregnancy.
Other places in t h e b o d y m a y s h o w idio-
syncratic changes in structure, changes away
from simple efficiency. W h a t , t h e n , is simple
efficiency? It m a y be visualized in terms of
the concept of an embryonic, undifferenti-
ated 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. As t h e b o n e s grow i n t o this
bed, their protuberances act as hooks, pro-
v 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.
5-2). For i n s t a n c 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 h i s c r e a t e s
Figure 5-1
c o n v e r g i n g folds at t h a t p o i n t . T h e sheet of The rotations in the fetus continue into the
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 , structure of the adult.
16 THE ENDLESS WEB

m o v e m e n t ; w h e n it is insufficiently estab-
l i s h e d , t h e g r o i n sags.
T h e l u m b o - d o r s a l f a s c i a , w h i c h lies i n a
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 , i s a s o f t tis-
Inguinal Rectus
A.S.I.S. sue structure that is established by t h e h o o k -
ligament abdominis
m. ing effect at t h e spinal flexures, those places
where t h e degree of b e n d i n g in the spine is
greater. 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 ; i t i s a seg-
Ilio-tibial m e n t e d curve. These segmental junctions
tract 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 .
These junctions probably determine regional
.Sartorius
variations in t h e shape of the vertebrae. T h e
m.
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 restric-
tion from the w o m b ; there seems to be gen-
e 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
pressure of t h e u t e r i n e walls as t h e child
Rectus
femoris m. grows.
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 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.
W h e n t h e c h i l d i s b o r n , i t h a s t o start w o r k -
Figure 5-2 ing—literally—to counteract some of the hab-
Arrows pointing in one direction indicate the
its 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 . Its
major tensions that are unidirectional. Note the
spinal curve and a kind of crouched position
tensions on the inguinal ligament are bidirectional
between the ASIS (anterior superior iliac spine) 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 -
and the pubic bone (not labeled). ened (Fig. 5-3).
EMBRYONIC LIMITATIONS AND EARLY STRUCTURAL ORGANIZATION 17

At birth, the head nods forward and the leg. 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


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

A B C D
PART TWO

Connective Tissue Body


SIX
The Effect of the Birth Process

The term "birth trauma" has considerable instituted deliveries of t h e b a b y u n d e r water.


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

very thin. Both light a n d sound can and do


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

Development is not complete at birth. Birth i s l a r g e l y c a r t i l a g e , w i t h s m a l l disks o f b o n e


marks a transition toward a greater a n d ulti- (Fig. 7-1). 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 -
m a t e l y m o r e refined use o f m o v e m e n t . T h e l e a b l e , 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
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 has great effect on this lower structure. If he
m e d i a t e m o v e m e n t , yet structurally, t h e least o r s h e lies o n t h e b a c k o r f r o n t , t h e legs t e n d
complete system is t h e c o n n e c t i v e tissue. to be splayed out because of limited pelvic
Increased d e m a n d for m o v e m e n t furthers ossification as well as lack of soft tissue t o n e
maturation of t h e c o n n e c t i v e tissue. As we t o p u l l t h e legs t o g e t h e r .
use a part, it b e c o m e s m o r e capable, m o r e At birth, the m o s t developed pelvic mus-
skilled. I n t u r n , a s w e b e c o m e m o r e s k i l l e d , culature is in the back. T h e gluteus m a x i m u s
we explore a wider range of m o v e m e n t . muscle is very well developed. T h e erector
Feedback systems can operate to increase spinae (long m u s c l e s of t h e b a c k ) are strong,
the range of m o v e m e n t , or t h e circuit c a n get w h i l e t h e b e l l y w a l l i s less s o . T h o s e m u s c l e s
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. F e e d - 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
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 ( a d d u c t o r s ) a r e e v e n less s t r o n g . S w a d d l i n g ,
organisms. the practice of binding a n e w b o r n closely
T h e r e is very little i n f o r m a t i o n available i n c l o t h , 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
about muscle, c o n n e c t i v e tissue, a n d o r g a n close together. It m a y be that isometric m o v e -
ments of the infant within this wrapping
stimulate balance in the hip joint.
Figure 7-1
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
At birth, centers of
ossification are more t h e stresses; l e a r n i n g t o u s e t h e b o d y r e i n -
fully developed in the forces t h e process. T h e m a j o r i t y of children,
upper body than in the 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 , p u l l
lower. This is especially themselves up with their arms and shoulders.
noticeable in the space
T h e y are u s i n g t h e i r stronger parts to h o i s t
between the bony ossifi-
cations in the pelvis and themselves up on the cartilaginous, rubbery
legs when compared to legs a n d p e l v i s . O b s e r v e a s m a l l c h i l d w h o
the shoulders and ribs. has just discovered h o w to stand. T h e child
spends the day going up and down, pulling
u p w i t h h i s a r m s , g e t t i n g r u b b e r y o n h i s legs,
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 . After t h e falling down, c o m i n g up, getting rubbery,
first t h r e e m o n t h s o f p r e g n a n c y , m o r e e m b r y - and so forth. He is visibly exploring the bal-
ology texts concentrate on t h e growth of a n c e possibilities in his pelvis. If t h e h i p j o i n t
external form. T h e sequence in which the has r e a c h e d t h e stage w h e r e t h e tissues are
head develops a h e a d o f t h e tail a n d t h e b a c k 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 , all i s
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 , a s far a s w e well. But children (and parents) are o f t e n t o o
c a n tell, a f t e r b i r t h . eager. 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
In the newborn, the bones of the head and adequately developed can physically change
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 . T h e p e l v i s 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. 7-2). O r t h e
24 THE ENDLESS WEB

course, 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 . Range of m o v e m e n t is restricted.
Maturity in a j o i n t is t h e exploration of t h e
Cartilage
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

Cleft -
Synovial membrane
stable m o v e m e n t .
Joint cavity
Joint capsule J o i n t s b e c o m e mature with use. This
Perichondrium - Articular cartilage process accelerates after birth with kicking,
Mesenchyme Periosteum rocking, looking around, a n d so forth. It is
important to remember that a child doesn't
start w i t h w a l k i n g . I f t h e c h i l d d o e s n ' t c r a w l
Immature Mature
before it walks, it is likely to h a v e m o t o r
Figure 7-2 u n c o o r d i n a t i o n for life. T h e child m a y also
The essential difference in the comparison of
h a v e a brain i n c o o r d i n a t i o n , m a n i f e s t i n g as
mature and immature joints is that the immature
" b o n e " is still cartilage. Thus the immature joint is disabilities in t h i n k i n g , reading, seeing, a n d
more pliable and, unfortunately, is more learning.
deformable by misuse. In crawling, 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
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.
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 . 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. T h e heel is an excellent e x a m -
ple of this. W i t h o u t a well-developed heel,
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. 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 Immature (4 yrs)
other. 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. 7-3). T h e b o n e
a n d tissue e l e m e n t s are present, 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. W h e n t h e
c h i l d starts to walk, it usually stands on t h e •Tibia

balls of t h e feet. It has to because t h e heel


c a n ' t reach t h e floor; t h e muscles c o n n e c t i n g Talus

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
•Calcaneous
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. Eventually,
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 Mature
h e e l rests f i r m l y o n t h e g r o u n d .
Adequate flexibility at t h e joints is t h e Figure 7-3
The black outlines in the immature foot represent
anatomical definition of maturity. W h e r e
cartilage that will eventually be replaced by bone.
t h e r e is i m m a t u r i t y in a j o i n t , it is c h i e f l y a Note the difference in the shape of the talus as it is
quality of t h e soft tissue p o r t i o n of t h e joint. molded by ossification and use. Concurrently note
W h e n it is inelastic, contracted, or pulled off the change in the position of the calcaneus.
DEVELOPMENTAL TRANSITIONS IN THE NEWBORN AND YOUNG CHILD 25

outside of the knee and the h i p a n d on up stability in position is harder to keep.


i n t o t h e b a c k (Fig. 7-4). C r a w l i n g r e d i r e c t s 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
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 . I t i s n e c e s - at the other end of the spectrum of malleabil-
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 ity of cartilaginous tissue. T h e r e are m i n e r a l
before going on to the elongations of t h e 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 ,
body required in walking. Crawling seems 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 . D i s k s
to establish the lower back (lumbar) curve. consist of fibrocartilage, w h i c h is dense a n d
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 fibrous. Functionally it is similar to b o n e ;
angles at b o t h the hip a n d the knee. Crawling histologically it is an i n t e r m e d i a t e stage b e -
develops t h e use of t h e pelvis, b r i n g i n g it t w e e n cartilage a n d b o n e tissue. Fibrocartilage
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 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
a n d belly. 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 - 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 .
n i z i n g t h e a r m s a n d legs, a s w e l l a s r i g h t a n d T h e difference between o n e kind of connec-
left sides. tive 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
A t b i r t h , t h e pelvis a n d legs are p r i m a r i l y 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
cartilage. Proportionately, t h e arms h a v e m o r e of the intercellular matrix. W i t h i n limits, any
b o n e , 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 o f these tissues m a y m o v e i n t h e direction o f
ribs, 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 increased rigidity or at a n o t h e r t i m e , reverse
than the ones down toward the lumbar t o t h e d i r e c t i o n o f g r e a t e r fluidity. T h i s c a n
r e g i o n a n d t h e s a c r u m . T h e full r e p l a c e m e n t h a p p e n at a n y age.
of cartilage by b o n e in t h e skeleton is n o t Reversibility of tissue density is an i n s t a n c e
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 - of the embryological nature of connective
five. 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 - tissue in t h e adult. I m p a c t e d areas, such as
t e b r a l c o l u m n , i t m a y b e e a s i e r t o c h a n g e its b e t w e e n t h e shoulder blades or across t h e t o p
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 - o f t h e p e l v i s , c a n f e e l like t e n d o n s . L i k e t e n -
bility. A t t h e s a m e t i m e , i t m a y b e t h a t a n y d o n s o r l i g a m e n t s , 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 e all h a v e w a y s o f s h o r i n g
Figure 7-4 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
(A) before birth; (B) creeping; (C) crawling; constriction. We create short "ropes" and
(D) standing.

A B C D
26 THE ENDLESS WEB

folds across a j o i n t or wide cross b a n d s to structure of the n e w b o r n into a c o m p e t e n t ,


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

Figure 7-5
EIGHT
Myofascial Structures
The Spine as an Example of "Living Anatomy"

The "organ" that transmits m o v e m e n t in the c o n n e c t i v e tissue. It is a heavier c o n d e n s a t i o n


body, that makes a structural w h o l e of us, is o f fibers a t t h e s u r f a c e o f m u s c l e . M y o f a s c i a
t h e mesodermal tissue—the c o n n e c t i v e tissue. also exists as layers b e t w e e n m u s c l e s , relating
These hard a n d soft tissues t o g e t h e r m a k e u p t h e m o r e superficial surface muscles to t h o s e
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 . " deeper in t h e b o d y as well as c o n n e c t i n g
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 - adjacent muscles into groups. We consider
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 fascia to be a c o n t i n u o u s system, e x t e n d i n g
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 . I n throughout the b o d y between the deepest
descriptive terms, this m e a n s t h a t s o m e is b o n e level ( p e r i o s t e u m - t e n d o n - l i g a m e n t )
h a r d e r o r softer, s o m e i s m o r e e l a s t i c o r m o r e (Fig. 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
rigid. 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 ( 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
throughout the body from toe to head. Bone, of fibrous tissue t h a t flows t h r o u g h t h e body,
for e x a m p l e , is a c o n c e n t r a t i o n of h a r d inter- eddying around b o n y protuberances that
cellular 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 . c o m p r e s s a n d r e d i r e c t its flow. I t i s t h e p a c k -
Histologically, therefore, b o n e is c o n t i n u o u s ing material of the body; it makes up our
with t h e total b e d of c o n n e c t i v e tissue. contours and holds us in place.
Myofascia, t o o , is a specialized type of 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 . I n a d d i -
t i o n , 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 ,
w r a p p i n g a r o u n d smaller m u s c l e fiber groups
(Fig. 8-2). M u s c l e fibers e x p a n d a n d c o n t r a c t ,
exerting internal pressure on this myofascial
Periosteum*
tissue. Acting like a guy rope, t h e fibrous
Tendon^

Fasciar-

Intramuscular
Brachialis- -•connective
tissue fibers Epimysium

Tendorw

Perimysium'

Endomysium. 1

Figure 8-1
Brachialis muscle in upper arm showing continuity
of connective tissue: periosteum and tendon with Figure 8-2
fascia. Ligaments similarly bridge the periosteum Cross section of the upper arm showing the fascial
of one bone to the periosteum of the other bone sheaths (labeled) surrounding muscle fibers (dots)
in a joint. and muscle groupings.
28 T H E E N D L E S S W E B

Coracoclavicular fascial s h e a t h t h e n transmits t h e m o v e m e n t


ligament &
to the periosteum of the b o n e with which it is
Subclavius m.
c o n t i n u o u s . In adults as well as in t h e e m b r y o
and neonate, where the myofascial covering
Coracoid 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
process
habitual tension or holding), it condenses
Coracobrachialis .Pectoralis to encase the muscle in such a way that there
m. minor m. 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 .
As we h a v e said, t h e m y o f a s c i a l b e d of t h e
adult, as well as of t h e e m b r y o , responds to
Biceps m.
habitual t e n s i o n with a localized increase of
(short head)
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. 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 , 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. T h e f o c u s
of Rolfing is this t o u g h e n e d myofascia, 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. We therefore have reason to
believe that this toughening of the myofascial
s h e a t h is reversible.
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 . An e x a m p l e is t h e coracoid process, 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. Fascia e x t e n d s as
a continuous sheet from the hand, arm, 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 .
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 , m o d i f y i n g its f l o w (Fig. 8-3).
S i m i l a r l y , 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 , 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. 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, stabilize, 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 . 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.
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 . For e x a m p l e , t h e
Figure 8-3 coracoid process is the point of a t t a c h m e n t
A look at the surface of the shoulder demonstrates
of muscles from t h e arms to t h e shoulder.
the continuity of the fascial sheath (photo). The
On the other hand, the tailbone is only min-
underlying fascial pulls graphically illustrate the
complex dynamics focused on the coracoid process i 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
(drawing). f r o m t h e l e g t o t h e t r u n k . Yet t h e t a i l b o n e ' s
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, 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. 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 , a n d e a s i l y
i g n o r e d . 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 .
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 .
The upper rim of the hip bones, the edge of
t h e l o w e r ribs, a n d t h e s h i n b o n e s a r e e x a m -
ples. T h e s e , t o o , 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. In general, t h e s e b r o a d e r Figure 8-4
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 Dowager's hump.
s o f t tissue o r g a n i z a t i o n . 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 deeper-
lying tissue. arm moves, that movement should continue
There is a f u n c t i o n a l reasonableness to t h e wavelike through the neck a n d i n t o the head.
c o m b i n a t i o n of myofascial sheets and b o n y 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 -
p o i n t s o f r e f e r e n c e . T h e g r o w i n g b o n e sets u p m e n t . For e x a m p l e , a t t h e j u n c t i o n o f t h e
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 neck with the chest vertebrae, there is often
tissue i n u t e r o . W h e n t h e s e a r e f r o m a s i n g l e 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
p o i n t (for e x a m p l e , t h e w a y t h e h a m s t r i n g s 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. 8-4).
a t t a c h to t h e ischial tuberosities), t h e result Since the spine is the focus of so m a n y
tends to be a grouping of rope-like structures. m o v e m e n t difficulties, w e will g o i n t o s o m e
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 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
example, the transverse muscles covering w h a t w e c a l l " l i v i n g a n a t o m y . " All o f t h e
t h e a b d o m e n ) , t h e r e s u l t i s m o r e like a b r o a d 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
sheet. every m o v e m e n t of t h e body. This is espe-
" P o i n t of a t t a c h m e n t " designates t h e sup- cially well d e m o n s t r a t e d in b r e a t h i n g , w h i c h
posed e n d p o i n t of m o v e m e n t for a muscle or is n o t generally t h o u g h t of as a " m o v e m e n t . "
group of muscles. It is i m p o r t a n t to r e m e m b e r T h e r e are t h r e e or four articulations b e t w e e n
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 refer- e a c h vertebra. I n t h e c h e s t region, t h e r e are
ence. Points of a t t a c h m e n t c h a n g e the quality three articulations of each of the twelve t h o -
of movement. They change the strength of 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 . T h e r e
t h e gesture a n d absorb s o m e of t h e energy of 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 -
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 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
of the body. 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
Ideally, 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 considered true joints, but t h e y do f u n c t i o n
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 as joints). Holding patterns can and do occur
spine. M o v e m e n t transmits as a wave d o w n 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
the spine as well as across t h e spine a n d i n t o articulations, restricting m o v e m e n t through-
t h e o t h e r side o f t h e b o d y . T h u s , w h e n t h e o u t t h e s p i n a l c o l u m n (Fig. 8-5).
30 THE ENDLESS WEB

We i n c l u d e b o n e , fascia, 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. 8-6). I n d i -
Costal facet of vidual vertebrae m u s t b o t h separate vertically
transverse process
Inferior costal
and rotate with every body m o v e m e n t . The
articular facet
spinal c o l u m n as a w h o l e integrates rotation
Superior costal
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
articular facet diagonal m o v e m e n t s . 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 . In d i s s e c t i o n , 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.
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 .
T h e spinal c o l u m n is constantly moving
Figure 8-5 in response to breathing, heartbeat, blood
In the thorax, the articulations of the ribs with
c i r c u l a t i o n , c r a n i a l r h y t h m , e t c . For e x a m p l e ,
the vertebrae add another level of complexity to
spinal mechanics. w h e n we i n h a l e , 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 ; spinal curves decrease in
a n g l e . W h e n w e e x h a l e , 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. 8-7). 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
Anterior "at rest."
longitudinal 1
„ Interspinous
ligament ligament
As m o v e m e n t b e c o m e s more active, con-
n e c t i v e tissue wraps m o r e tightly a r o u n d t h e
Intervertebral,
disc -Ligamentum s p i n e . 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
flavum
Vertebral goes f r o m a primarily vertical at-ease position
body
(centrum) .Spinous
process

Posterior
'longitudinal
ligament

Transverse,
process

Ventral Dorsal -

Figure 8-6
Lumbar vertebrae with associated ligaments Figure 8-7
illustrating the complexity of fiber direction. Inhale (B) and exhale (C).
MYOFASCIAL STRUCTURES 31

to a spiraling, narrower wrapping a r o u n d t h e protein solutions is their response to changes


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

t o t h e b o d y s u r f a c e , t e n d t o b e w h e r e large 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 . M u s -
m u s c l e masses cross e a c h o t h e r or attach to cles, in this m o d e l , provide t h e source a n d
bone (Fig. 8-8). direction of m o v e m e n t energy. Muscles exe-
We describe the c o n c e p t of joints in more cute movement.
d e t a i l l a t e r (see S e c t i o n 2 2 ) , b u t i t s h o u l d b e In t h e classically taught picture of t h e
mentioned now that between each of the body, b o n e s are t h e supporting structures.
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 However, b o n e s do n o t t o u c h . It is thus
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 impossible for t h e m to support t h e b o d y the
that is similar in c o m p o s i t i o n to t h e intercel- w a y a t a b l e is s u p p o r t e d by its legs. S u p p o r t
lular m a t r i x . As b o n e s articulate, t h e y are n o t in a m o v i n g structure is very different f r o m
in direct c o n t a c t with e a c h other. T h e y have s u p p o r t in a s t a t i c s t r u c t u r e , s u c h as a h o u s e .
fluid b e t w e e n t h e m . B o n e s " f l o a t " i n r e l a 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
ship to e a c h other. As t h e c o n n e c t i v e tissue organization and arrangement of the connec-
compresses around the spinal c o l u m n , the tive tissues. W h e n we speak of a m o v e m e n t
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 , b e i n g supported, we are describing t h e a c t i o n
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. 8-9). 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 . T h e
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 - r e c i p r o c a l , 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 tis-
nation of the narrower coiling of the connec- sue 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
tive tissue a n d t h e pressure of t h e c o m p r e s s e d elastic capability.
fluid b e t w e e n b o n e s . A s i n t h e s p i n e , all j o i n t s s h o u l d l e n g t h e n
This is a n e w picture of physical structure. 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
Here t h e c o n n e c t i v e tissue is t h e supportive 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 . For
aspect of t h e structure. B o n e s are spacers, this t o h a p p e n , t h e c o n n e c t i v e tissue m u s t b e
serving to position a n d relate different r e s i l i e n t . T h i s r e s i l i e n c e i s felt a s e a s e ; i n p h y s -
areas o f t h e c o n n e c t i v e tissue. B o n e s are n o t iological terms, it is described as t o n e . An
t h e supporting structures of t h e body; t h e 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.
T h e concept of physical support of move-
m e n t is simplified if we t h i n k in terms of the
E
c o n n e c t i v e tissue b e d rather t h a n in terms of
;Levator
'scapulae m.
Trapezius m.
A-
/Supraspinatus m. Figure 8-8
These fascial dumpings are the common "sore
places" that we complain about.
(A) The trapezius as it crosses the tip of the shoul-
B der (acromion).
C
(B) The trapezius as it crosses the scapula below
D .Latissimus the scapular spine.
dorsi m.
(C) The interaction of the levator scapulae and the
supraspinatus at the upper medial point of the
F scapula (often especially intractable).
(D) The interaction between the trapezius and
latissimus dorsi at about the lumbo-dorsal hinge.
(E) The attachment of the levator scapulae to the
base of the occiput.
(F) The pad created by the latissimus dorsi at the
lumbosacral junction.
MYOFASCIAL STRUCTURES 33

m u s c l e m o v e m e n t . Physical a c t i o n alters t h e resilient, either generally or locally, h o l d i n g


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 - patterns b e c o m e habitual. There is a c o n c o m i -
out t h e structure, creating greater c h a n g e t a n t loss o f range o f m o v e m e n t a n d o f energy.
where m o v e m e n t originates and rippling into 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
more attenuated change farther away from ability. T h e Rolfing i n t e r v e n t i o n is t h e o n e we
t h e origin of m o v e m e n t . B o n e s are spacers, k n o w b e s t . B y w o r k i n g t o e n h a n c e t h e resili-
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 . A s i m - e n c e of t h e c o n n e c t i v e tissue bed, Rolfing
plified m o d e l i s a t e n t , w h e r e t h e t e n t p o l e i s reeducates the b o d y toward an improved
held upright by the balanced tension between relationship to the gravity line.
r o p e s o n b o t h sides. B o t h Rolfing a n d m a s s a g e m i g h t b e classi-
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 fied 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 . S h i -
support from below from a base such as t h e atsu, acupuncture, a n d reflexology act by
e a r t h or a c h a i r . S u p p o r t in a l i v i n g , m o v i n g releasing energy t h r o u g h t h e c o n n e c t i v e tis-
b o d y c o m e s f r o m above as well as f r o m below. sue. O t h e r therapies work t h r o u g h retraining
T h e h e a d a n d t h e fingertips are as m u c h a m o v e m e n t , e i t h e r p a s s i v e l y (Trager m e t h o d )
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 . or actively, or by a c o m b i n a t i o n of active a n d
Adequate length in the neck and adequate passive (Rolfing M o v e m e n t work, Alexander
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 work, Feldenkrais Functional Integration).
integrity of t h e b o d y as a w h o l e . Exercise that is properly d o n e also t o n e s a n d
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 l e n g t h e n s c o n n e c t i v e tissue. S o m e forms of
exercise, s u c h as yoga, t'ai chi, a n d swim-
Figure 8-9 m i n g , are b y design activators o f c o n n e c t i v e
The figure to the right shows the lengthening that
tissue t o n e . Poorly d o n e exercise a n d exercis-
occurs with spinal movement as connective tissue
ing w h e n exhausted, however, have an oppo-
more closely wraps the joint. Notice that the con-
nective tissue fibers change direction, becoming site e f f e c t o n c o n n e c t i v e t i s s u e , c a u s i n g i t t o
more vertical as the spinal column elongates. harden and contract.

Lumbar vertebrae

Anterior
Interspinous
longitudinal'
ligament
ligament

Intervertebral,
disc' tigamentum
flavum
Vertebral
body*
(centrum) ^Spinous
process

Posterior
•longitudinal
ligament

Transverse,
process

Ventral Dorsal-
NINE
Movement and Gravity

W h e n a n y part o f t h e b o d y m o v e s , t h e entire the joints of the bones going from heel


b o d y responds. We always m o v e f r o m a base to toes, there is also w i d e n i n g b e t w e e n t h e
o f s u p p o r t . Ideally, w h e n w e sit, m o v e m e n t 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
is initiated f r o m t h e part of t h e pelvis t h a t is 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
resting o n t h e chair. W h e n m o v i n g forward, t h e structure a n d t o provide spring for t h e
t h e pelvis rocks forward, t h e pubic b o n e drops n e x t step. T h e spring action c o m e s from
slightly toward t h e sitting surface, a n d t h e the lengthening provided as the connective
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). 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 . T h e leg
T h e m o v e m e n t is like a spring. It starts at t h e becomes longer with m o v e m e n t . This is the
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 result of l e a n i n g forward f r o m t h e base of
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. support, allowing t h e leg to c o m e forward
T h i s falling-forward m o t i o n takes o n l y sec- 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 .
o n d s ; 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 - T h e hip j o i n t l e n g t h e n s as well as widens
m e n t . A s f o r w a r d m o t i o n starts, t h e p e l v i s w i t h m o v e m e n t . C o n n e c t i v e tissue wraps t h e
widens, h o w e v e r slightly. T h e r e is an increase 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
in t h e space across t h e sacroiliac j u n c t i o n (femur) and the hip socket (acetabulum), so
and a widening at the pubic b o n e (pubic that t h e h e a d of t h e femur drops slightly out
s y m p h y s i s ) . As a result, t h e h i p b o n e s (gene- 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
rally c o n s i d e r e d relatively i m m o v a b l e ) also pelvis for t w o of t h e three m o v e m e n t s charac-
widen. teristic of walking: rocking forward a n d back
In walking, we push off from the ground a n d f r o m side t o s i d e . ( T h e t h i r d m o v e m e n t i s
u s i n g t h e j o i n t s i n t h e f o o t (Fig. 9-2). T h i s swiveling, w h i c h results f r o m t h e f r e e d o m of
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 - s e c o n d ; m o v e m e n t between sacrum and ilium).
m o v e m e n t is t h e n transmitted to the ankle. A base of support is an u n m o v i n g surface
Above t h e ankle, t h e shin b o n e c o m e s for- or structure f r o m w h i c h m o v e m e n t is initi-
w 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 , a t e d . Ideally, all p a r t s o f t h e b o d y are free t o
thereby increasing the horizontal space in the respond to m o v e m e n t . But this is seldom
foot as well as t h e vertical space b e t w e e n foot fully realized. M o r e often, in walking we con-
and ankle. O n c e again, this is m o v e m e n t by tract s o m e part rather t h a n fully l e n g t h e n i n g .
lengthening. As the shin b o n e c o m e s forward, T h e leg m a y b e pulled u p against t h e h i p
t h e r e m a i n d e r of t h e b o d y is propelled for- joint; t h e hip m a y b e i m m o b i l i z e d a n d used
ward. Ideally, t h e resulting m o v e m e n t is 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 . A s t h e leg i s
literally a falling forward of t h e w h o l e b o d y pulled up, t h e hip joint is compressed, short-
—unless s o m e part of the b o d y is held back. ened. T h e pattern of compression is trans-
In walking, and particularly in running, mitted through the body. The most extreme
there is a great i m p a c t on t h e foot. T h e spaces exaggeration of this kind of walking is the
between the bones of the foot widen and goose step.
lengthen as the foot comes in contact with 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 -
the ground; they narrow and arch as the foot ing farther forward t h a n w h e n walking; you
lifts u p . 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 adjust your speed in walking or running by
MOVEMENT AND GRAVITY 35

h o w far y o u l e a n f o r w a r d . T h i s i s t h e h a r d e s t M a n y people have a t e n d e n c y to carry their


t h i n g f o r u s t o d o ; w e t e n d t o resist l e t t i n g 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 struc-
everything go forward. We bring t h e shoul- tures. A m o r e workable image is to consider
ders b a c k , t h e ass b a c k , a n d / o r h a n g o n t o o u r 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
s p i n e i n s o m e way, i n o r d e r t o h a v e a f e e l i n g of t h e spine. This allows us to visualize h o w
of control. A c o m m o n exaggeration of this is 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
holding the body tensely upright as we walk the spine. W h e n the m o v e m e n t of the spine
o r r u n , 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 is like a s p r i n g , t h e h e a d is its last s e g m e n t .
front of t h e torso. T h e b o d y is t h e n literally M o v e m e n t reverberates t h r o u g h the spine
leaning backward. a n d is released t h r o u g h m o v e m e n t of t h e
In m o v i n g with length, as m o v e m e n t is head. Holding anywhere in t h e structure
initiated, the joints open (lengthen) spon- reflects m o s t strongly at t h e ends of t h e
t a n e o u s l y a n d s e q u e n t i a l l y . First t h e a n k l e body—between the ankle and heel and
opens. As it reaches the proper limit, the knee between the head and neck. Holding can
joint opens, and so on. Insofar as the joints also originate at t h e t o p e n d . Almost uni-
are free t o o p e n , t h e m o v e m e n t o f w a l k i n g versally, w h e n w e t h i n k o f s o m e t h i n g o r
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 c o n c e n t r a t e i n a n y way, w e h o l d our h e a d s
head. rigidly. 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, r e s u l t i n g i n a n
audibly heavier tread. W h e n t h i n k i n g (which
is most of the time), we c o m e down heavily
on our heels.
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. 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 . 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 . 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:
Figure 9-1 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 , w e a r e
Rising
afraid t h a t we will be so jarred t h a t our h e a d
will be seriously disturbed, we're a l m o s t afraid
our brains will get rattled. W h e n w e w a n t t o
focus on something, 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. W e a r e
afraid we will lose t h e i m a g e . 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. It is a m i s u s e of our
abilities, yet it is very c o m m o n .
T h e other end of this c o n t i n u u m is allowed
movement. We can be confident that as we
walk our brains will n o t b e rattled. W e c a n
Figure 9-2 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
Walking. p i c t u r e s . W e all are a b l e t o see a n d u n d e r s t a n d
36 THE ENDLESS WEB

movies even though they show a new frame 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


twenty-four times a second. We don't have two bones as the foot moves. T h e density
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. W e 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
don't need to control every aspect of our physical nature of t h e intercellular matrix
m o v e m e n t ; w e n e e d t o let ourselves m o v e m u s t b e d i f f e r e n t , t o g i v e t h e n e c e s s a r y dif-
a n d a b s o r b a n d let g o . ference in compressor ability (resistance to
T h e idea that structure determines f u n c t i o n compression).
i s a n o l d o n e . Ida R o l f g a v e e x p a n d e d m e a n - We exist in gravity—we have weight and
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 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 . I n g e n e r a l ,
determines structure. Using the connective a body's o n l y g o o d c h o i c e with respect to
tissue m o d e l , we c a n elaborate h o w parts of g r a v i t y i s v e r t i c a l i t y . T h e c o n c e p t is, h o w e v e r ,
t h e b o d y t h a t are a n a l o g o u s structurally (arms merely a useful abstraction. Because t h e body
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 differ- is c o n s t a n t l y m o v i n g , there is rarely static
e 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 verticality.
trunk, reflecting a difference in n e e d a n d use. Bodies also d o n ' t m o v e straight forward.
I n t h e leg, 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 - 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 , a n d t h e s e diag-
ear tracking. T h e r e is t h e n e e d for t h e leg to o n a l s are b a l a n c e d . It is this b a l a n c e a m o n g
go forward a n d b a c k a n d for t h e joints of t h e c r o s s - 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 ver-
leg t o m o v e w i t h o u t excess r o t a t i o n . I n t h e t i c a l i t y i n t h e m o v i n g b o d y . For e x a m p l e , i n
arm and shoulder, t h e primary need is for walking, o n e leg a n d h i p c o m e forward t o -
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 gether with the opposite shoulder and arm
joints. T h i s is a very different kind of 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
lengthening. arm and shoulder balance backward. There is
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 always this kind of reciprocal m o v e m e n t tak-
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 ing place a r o u n d t h e central axis of t h e body.
f r o m t h a t o f t h e a r m . I n t h e leg, i t i s s t r u c - Turning the b o d y is initiated from the base
tured for stability; in t h e a r m , it is m o r e elas- of support which, in walking, is mediated
tic for flexibility. T h e shoulder blade a n d t h r o u g h t h e feet. T h e r e must therefore be
c o l l a r b o n e ideally float freely in t h e c o n n e c - e n o u g h elasticity of action at t h e ankle joint
t i v e t i s s u e , w h i l e t h e h i p b o n e a n d leg are and between the foot b o n e s to allow not only
m o r e closely knit. In m a n y m o v e m e n t s , the for b e n d i n g at t h e j o i n t but also for rotation
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 so as to m o v e quickly and smoothly from
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 t ' a i o n e side t o t h e other.
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 W i t h s o m e c a u t i o n , w e use t h e a m b i g u o u s
after m o v e m e n t has b e e n initiated in t h e word " c o r e " for t h e body's central axis. It is
legs a n d p e l v i s . a n o t h e r u s e f u l a b s t r a c t i o n ; t h e r e i s n o struc-
We believe that there is a difference in t h e tural correlate for this core. T h e b a l a n c e d
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 diagonals of the limbs function best in c o m -
legs a n d t h e a r m s , p a r t i c u l a r l y i n s t r u c t u r e s 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
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 - core. We have discussed the spring action of
a r m a n d l o w e r leg. I n t h e a r m , t h e i n t e r o s - the spine. T h e concept of a core includes both
seous m e m b r a n e needs to be elastic so that spine (with head, sacrum, and coccyx) and
the b o n e s can rotate with the multidirectional t h e viscera. There is reason to believe that the
u s e o f t h e h a n d . I n t h e l o w e r leg, t h e i n t e r - c o n n e c t i v e tissue of t h e organs is also a part
osseous m e m b r a n e must be denser to support of movement. This can be demonstrated in
MOVEMENT AND GRAVITY 37

dissection a n d is visible in behavior. T h e


viscera themselves, t h e n , 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 .
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, n o t t h r o u g h t h e spine
(Fig. 9-3). A s t o m a c h a c h e , a h e a r t s p a s m ,
hemorrhoids, 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 . F u n c -
t i o n a l l y , t h e n , 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.
Even w h e n the primary m o v e m e n t is
straight forward, such as walking across an
u n i m p e d e d floor, 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 .
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. 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. T h e m o v e m e n t i s a l m o s t like a figure
eight, absorbing a n d a c c o m m o d a t i n g t h e Figure 9-3
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 Central axis of the body.
r e a c h e s t h e floor. ( 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. T h i s i s a n e x a g - b e c o m e s f u n c t i o n a l l y lighter. T h e muscles o f
geration, b u t it is graphic.) the back of the neck and the shoulders can
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, t h e n start t o r e l a x .
i f w e are i n a l i g n m e n t , o u r w e i g h t i s c o m f o r t - T h e c o n c e p t of gravity is particularly
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 appropriate to a m o v i n g body. The b o d y
u p r i g h t . I n s t a n d i n g still, t h e c o n c e p t o f 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
weight is a g o o d w a y of analyzing structure. w i t h t h e shoulders, t h e shoulders are i n line
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 posi- with the a b d o m e n , the a b d o m e n is in line
t i o n o f t h e h e a d . I f t h e h e a d i s t o o far f o r w a r d w i t h t h e pelvis, t h e pelvis is in line w i t h t h e
— t h a t is, 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 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 -
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 tion the body leans. T h e exception is the o n e
the neck. It is cantilevered. Since the head 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
weighs somewhere between ten and fifteen falling. W h e n t h e leaning b o d y is in align-
p o u n d s , w e m u s t t h e n use t h e large m u s c l e s m e n t , this forward foot is directly under the
in t h e back of t h e shoulders a n d n e c k literally h e a d (Fig. 9-4). T h e s u p p o r t f o r t h e h e a d i s
to hold o n t o our heads. As soon as the head t h e forward foot. Gravity t h e n acts t h r o u g h
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 the b o d y in the w h o l e space that it occupies,
centered on and supported by the neck, it a broad base b e t w e e n t h e t w o feet.
38 THE ENDLESS WEB

placement of the organs is asymmetrical.


Further, it seems possible that differences in
brain function engender asymmetrical move-
m e n t preferences resulting in structural asym-
m e t r y . 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 , ideally, 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.
T h e r e is a further m e a s u r e of proper align-
m e n t . This is the relationship of the deep to
t h e m o r e superficial structures, 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 . This is visible in t h e surface
Figure 9-4 contour. W h e r e there is excessive knotting
Walking. or flabbiness, there is this kind of surface-to-
deep tissue i m b a l a n c e .
In l o o k i n g at t h e c o n n e c t i v e tissue arrange- 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
m e n t in dissections of h u m a n bodies, we b a l a n c e , t h e tissue h a s w h a t we call proper
n o t e d t h a t there was s e l d o m a linear (vertical t o n e , m u c h t h e way a violin string that is
or horizontal) arrangement of connective 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 . All t h e
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 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 -
the body. T h e fibers tended to run diagonally j e c t i v e — t h e y have to do w i t h personal experi-
across t h e b o d y . For i n s t a n c e , we saw a h e a v y e 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 . Yet g o o d
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 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 . It is a
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 springiness to t h e t o u c h and suppleness in
the a b d o m e n and down to the opposite hip. movement.
Fascial crisscrosses seen in dissection s e e m to Vertical integrity a n d g o o d t o n e are our
relate to t h e n o r m a l rotations in a m o v i n g measures of a properly aligned body. W h a t
body. W h e n crisscrosses h a v e h e a v y c o n c e n - 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
t r a t i o n s of fat a n d gristle, this is t h e excessive Rolf, 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 .
response of a b o d y that is n o t in alignment. 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
M a n y of these padded oblique angles can be ultimate goal the creation of better balance in
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 . T h e y are u s u - t h e pelvis. This has to do with t h e relations of
a l l y f o l d s , 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 the hip b o n e (ilium), the sacrum, and the
a s fat t h a t t h e y c a n ' t g e t rid o f . B u t t h e y a r e lower back (lumbar) vertebrae. These relations
actually heavier b a n d s of c o n n e c t i v e tissue, are n o t s i m p l e . T r o u b l e — p a i n , awkwardness,
usually a response to a b n o r m a l rotation of stiffness, heaviness—is a product of misalign-
the b o d y in m o v e m e n t . In an aligned body, m e n t (rotation) of any one of these elements
o b l i q u e fascial structures are n o t r a n d o m . with respect to another. In the pelvic region,
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 . 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 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 t h e s a c r u m o r t h e leg b o n e . T h e sacrum c a n
in balance with those on the back. be rotated with respect to the lumbar spine
Seen from the front, a well-aligned person or the tailbone or the hip bone. There may be
s h o u l d a p p r o a c h s y m m e t r y , b u t w e are n e v e r further rotations between individual lumbar
entirely s y m m e t r i c a l . For o n e t h i n g , t h e vertebrae.
MOVEMENT AND GRAVITY 39

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

W h e n we look at the contour of the whole 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


b o d y , 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 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
structures as t h e y affect t h e c o n n e c t i v e tissue v a l l e y s (Fig. 10-1). T h e r e are areas w h e r e t h e
bed. Muscles expand and contract in response 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
t o d e m a n d . Habits lay d o w n pads, s o m e t i m e s h e l d d e e p . H i g h l i g h t s (hills) c o r r e s p o n d t o
c o n t a i n i n g fatty accumulations. T h e position t h i c k e n e d pads of tissue b e t w e e n skin and
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 b o n e ( a n d / o r m u s c l e ) . T h e s e p a d s are o f t e n
controls the direction of m o v e m e n t . Volition, m a d e up of fatty tissue in association with
habit, a n d self-image shape the connective f i b r o u s c o n n e c t i v e t i s s u e . T h e s h a d o w s (val-
tissue, w h i c h in t u r n supports a n d restricts leys) 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
the activity of muscle, b o n e , and other func- sticks to b o n e ( a n d / o r m u s c l e ) . W h a t is creat-
tions such as circulation, breathing, and ing these adhesions seems to be a compacted
digestion. T h e result is a person's s h a p e . 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
The contour of the body is based on con- m a t r i x i n its gel s t a t e .
nective tissue. As it interacts with b o n e s a n d B o t h o f t h e s e modifiers o f c o n t o u r reflect
m u s c l e s , t h e s e soft tissues are t h e p r i m a r y t h e w a y t h e b o d y i s u s e d . H e a v y fat a n d c o n -
determinant of body shape. This is in contrast 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
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 h a v e b e e n u n d e r t e n s i o n for a lifetime. T w o
anatomy as determining the outline of the 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
body. Body shape is therefore affected by the 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
holding patterns that we have described. a n d a heavy pad at t h e base of the spine, over
t h e t o p o f t h e b u t t o c k s (Fig. 10-2). M u s c l e s
Figure 10-1 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 . T h e large,
Body contour tells us a lot about the condition of
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 (trapez-
the underlying connective tissue and its potential
ius) 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 -
for movement. Here are photographs of three very
different body types. Intuitively we have expecta- port a forward head. T h e upper margin of the
tions of how these bodies will move. gluteus m a x i m u s habitually contracts to hold
BODY CONTOUR 41

t h e p e l v i s rigid. 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.
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.
T h e b o n e appears to be right at t h e i n d e n t e d
surface, just u n d e r t h e skin. Actually, 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. T h e skin sticks to t h e leath-
e r y (or glassy) c o n n e c t i v e t i s s u e . O n t h e o t h e r
h a n d , 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 , t h e skin c a n m o v e freely
over b o n e a n d tissue. We never actually t o u c h
b o n e in palpating t h e body. 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.
C o n t o u r is idiosyncratic e v e n at birth. In a
detailed dissection on t w o stillborn infants,
there was a considerable difference in m u s c l e
development. In one, the musculature of the
b o d y was relatively undeveloped, 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. The heavy pad of fat over the
gluteal region was a thick mass of connective tis-
Fat& sue containing fat. Note the similar padding across
"connective the shoulders and up into the neck.
tissue pad

d o w n to t h e tiniest muscle. However, t h e pat-


terns of c o n n e c t i v e tissue padding in t h e t w o
.Trapezius 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. 10-3).
m.
In b o t h , there was a heavy pad of fibrous c o n -
nective tissue across t h e upper posterior bor-
Erector der o f t h e large h i p b o n e s , crossing over a n d
spinae
m. tying the hip bones to the sacrum. There were
Fat& also pads of fatty c o n n e c t i v e tissue b e t w e e n
-.connective 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
tissue pad
t h e genitals). These pads were thick, s o m e -

.Gluteus w h a t like a diaper b e n e a t h t h e skin. T h e pres-


maximus m. ence 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 . 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 .
We tend to think that heavy muscle is good
Figure 10-2 a n d that the more a muscle is developed, the
Fat and connective tissue pads. better off we are. Overdeveloped m u s c l e s l o o k
42 THE ENDLESS WEB

impressive, b u t t h e y t e n d t o reduce free range a n d therefore c a n n o t m o v e straight forward


of m o v e m e n t . This is because the pumped a n d b a c k w a r d (Fig. 10-4). W h e r e b o d y b u i l d -
muscle is contracted, resulting in compression ing is c o m b i n e d with stretching and body
a n d s h o r t e n i n g at t h e joints. For b a l a n c e , a a w a r e n e s s (e.g. y o g a ) , i t i s s o m e t i m e s p o s s i b l e
heavy muscle needs another equally heavy to maintain adequate freedom of movement
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 . W h e r e in the joints along with development of the
there has b e e n m o r e persistent effort at m u s - muscle mass.
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 A reasonable a m o u n t of bodybuilding
other, t h e j o i n t torques (twists). is a good thing, creating t o n e and strength.
A bodybuilder w h o conscientiously works T o o m u c h of a g o o d t h i n g in this case causes
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 restriction and exacerbates preexisting habit-
tightness around individual joints. This bal- ual distortions. Excessive d e m a n d on a b o d y
a n c e is based on partial c o n t r a c t i o n ; it will be part always brings out whatever c o m p e n s a -
functional as long as t h e program of exercise t i o n s or restrictions already exist in t h e part.
is m a i n t a i n e d . But w h e n such a person walks, This is true for p u m p i n g iron, working out
he or she ends up with a kind of waddle. T h e on m a c h i n e s , r u n n i n g or jogging, or ballet.
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 Unless there is modification of t h e exercise to
a c c o m m o d a t e individual idiosyncrasies, there
will e v e n t u a l l y b e p r o b l e m s . I n a d d i t i o n , c h a l -
Proportionately l e n g i n g w o r k o u t s are generally associated
small head
w i t h exercising past t h e p o i n t of efficiency.
Short neck This is where most of the mischief occurs. It
is virtually impossible n o t to create chronic
a n d / o r acute injury w h e n repeatedly exercis-
Arms pulled
into shoulders i n g i n a n e x h a u s t e d s t a t e . O u r a d v i c e i s t o let
Shortened pleasure be your guide. How m a n y people
torso
have you seen smiling while running?
Arms go wide T h e c o n c e p t s o f c o n t o u r a n d posture over-
l a p a n d b l e n d i n t o e a c h o t h e r . B o t h are t h e
result of habitual h o l d i n g patterns. 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. From t h e front,
Legs pulled
into pelvis 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

Legs go
higher t h a n the other, o n e arm longer than
wide t h e o t h e r , 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. From the
side, w e h a v e already m e n t i o n e d t h e devia-
tions f r o m vertical such as the head forward,
shoulders up or r o u n d e d , chest depressed,
pelvis tipped forward or tucked back.
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 . Its c o n n e c -
Figure 10-4
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 -
The muscle development of this body looks
impressive, but that muscle bulk is a major tant. T h e psoas myofascia is interwoven with
impediment to freedom of movement. t h e fascia o f t h e muscles o n t h e inside o f t h e
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 . pelvic b ri m, chronically flexes t h e b o d y at


I n t h e g r o i n a r e a , j u s t t o t h e side o f t h e p u b i c t h e level of t h e groin, so t h a t it p r e v e n t s truly
b o n e , the direction of t h e psoas changes. This erect posture."*
allows it to act as a k i n d of pulley. T h e psoas T h e preferences o f t h e psoas are n o t obvi-
tendon attaches to the femur at the top of the o u s a t b i r t h . T h e y start t o s h o w w h e n t h e legs
inner thigh and is thus c o m m o n l y bound up adjust to bearing weight, as t h e child crawls
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 a n d starts t o s t a n d u p . Nevertheless, m u s c u l a r
d o w n t h e leg. imbalances do exist in t h e n e o n a t e . As we
W h e n the psoas is habitually contracted, h a v e said, 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 -
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 - oped muscle in back t h a n in front. At about a
ties c a n arise. T h e p s o a s c a n b e t o o s h o r t , t o o year old, in order to walk, t h e child has s o m e -
wide, t o o narrow, t o o flaccid. Moreover, e v e n h o w to solve the p r o b l e m i n h e r e n t in this
t h o u g h centrally located in the body, it is 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 b i l a t e r a l m u s c l e . T h e t w o sides a r e r a r e l y 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
s y m m e t r i c a l i n t o n e , p l a c e m e n t , a n d size. A psoas, pulling the lumbar vertebrae forward.
physically asymmetrical psoas t h e n leads to This is the origin of the typical big-bellied
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. 10-5). baby look.
A c c o r d i n g t o Ida Rolf, t h e p s o a s i s o n e o f I m m a t u r e b o d y patterns f r e q u e n t l y persist
the most significant muscles of the body. It
maintains body structure a n d b o d y relation- *Ida P. Rolf, Rolftng: The Integration of Human Structures
s h i p s (Fig. 10-6A and 6B). T h e p s o a s o r i g i - (New York: Harper & Row, 1 9 7 7 ) , p. 1 1 0 .

nates along t h e upper l u m b a r spine; 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 Lateral pelvic tilt

t h e l u m b a r v e r t e b r a 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; t h r o u g h these n e i g h b o r s , t h e
psoas c a n involve t h e respiratory pattern. It
diagonally traverses t h e cavity of t h e pelvis,
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 ilia-
c 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. T h e iliacus lines t h e Psoas
i l i u m , t h e large b o n e o f t h e p e l v i c b a s i n . ' longer lax
Psoas shortened;,
S t r u c t u r a l l y , t h e p s o a s is a b r i d g e b e t w e e n pulls pelvis up

u p p e r b o d y a n d legs.
"If a b o d y is n o r m a l , 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. 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 , irre-
spective of general b o d y position. 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,
lengthening with every m o v e m e n t of flexion,
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
Figure 10-5
beginning of t h e bad lower back. A deterio- A physically asymmetrical psoas leads to lumbar
rated psoas, glued d o w n as it crosses t h e rotations and pelvic tilts.
44 THE ENDLESS WEB

the psychological pattern tends to change


as t h e physical structure is able to evolve.
On t h e other h a n d , physical culture experts
a t t e m p t to m o d i f y structural patterns by
building up muscle mass. 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 . " 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. We believe that
n o a m o u n t o f s i t - 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 .
Moreover, no physical p r o b l e m exists in iso-
lation, 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 . For e x a m p l e , 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 . 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 ) . 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.
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 . 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 .
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.
A n o t h e r e x a m p l e of a c o m m o n postural
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
Figure 10-6A
c e r v i c a l v e r t e b r a ) . A t its e x t r e m e , t h e h e a d i s
This masterly drawing by John Lodge has been
taken from Ida Rolf's book on Rolfing. It shows the p u s h e d v e r y far f o r w a r d . T h e s h o u l d e r b l a d e s
iliopsoas and its associated muscles. 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, cantilev-
into adulthood. T h e y intensify to pervade the ering it out over t h e chest. A variation of this
b o d y a n d t h e personality o f t h e adult. Start- pattern is often seen in older w o m e n and
ing with the work of W i l h e l m Reich,* there m e n . T h e " d o w a g e r ' s h u m p " i s t h e result o f
has b e e n t h e t e n d e n c y t o classify characteris- creating an excessive pad at the base of the
tic b o d y postures in clinical terms. Reich clas- neck.
sifications were hysteric, psychotic, schizoid. Like t h e folds of a curtain, w h e n t h e h e a d
T h e basis for these types is considered to be is forward, everything in t h e b o d y appears to
b o d y a r m o r i n g , w h i c h is w h a t we call h o l d i n g h a n g from the base of the neck. There is no
patterns. Psychological treatment of character way this posture can be corrected by simply
a r m o r i n g is designed to release these patterns. "holding your head u p . " It is too hard to hold
We prefer n o t to classify physical habits in y o u r h e a d up; y o u will stop t h e effort as s o o n
psychological terms. Our assumption is that as your attention is deflected from bettering
your posture. To get t h e n e c k straight, you

*See W i i l h e l m Reich, Character Analysis (New York:


m u s t exert c o n s t a n t effort to pull against
N o o n d a y Press, 1 9 9 0 ) , p. 7 2 . d e p r e s s e d ribs a n d c o l l a r b o n e . Y o u m u s t p u s h
BODY CONTOUR 45

against h u n c h e d or rounded shoulder blades.


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 , 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,
squandering their energies and working
against themselves. 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. 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. T h e total b o d y tissue—bone,
muscle, 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 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, 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.
T h e goal, t h e n , is n o t so m u c h to achieve
perfect vertical a n d horizontal structure lines
in a body. Rather it is to free t h e soft tissues so Figure 10-6B
A chronically short psoas will have its greatest
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
impact on the groin, forcing the pelvis down in
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 verti-
front. There is a concurrent loosening of the nor-
cal. 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 mal t o n e of the rectus abdominis. One very com-
they were in line. mon result is lordosis and a pot belly.
ELEVEN
Emotions and the Fascial Web
Body Awareness and Response Patterns

As children, we are taught almost everything t h o s e early fears. I n W i l l i a m J a m e s ' f a m o u s


w e d o i n life, 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 d i c t u m , "I d o n ' t r u n b e c a u s e I am afraid;
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 . It's I am a f r a i d b e c a u s e I r u n . "
assumed that we n e e d to learn h o w to use M o v e m e n t patterns express personality
our brains, but presumably using our bodies 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 . Fear m a n i f e s t s
i s d o i n g w h a t c o m e s naturally. N o o n e gives 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
us i n f o r m a t i o n on h o w to create balance or t h e individual's identity—in body, e m o t i o n ,
change physical problems. e n e r g y , m i n d . T h e t r u e n a t u r e o f fear (lack
W h e n a c h i l d starts to walk, it is no l o n g e r 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 .
an o b j e c t to be carried a r o u n d (however lov- 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
ingly). It is b e c o m i n g independent in the fight or flight. Even in t h e case of a b o d y part
w o r l d , t a k i n g c h a r g e o f its o w n l i f e . J u s t t h e t h a t h u r t s w h e n i t i s m o v e d , fear i s m o r 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 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 . It s h o u l d
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 . I t not cause us automatically to tighten that
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 , a r e a . T h e m o r e w e t i g h t e n it, t h e m o r e i t will
even t h o u g h this would be the best time to hurt. This "natural" reaction has an outcome
s h o w a c h i l d h o w t o u s e its l e g s . 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 . T h e fear
I m a g i n e , f o r a m o m e n t , a b a b y ' s first s t e p s . 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
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, unconscious modifications—locked neck,
accompanied by attempts at balancing with g r a b b e d t o e s , s u c k e d - i n ass, h e l d s h o u l d e r s ,
t h e a r m 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 c l e n c h e d j a w s . T h e s e a r e all i n r e s p o n s e
fours, security lay in keeping t h e back steady 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
and pushing off with the hands and knees. m o v e m e n t or are d o n e to avoid ridicule or
W h e n there is unsteadiness in walking, the embarrassment.
baby again attempts to control with arms Integrated m o v e m e n t centers around the
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. c o n c e p t of l e a n i n g forward so that gravity
W h e n adults h o l d a child to help it walk, 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 . For m a n y
they generally hold under the armpits or by p e o p l e , 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 ,
the hands. This again reinforces the pattern instead of creating a relaxation response,
of c o n t r o l l e d shoulders to stabilize walking. 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 .
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 T h e result is a g r a b b i n g p o i n t (or several).
adult (Fig. 11-1). This holding is unnecessary. The whole body
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 - c a n b e i n a fluid s t a t e a t all t i m e s . T h e r e a s o n
t i o n a l fear, l a c k o f t r u s t . R e a s o n a b l e c a u t i 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 " for-
and attempts at control by the infant as it w 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
learns to walk can be retained as m o v e m e n t his structure.
patterns in t h e adult. T h e adult is n o t afraid 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
of losing b a l a n c e a n d falling, but as t h e adult fear. 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
walks, h e / s h e u n c o n s c i o u s l y restimulates t o o early, 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
EMOTIONS AND THE FASCIAL WEB 47

point where leaning forward is comfortable. Ideally, 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


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

Figure 11-1
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 Evaluating bodies, we tend to focus on


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


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

wish to recognize that they have an e m o - are h u n c h e d a f t e r a b a d fall. B o t h h a v e b e -


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

Body Retinaculae
(Bands/Straps)
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 , w e soft tissue structures. T h e c o n t o u r patterns


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

Figure 12-1
Body Retinaculae: The Seven Body Bands of the Torso

1. The lowest band in the torso (pubic band) along the lower border of the pectoralis major,
extends from the pubic bone in front across the across the mid-lateral chest, and down the lat-
groin (which is thereby shortened), around the eral margin of the latissimus dorsi where it
hip bones (the greater trochanter of the begins to run parallel to the scapula toward the
femur), and across the buttocks, ending at the arm. The strap appears to tie the lower tip of
junction of the sacrum and coccyx. the scapula to the back ribs and ends at the dor-
2. The band across the lower abdomen sal hinge of the spine. When this strap is pro-
(inguinal band) is frequently more prominent in nounced, there is not only a depressed mid-
men. It connects the two bony projections of chest, but an inability to expand the ribs side-
the pelvic bones in front (the anterior superior ways in breathing.
spines of the ilia). It usually dips slightly down- 5. The fifth strap at the shoulders (collar
ward in front, like an inverted arch, resembling band) involves the clavicle and is part of the tis-
an internal jock strap or chastity belt. Its lower sue gluing the clavicle to the first and second
margin tends to include the inguinal ligament, ribs in front. It can be felt as a pad of tissue just
connecting the band downward to the region below and deep to the collar bone (clavicle). It
of the pubic bone. This band extends laterally extends laterally to the tip of the shoulder, with
along the upper margin of the large wings of some fibers fanning down into the armpit. The
the pelvic bones (ilia), ending at the lumbo- strap continues toward the back on the inside
sacral junction. and outside of the upper border of the shoulder
3. The third band crosses the abdomen blade (scapula), and ends at the junction of cer-
(belly/umbilical band) and is perhaps the most vical and thoracic vertebrae.
variable in location. It may cross at the umbili- 6. The area below the chin (chin band) is an
cus (sometimes creating a crease in the abdomi- area of concentration of fibers and padding
nal wall extending out on either side of the which includes the hyoid bone and the base of
umbilicus), or it may lie midway between the the jaw, passing just below the ear, and ending
umbilicus and the midcostal arch (tying where the base of the skull joins the first cervi-
t o g e t h e r the two sides of the costal arch). In cal vertebra (atlas).
either case, it will extend laterally to form an 7. The top band (eye band) is the most diffi-
arch across the abdomen to the lower ribs on cult to visualize. It originates on the bridge of
each side—particularly to the free tip of the the nose, travels across the eye sockets and
eleventh rib. It travels backward along the above the ears, and ends at the back of the skull
lower ribs, ending at the junction of the tho- just above the occipital crest (the bump at the
racic and lumbar vertebrae. back of the skull).
4. The fourth band is in the area just below
the nipples (chest band) and is visually the most Reprinted from Rolf Lines, The Journal of the
apparent. It is usually a non-moving depressed Rolf Institute, 1 9 9 5 , with permission.
area on the chest; the skin seems glued down NOTE: For the body retinaculae, we have used
onto the ribs and muscle. Laterally, it extends the terms " b a n d " and "strap" interchangeably.

muscle and the lower insertion of the pecto- of the chest, hinging between the fifth and
ralis m a j o r m u s c l e (Fig. 12-3). T h e b a n d is 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 -
slightly higher as it m o v e s around to t h e back b r a e . 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
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 parts was apparent in our dissections. T h e
downward in front. The back extension of 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 rela-
this strap seems to be t h e dorsal h i n g e , a t i v e l y a b r u p t l y ; t h e q u a l i t y o f t h e t i s s u e dif-
functional division of the chest (thorax). T h e fered as well.
dorsal h i n g e is visible as a c h a n g e in m o v e - I n f r o n t , t h e s t r a p starts a b o u t a n i n c h
m e n t pattern between upper and lower halves 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 . T h i s also
THE CHEST BAND 55

A B

Figure 12-2 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


Body Straps: (A) side view; (B) front view 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.
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 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
body to the other. We tend to ignore this t h e u n d e r l y i n g ribs a n d t h e intercostal m u s -
right-to-left relationship across t h e s t e r n u m , 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
yet it is an i m p o r t a n t o n e , reinforcing a n d 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
often c e m e n t i n g side-to-side variations in 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 . Because there is little m u s c l e 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 b d o m i n a l region a n d a depression at the
A
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 ster-
n 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
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
B
e n v e l o p e of c o n n e c t i v e tissue, allowing it
Figure 12-3 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,
Mid-chest strap: (A) front view; (B) side view. walks, etc. T h e m u s c l e tissue of t h e rectus
The arrows denote the major lines of force of the a b d o m i n i s a n d t h e pectoralis m a j o r is sepa-
muscles involved in the movement between pelvis
rate, b u t their c o n n e c t i v e tissue forms a
and arms. Ideally, movement flows through the
continuous, segmented web, allowing the
muscles in sequence. This flow is interrupted by
the mid-chest strap. Its location is defined by 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
major lines of force of the muscles. 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 tis-
sue 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 nar-
rows 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 (scap-
ula). 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 pec-
toralis 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 Figure 12-4
restricts lateral rib m o v e m e n t a s w e l l a s The " Y " of the front and the "V" of the back.
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 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
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 ends approximately at t h e dorsal h i n g e . W h e n
the scapula. It c o n t i n u e s across t h e b a c k of t h e strap is h e a v y a n d tight, it inhibits t h 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 . Ideally, t h e s c a p u l a stress a t t h e d o r s a l h i n g e . P u d g y a d o l e s c e n t
is suspended a n d c a n " f l o a t " freely over t h e boys also c a n be uptight about nipples and
ribs a s t h e a r m m o v e s . F o r e x a m p l e , w h e n breast tissue, a n d t h e y h u n c h over for t h e
you reach the arm forward and up, the s a m e reason. An aberrant pattern takes h o l d
scapula drops. As the reach continues, the 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
scapula t h e n floats upward. W h e n there is a d o w n , c o n t r o l , hide. C o n t r o l is really t h e
restriction by a band, neither the downward m o s t descriptive term here.
nor the upward m o v e m e n t of the scapula is T h e r e are a limited n u m b e r of ways to
possible without exertion and the recruitment effect control in the body. W h i l e emotional
of e x t r a n e o u s m u s c l e (Fig. 12-5). rationales underlying a n y given structure
As t h e strap runs f r o m front to back, it vary, 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 .
crosses over a n u m b e r of additional deeper 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 . I n
muscles as well as t h e superficial o n e s we m i d - c h e s t , t h e strap m a y b e caused b y a n
h a v e described. T h e c o n n e c t i v e tissue asso- accident, by a desire to hide t h e breasts, by
c 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 a desire n o t to b r e a t h e , by t h e n e e d n o t to
that modify the horizontal quality of the 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, o r b y res-
s t r a p . 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. p i r a t o r y d i s e a s e . All t h e s e d i f f e r e n t c a u s e s
T h e r e are pulls u p i n t o t h e armpit, d o w n manifest in t h e b o d y as a similar pattern.
toward t h e lower lateral m a r g i n of t h e rib 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
cage, a n d t o w a r d t h e pelvis. T h e result is a 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
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 guard t h e armpits. Armpits are sensitive a n d
main path around the chest. 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 -
This, then, is the physical description of uals. As t h e strap b e c o m e s tighter a n d m o r e
t h e mid-chest strap—the nipple binder. We f i r m l y e s t a b l i s h e d , d i f f e r e n t parts o f t h e b o d y
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 get drawn in. T h e pressure of hiding t h e
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 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
tissue p a t h w a y s by w h i c h it influences t h e 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
body. T h i s b r o a d effect is probably a reason t h e w h o l e t o p o f t h e rib c a g e .
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 F o r e x a m p l e , i n b a b y p i c t u r e s a t less t h a n
and influence every aspect of the body. a year old, o n e child's shoulders were very
H o w d o straps c o m e i n t o b e i n g ? T h e narrow and high, obscuring the neck. The
reasons are generally m u l t i p l e a n d c u m u l a - 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
t i v e . First, 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 body, protecting t h e armpits. As this child got
through the challenges of growing up. They to be about eight or nine, he went through
a r e like s e e d s i n a p e a r l . S o m e t i m e w e s u c c e s s - a period of b e i n g a "sulky c h i l d . " This gave
fully incorporate t h e m with m i n i m a l c o n n e c - impetus to the h u n c h e d - u p physical pattern.
tive tissue disturbance. O t h e r times we grow As an adult, his chest seemed too narrow in
successive c o n n e c t i v e tissue layers to c u s h i o n 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 e f f e c t
a n d protect ourselves from t h e irritation. T h e of b o d y w o r k was dramatic: his chest got four
seed m a y be physical or e m o t i o n a l in origin. c o a t sizes bigger. T h e b o d y w o r k d i d n ' t give
We h a v e described several scenarios of physi- h i m t h e n e w chest; it merely allowed h i m
cal origin. to use w h a t was there.
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 , A m o r e e m o t i o n a l l y based way of express-
they try to hide t h e m . T h e y cave in at t h e ing what we m e a n is that the blueprint of the
sternum a n d h u n c h their shoulders, creating 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 , b e c o m e s
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. The positions of
the scapulae have been outlined. Notice the great differences in muscle recruitment at the elbow, neck, and
along the spine.
60 T H E E N D L E S S W E B

established as the character type, and t h e n a n d t h e o t h e r s f o l l o w . D e c i d i n g w h i c h i s first


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 . It's cause is difficult a n d usually n o t necessary.
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 T h e b o d y has certain places where it can most
a n y o n e place a n d t h e n spread outward. T h e 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 . T h e s e c r e a t e
pattern as a w h o l e is sketched in a n d t h e n 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
becomes reinforced and more pronounced of cause.
w i t h age a n d use. J u d g i n g f r o m t h e t w o babies 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
t h a t we dissected, t h e p a t t e r n is laid d o w n in individuals. There is s o m e variation in place-
utero. As early as in t h e n e w b o r n , we have the m e n t a n d shape. T h e strap is t h e structure as
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 . Later, a w h o l e . Individual variations pull it d o w n in
if aberrant t e n s i o n s are m a i n t a i n e d , these o n e place, tighten it in another. T h e attach-
b e c o m e like a b r o a d t e n d o n . T h e s t r u c t u r e m e n t s o f t h e strap, t h e differences i n e m p h a -
s o m e t i m e s looks like t e n d o n in dissection; sis, 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
it certainly feels like t e n d o n u n d e r t h e skin. w h o is barrel-chested and s o m e o n e w h o is
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 very n a r r o w f r o n t - t o - b a c k a n d wide side-to-
described in that location. s i d e . 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
T h e restrictions inhibit our evolution to n o t a s t r u c t u r e p e r s e . It is a l o c a l c h a n g e
an " u p r i g h t s t a n c e . " Shoulders get raised as in the balance between fiber and matrix
t h e chest sinks d o w n a n d t h e head c o m e s organization within the total connective
f o r w a r d . O r t h e h e a d m a y c o m e f o r w a r d first, tissue bed.
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 A
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. 13-1). 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). This c o n -
Costal Rectus
n e c t i o n i s like a h a l f - m o o n s h a p e , c u r v i n g arch/ abdominus
m.
downward from these protuberances. 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 .Inguinal

b o n e so t h a t t h e strap crosses t h e lower part 'band

of this muscle. T h e strap b r o a d e n s across t h e Inguinal


ligament "
lower a b d o m e n . In m a n y people it includes
1

Pubic
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 . tbone

These c a n e x t e n d deep i n t o t h e pelvis, filling


the pelvic bowl.
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 tis-
sue. 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. 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 .
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 .
Because of this lack of intercellular matrix,
t h e fat tissue h a s b e c o m e i n f l e x i b l e . I t i s B
therefore an effective inhibitor of energy
and movement.
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. G y m n a s t s , f o r e x a m p l e , t e n d t o h a v e
an almost horizontal line across t h e groin,
f o r m i n g a shelflike ridge in t h e lower a b d o -
m e n . T h i s c a n b e felt a s a t o u g h m a r g i n A.S.I.S.
halfway between the belly button and the Sacral
pad' , Inguinal
pubic bone. The a b d o m e n immediately above band

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 , less rigid i Inguinal


ligament
to the touch. -.Pubic
bone
O n e o f o u r f r e q u e n t l a m e n t s is, " N o m a t t e r
h o w m u c h I d i e t , 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 ; i t still sticks o u t . " T h e b u l g e , h o w - Figure 13-1
ever, 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 . Inguinal band: Front and side views.
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 . 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). 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 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. Similarly, 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 - 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 . 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. In s o m e individuals,
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 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 y i n g left
a n d r i g h t sides t o g e t h e r .
M o s t "lower back p a i n " appears to c o m e
from this region. 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), i n h i b i t
sacroiliac 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 . 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 restric- of m o v e m e n t across t h e sacrum. This m o v e -
tions resulting from tightness above (chest 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, p r o b a b l y
strap) a n d t i g h t n e s s b e l o w (groin strap). Or i n t h e t e e n s . W e all s e e m t o w a n t / n e e d t o
t h e tightness m a y b i n d at mid-belly; we talk control pelvic m o v e m e n t .
a b o u t a strap there in Section 15. 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
In general, t h e r e are t w o a b e r r a n t a b d o m i - and/or fatty pad normally present on the
nal patterns, each with variations. O n e is the s a c r u m . W h e n this is t o o thick, it adds to t h e
individual whose lower belly is held in; his i m m o b i l i t y of t h e area. T h e b a n d thereby is
back t h e n b e c o m e s taut and his upper belly continued down to the tailbone (coccyx). In
b u l g e s (Fig. 13-2). T h e o t h e r p a t t e r n i s t h e d e s i g n , 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
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 belt. 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
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 t h e legs t o t h e V - s h a p e d b o n y b a s e o f t h e
b u t t o n . Here, t h e upper a b d o m e n b e c o m e s 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
tight a n d t h e area b e l o w t h e belly b u t t o n tissue t h a t is t h e n o r m a l filling of t h e space
p r o t r u d e s (Fig. 13-3). W h i c h e v e r p a r t is b e i n g 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 , p e l v i c
held, t h e o t h e r m u s t of necessity stick out; rami, and pubic bone). W h e n the V of the
t h e tissue has to go someplace. N o t o n l y t h e rami is compressed and too narrow, particu-
soft tissue b u t also b r e a t h needs space. People l a r l y i n m e n , t h i s t i s s u e c a n feel like c e m e n t
breathe predominantly in the upper or lower 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
a b d o m e n . In either case, t h e h o l d i n g inter- w h o l e b a s i n o f t h e p e l v i s . T h u s straps are n o t
feres w i t h t h e f r e e f l o w o f b r e a t h , e n e r g y , a n d o n l y surface p h e n o m e n a b u t traverse t h e
movement. body space.
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 ,
a l t h o u g h it varies in degree of t e n s i o n . In
back, 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 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 . 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,
Fascia of
d o w n t o t h e b o n e . M a n y m e n are t o o n a r r o w -erector spinae
at t h e base of t h e pelvis, b e t w e e n t h e legs. jlumbo-dorsal
fascia)
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 . T h e h i p b o n e l o o k s a s .Sacroiliac
t h o u g h it wings out. This again adds to a wide junction

abdominal contour. Fascia of


-•gluteus
In m e n , t h e c o n n e c t i o n across t h e front of maximus m.
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. In w o m e n , t h e s a m e Jlio-tibial
tract
kind of narrowness is m o r e c o m m o n in back,
across t h e sacrum. I n b o t h cases, t h e t e n s i o n
on t h e outside of t h e pelvis produces a corre-
sponding 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 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
Figure 13-4
leg (Fig. 13-4).
The connective tissue of the surface muscles
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 relates the movement of the lower back region
from the inside lower back to t h e inside (me- to the outside (lateral side) of the leg.
dial 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. 13-5). 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 of t h e ilium w i n g out in front. T h e iliacus
and deep) b a l a n c e e a c h other. Tightness in then tightens and is too short to function
o n e will b e reflected i n t h e o t h e r w i t h every with ease. T h e b r i m of t h e pelvis is pulled
m o v e m e n t of t h e leg or pelvis. forward and d o w n toward the pubic b o n e .
In walking, the most p r o m i n e n t l y involved W h e n t h e iliacus is very short, t h e inside of
muscle structure f r o m inside t h e pelvis is t h e 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.
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 . W e w i l l 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
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 . T h e p u b i c b o n e . A b a n d of strain (inguinal strap)
iliacus, t h e o t h e r part o f t h e iliopsoas c o m - across t h e lowest part of t h e a b d o m e n
plex, lines t h e inside of t h e b o w l of t h e pelvis. attempts to balance that internal shortness,
It diagonally crosses t h e p u b i c b o n e a n d often resulting in a heavy fatty c o n n e c t i v e
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 tissue b a n d o n top o f t h e p u b i c b o n e .
lesser t r o c h a n t e r . W h e n t h e p e l v i s i s b o u n d In m e n , b o t h sexual f u n c t i o n and feelings
tightly in back, t h e anterior superior spines 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 .
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 . 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. This limits sexual e n j o y m e n t to
t h e penis. A n o t h e r e l e m e n t in sexual blocking
is m e n ' s castration worries. These seem to be
centered n o t around the scrotum, but at a
m o r e lateral region of t h e groin where, before
birth, t h e testes leave t h e protection of t h e
b o d y . 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.
13-6).
T h e inguinal canal is t h e target of a variety
of problems, particularly in 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. We have found
that lessening the tightness of the groin b a n d
Figure 13-5 reduces t h e severity of t h e hernia or elimi-
This drawing from Dr. Ida Rolf's book on Rolfing n a t e s it. 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 ,
illustrates the psoas and iliacus muscles on the w h o o f t e n h a v e a " d o n ' t t o u c h " signal there
inside of the pelvis. The connective tissue of these
such as ticklishness.
inside muscles of the pelvis connects the inner
abdomen and inside lower back to the inside For b o t h m e n a n d w o m e n , t h e b a n d often
(medial side) of the thigh. shows up in the breathing pattern; 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 , 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 . I n w o m e n , 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 ,
shelving u n d e r n e a t h t h e ovaries a n d func-
Pathway of
tionally separating t h e ovaries from t h e gen-
-"testes' d e s c e n t
inguinal
b e f o r e birth
i t a l s . 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
canal
(pathway of s y n d r o m e a n d the reason PMS so often does
spermatic
Inguinal l i g a m e n t
cord)
H (inferior j u n c t i o n of n o t yield to medication. T h e banding tends to
internal a n d external
abdominal obliques) be deep a n d shelflike, so that a c c o m m o d a t i o n
i
of the necessary changes in posture caused by
pregnancy is inhibited. In pregnancy, 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,
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 .
After b i r t h , t h e t h i c k e n e d b a n d r e m a i n s .
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 , o f t e n ris-
Figure 13-6 ing as h i g h as t h e twelfth rib, where it m e s h e s
Inguinal band and descent of testes. 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.
THE INGUINAL BAND AND THE VERTEBRAL COLUMN 65

A s w e h a v e said, t h e b a n d a t m i d - 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
(1) Junction at
region of t h e sixth dorsal vertebra. Clearly, lambda/
sphenoid
therefore, t h e structural i n h i b i t i o n created by
the bands influences spinal integration a n d (2) Occipital-cervical

m o v e m e n t . In turn, restriction of m o v e m e n t
at the junctions of the vertebral c o l u m n - ( 3 ) Cervico-dorsal

increases t h e tightness of t h e bands. Interfer-


e n c e in spinal f u n c t i o n leads to characteristic
changes in posture and physical behavior. We
(7) Dorsal hinge
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.
T h e muscles a n d fascia t h a t r u n longitudi-
nally 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 -
(4)Lumbo-dorsal
plex interweaving of layers. 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 .
A l t h o u g h t h e vertebrae are similar in s h a p e , . ( 5 ) Lumbo-sacral

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.
These differences imply differences in range
•(6)Sacro-coccygeal
and direction of m o v e m e n t . In general, the
b a n d s relate to j u n c t i o n s of t h e spinal col-
u m n , places where t h e vertebrae c h a n g e Figure 13-7
shape. 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 Junctions of the spine.
and neck (occipito-cervical), between the
neck and chest (cervico-dorsal), between chest On the inside of t h e body, just in front
and lower back (lumbo-dorsal), b e t w e e n lower o f t h e s p i n e , lies t h e a u t o n o m i c n e r v o u s sys-
back and sacrum (lumbo-sacral), and between t e m (ANS). 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
the sacrum and tailbone (sacro-coccygeal). 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 . A l o n g its
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 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 .
list (Fig. 13-7). 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 h e change in vertebral shape at t h e dor- t i o n a l o n g t h e system. T h e y serve m u c h t h e
sal h i n g e i s m o r e s u b t l e ; t h e c h a n g e i n m o v e - same function as a busy t e l e p h o n e e x c h a n g e ;
m e n t pattern is m o s t visible in a living, m o v - t h e y are places w h e r e n e u r a l messages c a n get
ing body. T h e reason for this a p p a r e n t l y is t r a n s m i t t e d in diverse directions. G e n e r a l l y
that the change in function and morphology 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
here entails t h e soft tissue a n d o u t l y i n g b o n e s t h e spinal j u n c t i o n s t h a t we listed a b o v e . It is
as well as t h e vertebrae t h e m s e l v e s . T h i s is interesting to n o t e that these places of m a x i -
s o m e w h a t true everywhere along t h e spine, m u m m o v e m e n t o f t h e spine are associated
of course, but it is m o r e i m p o r t a n t in t h e 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 .
upper chest. T h e additional stabilizing influ- 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
e 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 tis- junctions there can be stimulation of the
sue 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 nervous impulses that control metabolic
their m o v e m e n t . activity.
66 THE ENDLESS WEB

As the embryo is enfolded in the w o m b ,


its b a c k d e s c r i b e s a C c u r v e (Fig. 13-8). As we
h a v e said, t h i s is n o t a s m o o t h c u r v e ; it is a
series o f b e n d s i n t h e b a c k . 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. 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 . Ultimately, there is a
c h a n g e in t h e direction of s o m e of t h e angles,
creating t h e snake-like f o r m of an adult
upright spinal c o l u m n .

A Bonnie Bainbridge Cohen's Develop-


B C
mental M o v e m e n t Sequences* graphically
Figure 13-8
The embryonic C curve (A) straightens as the
infant begins to walk (B) and later assumes the *See B o n n i e Bainbridge C o h e n , Sensing, Feeling, and
Action: The Experiential Anatomy of Body-Mind Centering
normal adult curves (C).
(Northampton, Massachusetts: Contact Editions, 1 9 9 3 ) .

A B C D

Figure 13-9
Developmental movement sequences: (A)
intrauterine folding; (B) contralateral creeping; (C)
crawling; (D) standing.
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 . As she describes t h e sequence, in - (1) J u n c t i o n at
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 lambda /
sphenoid
its h e a d . S o o n i t raises t h e h e a d , t h e n p u s h e s
(2) Occipital-cervical
o f f w i t h its h a n d s . 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 swing-
-(3) Cervico-dorsal
i n g f r o m side t o side. 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. 13-9).
(7) Dorsal hinge
These m o v e m e n t s correspond to t h e activa-
t i o n of b o t h t h e spinal flexures a n d t h e asso-
c 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 , b e l o w ) ; (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 ; (3) j u n c t i o n
(4)Lumbo-dorsal
b e t w e e n n e c k a n d c h e s t ; (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 ; (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 ; (6) j u n c t i o n b e t w e e n
(5)Lumbo-sacral
s a c r u m a n d c o c c y x ; (7) j u n c t i o n a t d o r s a l
h i n g e (Fig. 13-10). C o h e n h a s n o t e d t h a t
-(6)Sacro-coccygeal
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, there can be dysfunction, and
that this dysfunction is correctable even in Figure 1 3 - 1 0
the adult as t h e missing m o v e m e n t pattern is Spinal junctions.
practiced. There is often resistance to activat-
i 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 . T h e they compress the b o d y at spinal junctions.
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 . O n e o f 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 -
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. forcing structures w h e r e w e d o n ' t w a n t t o (or
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 can't) trust t h e u n d u l a t i o n s of an upright
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 spine. Their t e n d e n c y is to pull us forward
m o v e m e n t . T h e resulting position as t h e child and d o w n in front. Kinesthetically, this is
hangs head back and spine locked in a back- sensed as resistance to the feeling of openness
ward curve causes an acute w r e n c h i n g a n d that comes with being upright. It isn't that
ripping of fragile fascial c o n n e c t i o n s . T h i s 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 ; it's t h a t
is very similar in effect to a w h i p l a s h i n j u r y it refused to o p e n u p . E m o t i o n a l l y , we feel
in an auto accident. t h a t s a f e t y lies i n t h e c u r l e d - i n - o n - o n e s e l f
M o s t people u n c o n s c i o u s l y try to retain p o s i t i o n . It's r e a l l y a r e m e m b e r e d safety. T r u e
s o m e part of their fetal curve. T h e b o d y 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 ,
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 flexible, a n d resilient.
FOURTEEN
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 . 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 , 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 cra-
n i u m a s a w h o l e . H a b i t u a l t e n s i o n i n t h e sur-
f 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 . 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, 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 . 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 . T h e areas indirectly affected
include the brain stem, the limbic system, Figure 14-1
and the pituitary a n d pineal glands. Eye strap.
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. 14-1). I n t h e b a c k , i t
is at about the main junction of bones of the
skull. Starting at t h e f r o n t m i d l i n e , this b a n d
crosses t h e muscles o n t h e bridge o f t h e nose,
the circular muscles ringing t h e eye sockets,
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
Frontal
e a r s , 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
Lacrimal
a t t a c h i n g t o t h e jaw.
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. 14-2). T h e u p p e r p o r - Sphenoid
Zygomatic
tion is the frontal b o n e , 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. Medially,
Ethmoid
t h e r e are lacrimal a n d e t h m o i d b o n e s , w h i c h
also f o r m t h e upper medial part of t h e nasal
Maxillary
cavity. 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). Laterally
there is the zygomatic bone, which continues
a s a b o n y a r c h t o w a r d t h e ear. P o s t e r i o r l y ( t h e Mandible

back of the orbit) there is the sphenoid b o n e ,


w h i c h also forms part of a shelf below t h e
b r a i n . T h e s e b o n e s are tied t o g e t h e r b y Figure 14-2
sutures t h a t a n a t o m i s t s consider to be Bones of the eye socket.
THE EYE BAND AND CHIN BAND 69

Anterior tiny increments of movement, they neverthe-


fontanelle
less 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
Posterior
fontanelle well as t h e free use of t h e senses—sight, hear-
ing, smell, taste.
Anterolateral Tension across t h e orbit of t h e eye c a n
fontanelle
result in a n a r r o w i n g of t h e entire facial
r e g i o n . 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
Posterolateral together. There is chronic tension in the eye
fontanelle
s o c k e t a n d o n t h e e y e b a l l itself. 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
Figure 14-3 n e a r a n d far v i s i o n . A s w e s a i d , c o n n e c t i v e
Fontanelles are locations of non-fusion between 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 —
bones in the fetal and infant skull. The dotted line 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 .
embryologically is the site of the first flexure of
Prolonged immobility and compression in
the body.
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 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 e n ,
t h r o u g h h a b i t u a l t e n s i o n s , t h e eyes are fixed
Frontal i n o n e attitude, t h e free range o f e m o t i o n a l
Ethmoid
expression is also d i m i n i s h e d .
This t o p m o s t b a n d relates t o t h e suture
-Sphenoid
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 ) .
T h i s is n o t as o b v i o u s l y a spinal flexure as are
'Temporal t h e vertebral flexures. In e m b r y o l o g i c a l terms,
it is t h e fusion of t h e apical (topmost) b o n e s .
I n f a c t , 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. 14-3).
•Parietal We have talked about the sphenoid b o n e
in relationship to t h e eye socket. T h e sphe-
Occipital
n 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. 14-4).
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
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
Figure 14-4
l a t e r a l t o t h e e y e s . B e c a u s e o f its l o c a t i o n , t h e
Notice the juncture between the sphenoid and
occipital bones at the base of the skull. This inter- s p h e n o i d c a n get locked in place as a result of
face is the focus of most cranial manipulation. tensions from t h e surface. W h e n t h e eye b a n d
tightens, the sphenoid can't move. Converse-
immovable joints. ly, 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
William Sutherland,* the originator of reflected on t h e surface.
cranial osteopathy, realized t h a t slight inter- O n t h e c o v e r o f The Protean Body b y D o n
osseous m o v e m e n t s , w h i c h he termed the J o h n s o n / there is a drawing of the sphenoid
b r e a t h i n g o f t h e skull, a r e n e c e s s a r y f o r t h e f l o a t i n g i n t h e air. S e e n like t h i s , i n i s o l a t i o n
h e a d t o f u n c t i o n . A l t h o u g h t h e s e are v e r y 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 , i t

*See William G. Sutherland, The Cranial Bowl (Meridian, t S e e D o n J o h n s o n , The Protean Body (New York: Harper &
Idaho: The Cranial Academy, 1 9 4 8 ) . Row, 1 9 7 7 ) .
70 THE ENDLESS WEB

r e s p o n d freely, t h e o t h e r e n d p o i n t i s a l s o
restricted, inhibited, or immobilized.

T h e strap just under a n d including t h e c h i n


(Fig. 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 .
This is the juncture of the occiput with the
a t l a s a n d a x i s . 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 - t i m e f a s h i o n m a g a z i n e , d e s i g n e d t o lift
sagging or double chins. It surrounds and
binds d o w n a floating b o n e on the front of
the neck called the hyoid. This U-shaped
b o n e defines the angle between the chin and
the throat. The hyoid anchors many of the
so-called strap m u s c l e s of t h e throat. 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.
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 ,
t h e h y o i d is a focus of tissue buildup w h e n
Figure 14-5 there is habitual t e n s i o n . It is tugged down-
Chin and collar straps. w 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. 14-5). T h i s is s e e n as a d o u -
is easily m i s t a k e n for t h e b o n y pelvis. This ble c h i n .
similarity is m o r e t h a n visual. In fluid b o d y The band continues from the hyoid and
m o v e m e n t , s p h e n o i d a n d pelvis m o v e i n 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
concert and reciprocally If one doesn't move, a n g l e o f t h e jaw. 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 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 , a s h a s t h e a n g l e o f t h e jaw, j u s t b e l o w t h e ear. W h e n
been demonstrated in Sutherland's cranial t h e b a n d is particularly tight, an increasingly
osteopathic work. A further relationship 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 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 b i l i z e s t h e a n g l e o f t h e jaw. T h e j a w i s b o t h a
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 sliding a n d a hinged joint. W h e n the jaw is
e n d o c r i n e g l a n d s . T h e p i t u i t a r y g l a n d lies i n strapped back, t h e sliding m o t i o n is limited
an indentation at the center of the sphenoid. a n d m a y d i s a p p e a r . As we see it, t h i s is a
The gonads develop within the protection of m a j o r factor underlying temporo-mandibular
t h e b o n y pelvis. joint (TMJ) problems.
Cranial osteopaths have m a d e the obser- The continuation of the band thickens
vation that the sphenoid rocks. There is s o m e around the mastoid process b e h i n d and below
controversy about whether this m o v e m e n t is 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
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 b e t w e e n t h e occiput, atlas, a n d axis. W h e n
response to the r h y t h m of the breathing. In this h a p p e n s , n o d d i n g b e c o m e s a n effort a n d
either case, the m o v e m e n t is observable and the head's gliding response to walking is
palpable. We have seen this rocking reflected bound down.
b e t w e e n pelvis a n d s p h e n o i d . W h e n o n e o f 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
the endpoints of this flow can no longer 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 II I 1 YI HAND AND C H I N HAND 71

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

Figure 14-6
Upper body bands.
FIFTEEN
The Collar Band, Umbilical Band, and Groin Band

Like t h e c h i n s t r a p , t h e n e x t s t r a p — t h e c o l l a r a c r o m i o n just in front of t h e shoulder joint.


strap (Fig. 15-1)—is of g r e a t i m p o r t a n c e to 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
singers, 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 . I t movable joint, w h i c h can be a misleading
involves primarily t h e base of the throat, t h e c o n c e p t . For e x a m p l e , in a w h e e l w i t h ball
upper tip of t h e lungs, a n d t h e upper m a r g i n bearings, t h e ball bearings m o v e o n l y slightly.
of t h e shoulders. W h e n this strap is very But if o n e is stuck, t h e larger m o v e m e n t of
t i g h t , 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 t h e wheel stops or eccentrically grinds d o w n
underneath the Adam's apple where the two its c o m p o n e n t s .
clavicles (collarbones) m e e t t h e s t e r n u m 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
(breastbone). T h e m o s t c o m m o n result i s the inner and outer margin of the scapula. It
compression around the base of the neck. ends b y spreading o u t over t h e area o f t h e
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 dowager's h u m p — f r o m t h e upper medial tip
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 of the scapula to the cervicothoracic j u n c t i o n .
upper margins of t h e shoulder blades (scapu- 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 , like t h e
lae) i n t h e b a c k . D e e p h o l l o w s a t t h e b a s e o f o t h e r straps, c a n be c o m p a r e d to a p i e c e of
t h e n e c k , just b e h i n d t h e c o l l a r b o n e s , are c l o t h in w h i c h part of t h e weaving is very
evidence of t e n s i o n w h e n this strap h a s tight a n d part of it is very loose. T h e tightest
b e c o m e too tight. area b i n d s t h e clavicle a n d t h e u p p e r part of
In front, t h e strap seems to e n c l o s e t h e t h e s c a p u l a . 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
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 influence out i n t o the upper part of t h e arm,
two u p p e r m o s t ribs. It includes a small m u s c l e pulling the arm in closer to the b o d y and
called the subclavius. 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
Fascia of _
sternum and coracoid process, medially a n d
scalene m
laterally, r e s p e c t i v e l y . T h i s s m a l l m u s c l e i s
Hyoid bone
active in respiration w h e n t h e c o l l a r b o n e Collar
m o v e s i n relation t o t h e ribs. W h e n t h e fas- strap .Fascia of
strap m.
cial 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 , 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 • Clavicle

bones. Coracoid
T h e collar strap c o n t i n u e s a l o n g t h e clav- Acromion
process
icle 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 -
Scapula •Sternum
m i o n ) . 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).
W h e n there is a heavy pad on top of the
acromion, 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 Figure 15-1
of the arm. T h e clavicle articulates with t h e The collar strap.
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 . O t h e r h o r i z o n t a l direction a n d in t h e vertical cross-


fibers e x t e n d i n t o t h e a r m p i t , c l o s i n g t h e b a n d i n g s . W h e n b o t h pulls are unusually
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. T h e s e s t r o n g , 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
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 mass of tissue.
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 This k i n d of i n t e r a c t i o n also occurs
a third dimension going deep inside, crossing b e t w e e n t h e c h i n strap a n d t h e collar strap,
t h e b o d y like a shelf. In t h e collar strap, t h e and it strongly influences the front of the
shelf c a n be seen on t h e surface of t h e body. throat. Four muscles ( c o m m o n l y termed the
It crosses over t h e o f t e n - h o l l o w spot in t h e 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
base of the neck containing the scalene mus- 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 larger ster-
c l e s (Fig. 15-1). 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 n o c l e i d o m a s t o i d overlies these a n d provides
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 a direct vertical c o n n e c t i o n between t h e
to t h e upper tip of t h e lungs. Very few of us t w o s t r a p s . C h r o n i c t e n s i o n i n t h e fascia
are aware t h a t lungs e x t e n d so h i g h up in t h e surrounding these muscles brings the front
body, 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 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 , a s c a n
of this upper tip of our respiratory capacity. be seen in people w h o "lead with their
Two characteristic m o v e m e n t patterns rein- chins."
force t h e tightness of this strap—compressing 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
the armpits and h u n c h i n g the shoulders. well as m o r e c o m p l e x vocalizations such as
Armpit c o m p r e s s i o n is a k i n d of guarding, singing or playing a wind instrument. Any
protecting the body because of ticklishness, 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
habitual anxiety, protecting t h e breasts, etc. t h r o a t a r e a . W h e n a n g r y , o n e ' s v o i c e m a y rise
Shoulders pulled up c a n also be a response o r w o r d s m a y n o t c o m e o u t . I n grief w e g e t
to perpetual anxiety, or it can be carrying the " a l l c h o k e d u p . " T h i s i s a t least p a r t o f t h e
weight of the world on your shoulders. Mind- 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
set 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 . B o t h r e s u l t speaking.
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 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
kind of breathless feeling. 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
Like t h e o t h e r s , t h e collar strap is present of t h e pectoralis m a j o r ; this c a n cause a verti-
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 . S o m e - cal c o m p r e s s i o n on t h e upper chest. Reduced
times it is visible as a light b a n d i n g on t h e 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)
s u r f a c e . 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 correlates with lack of m o v e m e n t in the up-
felt as a very tight b a n d a l m o s t at b o n e level. per ribs a n d shortness of breath. Tightness
Very d e e p h o l l o w s in t h e body, areas t h a t are 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
ticklish or painful to t h e touch, and marked inhibits freedom of m o v e m e n t of the arm
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 at t h e shoulder joint f r o m above and below.
in c o n n e c t i v e tissue fluidity a n d b o d y
flexibility. T h e strap associated with t h e u m b i l i c u s
Functionally, t h e straps overlap. For e x a m - (Fig. 15-2) i n t h e f r o n t a n d t h e l u m b o - d o r s a l
ple, t h e eye strap a n d t h e c h i n strap pull o n hinge in the back tends to make the body
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. look as t h o u g h it were divided into an upper
Both act on t h e m o v e m e n t of t h e jaw a n d a n d a l o w e r h a l f . It is v a r i a b l e in its p o s i t i o n
t h e tipping of t h e head. W h e r e strong vertical r e l a t i v e t o t h e u m b i l i c u s . I t c a n r u n just u n d e r
m u s c u l a r a n d fascial pulls cross t h e b a n d s , t h e 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 ster-
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 n u m (the x i p h o i d process), a few i n c h e s
THE COLLAR BAND, UMBILICAL BAND, AND GROIN BAND 75

above the umbilicus. It m a y run directly


across t h e u m b i l i c u s , 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. 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. 15-3).
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
m o s t cases a little b e l o w t h e arch of t h e ribs.
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
11th&12th,
ribs d e e p i n s i d e t h e b o d y . I n d o i n g s o , i t m a y ribs •Umbilicus
compress t h e a c t i o n of t h e lateral part of t h e
•Umbilical
d i a p h r a g m . T h e strap c o n t i n u e s t o t h e b a c k
strap
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 , 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 . 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 . 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 Figure 15-2
t h e l o w e r r i b s . T h e t i p o f t h e e l e v e n t h rib i s Note that the area of the eleventh and twelfth ribs
pulled deep into the b o d y in m o s t people. is the lumbo-dorsal junction.

Ideally, 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. 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 ) . 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 . S i m i l a r l y , 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.
Costal
T h e free r i b s — t e n t h , e l e v e n t h , a n d t w e l f t h arch
Umbilical
—are attached to the diaphragm and establish ^trap
Umbilicus (variable
its w i d t h a n d r a n g e o f m o v e m e n t . T h e u m b i l -
locations)
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. 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. 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 . A n
e x t r e m e version of this is k n o w n as a pigeon
breast.

T h e pubic or groin strap is t h e lowest strap Figure 15-3


i n t h e a b d o m e n (Fig. 15-4). I t m a y b e s e e n o n The location of the umbilical strap is variable
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 . It c o n t i n u e s sideways a r o u n d t h e body,
crossing the groin. 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 . 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 . After i t
crosses t h e inguinal ligament, 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), 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 . T o t h e rear,
it runs deep to the lower border of the gluteus
m a x i m u s (Fig. 15-5), e n d i n g a t t h e j u n c t i o n
of the sacrum with the tailbone (coccyx). Figure 15-4
Posteriorly, it c o n t r i b u t e s to (and s o m e t i m e s Groin strap, anterior view (also showing inguinal
forms) t h e gluteal fold. It blends into t h e strap and ligament).
heavy pad f o u n d on t h e ischial tuberosities
(sitting b o n e s ) .
S t r o n g cross-pulls are associated w i t h this
b a n d . In the center front, 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 abdo-
m 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. 15-6).
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 (over-
strong). 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 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.
O n e i t h e r side o f t h e p u b i c b o n e , cross-
pulls 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 Figure 15-5
o b l i q u e . O n e arises f r o m t h e l o w e r m a r g i n Groin strap, posterior view.
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 liga- as a V-shaped t h i c k e n i n g on t h e inside of
m e n t . As t h e strap crosses t h e greater t h e legs, a l o n g t h e p u b i c r a m u s . T h e strap
t r o c h a n t e r o f t h e f e m u r , t h e r e are p u l l s f r o m 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
b e l o w , c o m i n g f r o m t h e leg, a n d f r o m a b o v e , part goes a r o u n d t h e legs.
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 p u b i c strap is a c o m p l e x weaving in
As was t h e case in t h e collar strap, s o m e a n d out of t h e b o n y structure at the base of
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 a b d o m e n . T w o internal cross-structures
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 sur- are l o c a t e d h e r e — t h e pelvic a n d urogenital
f a c e , 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 diaphragms. The internal extension of the
h i p socket. In addition, parts of t h e strap exist 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
THE COLLAR BAND, UMBILICAL BAND, AND GROIN BAND 77

tissue of b o t h of t h e s e . In turn, these dia-


p h r a g m s are p e n e t r a t e d by, a n d c o n t i n u o u s
with, the musculature of the rectum, urethra,
and vagina (Fig. 15-7).
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 . I t i s a l s o , a t its
connection with the sacrum, the endpoint of
t h e p u b i c strap. Unfortunately, t h e t a i l b o n e
is one of the most vulnerable and accident-
prone locations in t h e body. Children repeat-
e 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 . I n
l a t e r life, 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 , r o l l e r
skates, 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 . In general, 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 , i t i s n ' t seri-
ous. But this can be o n e of the longest lasting
kinds of imbalance in the body. A w r e n c h e d
tailbone has no support to pull it b a c k i n t o
Figure 15-6
Groin strap with rectus abdominis. position; no o n e has ever seen a plaster cast
on a tailbone. Most doctors, bodyworkers,
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 . To us, seen a n a t o m i c a l l y , it
is r e m i n i s c e n t of t h e tip of an arrow. T h e V-
shaped sacrum is t h e arrowhead, a n d t h e ver-
t e b r a l c o l u m n i s t h e s h a f t . T h e c o c c y x , like
t h e arrow tip, guides t h e direction of m o v e -
ment; the spine compensates by flexion,
extension, and rotation. W h e n the pubic
strap t i g h t e n s d o w n , it reduces flexibility,
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.
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. 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 tra-
verses 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. It has sideways ramifications that
thicken the inguinal ligament. In the back,
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 . This configuration, with
the connections in front and back, and the
Figure 15-7 straps b e t w e e n , gives a m o d i f i e d " j o c k s t r a p "
The pelvic and urogenital diaphragms. or "chastity belt" under t h e skin.
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
Internal Body Awareness

M o v e m e n t can be evaluated from the outside 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


by a trained observer. It is evaluated f r o m t h e okay as a teenager to be athletic and to show
inside by proprioception. This is t h e internal 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
physical sensation of position in three-dimen- swank your hips or push out your breasts.
sional space. Most of us c a n sense our bodies 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
to s o m e degree. W h e n we t u n e in, however, it bodies in this way, it is n o t a f r e e d o m easily
is surprising h o w m a n y parts of our bodies we regained. T h e teenager w h o chooses n o t to
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 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
around with one shoulder higher than the an adult t h a t t h e r e is a loss of sexual feeling.
other, o n e eyebrow higher t h a n t h e other, etc. Pelvic m o v e m e n t , sexual identity, a n d t h e
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 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
w h e n s o m e o n e points it out, and usually find turn to s o m e t h i n g neutral, such as throwing a
it difficult to sense e v e n t h e n . W i t h s o m e 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
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 - defined by body image, m o v e m e n t image,
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 accidents, and physical structure.
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 Proprioception is the summation of our
a sense of our i n n e r thighs. physical history into the m o m e n t of present
T h e older w e get, t h e m o r e w e t e n d t o limit 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
our body sense to w h a t hurts. Children often 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
seem to have a pleasurable sense of their b o d - awareness of h o w my elbow extends. I m a y
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 - 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 m e sensations, adults learn n o t to take c o n n e c t s to my back or h o w my back is sup-
pleasure in their bodies. Everything f r o m p o r t e d t h r o u g h m y pelvis a n d legs. I n t h e
cultural taboos t o u n w a n t e d e m o t i o n s a n d Midwest, t h e t e r m for this kind of w h o l e b o d y
painful memories (physical a n d e m o t i o n a l ) e n g a g e m e n t is " b o d y English." Every physical
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 . act reverberates t h r o u g h t h e w h o l e body, a n d
Proprioception is the conscious part of 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 ,
body awareness. There is also an u n c o n s c i o u s then, is sensing the mechanics of m o v e m e n t .
aspect of t h e body, and it is here that cultural W h e r e there is a gap in proprioception, there
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 - is a habitual i n h i b i t i o n of m o v e m e n t . This is
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 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 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 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
feel m y s h o u l d e r s ; it's less o k a y t o feel m 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
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 shape. Releasing these contractions in the
breasts w h e n I'm a l o n e t h a n w h e n I ' m i n c o n n e c t i v e tissues is a m a t t e r of physical or
public, and this is again different from breast mental awareness.
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 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
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 a n d proprioception. An i m a g e of h o w a strap
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 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
84 THE ENDLESS WEB

early part of this c e n t u r y wearing a corset. m u c h smaller t h a n t h e actual physical struc-


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

T h e r e are m a n y ways t o analyze h u m a n struc- t h e ribs i n f r o n t t o c o m e u p w a r d . F o r e a c h


ture. Osteopaths, orthopedists, physiatrists, person, t h e initial c h a n g e is different. But for
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 o n e of these habits to be modified, the other
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, h o w two m u s t c h a n g e as well.
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. The position of the head, upper chest, and
General medical practitioners generally evalu- 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
ate h e a l t h in terms of t h e soft t i s s u e s — m u s - b o d y . 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 ,
cles, b l o o d a n d n e r v e s u p p l y , i n t e r n a l o r g a n s . 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 .
W e are p r o p o s i n g a n o t h e r perspective—evalu- The extreme of this is the pear-shaped body,
a 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 . 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
This includes the conformation of muscle and 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
b o n e but is not limited to these. shoulders are d r a w n t o g e t h e r a n d narrow.
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 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
of h o w c o n n e c t i v e tissue c a n create structures rise t o t h e s e s i l h o u e t t e s . A m o r e d e t a i l e d a n a t -
that overlap and interconnect. T h e direction o m y of the chest and upper back is needed to
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 flesh o u t o u r p o i n t . T h e c o n n e c t i v e tissue
any one muscle or muscle group. Our purpose c o n f o r m s to t h e muscle. In fact, it would be
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 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 tis-
m o r e inclusive, m o r e directly related to t h e sue guides t h e m u s c l e pathways. F u r t h e r m o r e ,
experience of structure a n d to m o v e m e n t . 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
In order to discuss structure, we analyze t h e b o n e , b u t this is n o t strictly true. T h e c o n n e c -
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 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 (ten-
halves. T h e easiest w a y t o b e g i n talking a b o u t dons, aponeuroses) continue on as the
the upper body is to look at the position of c o n n e c t i v e tissue covering of b o n e (perios-
t h e ribs. I n m o s t p e o p l e , t h e ribs a n g l e t o o t e u m ) . 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
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 t h e c o n n e c t i v e tissue w e b .
would hang more horizontally, although nor- In the front of the chest, the major mus-
mally there is always s o m e slight angle. cle of t h e outer layer is t h e pectoralis major,
The typical b o d y configuration that a c c o m - t h e " p e c s " that muscle builders attempt to
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 d e v e l o p (Fig. 17-1). It is a l a r g e f a n - s h a p e d
sunken and flattened upper chest, elevated muscle covering the majority of the upper
shoulders, a n d a head thrust forward. These c h e s t , 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
t h r e e g o t o g e t h e r . I f t h e u p p e r ribs w e r e raised 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 -
in front, the shoulders would automatically dle half of t h e c o l l a r b o n e . T h e fan converges
drop and the head c o m e back to a m o r e across the shoulder in front, a n d ends by
upright position. Likewise, if t h e focus is on attaching to the humerus an inch or two
bringing the head back, it is necessary to below the shoulder joint.
allow m o r e space for t h e b r e a t h t o c o m e u p In the back, there is t h e trapezius, t h e
i n t o t h e u p p e r ribs. O r i f t h e s h o u l d e r s r e l a x , w e i g h t l i f t e r ' s " s t r a p s " (Fig. 17-2). T h i s o r i g i -
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 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
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 . It, t o o , i s f a n - s h a p e d , 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 called t h e a c r o m i o n . T h e a c r o m i o n is a b o n y
Fascia of trapezius m.
sternocleido- shelf that can be palpated at the corner of the
mastoid m. junction between the shoulder and the arm.
Fascia of 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 , a s i t crosses
pectoralis t h e shoulder blade (scapula), also attaches to
major m.
t h e a c r o m i o n as well as to t h e scapular spine.
In t h e b a c k , a n o t h e r large fan-shaped mus-
cle flows up f r o m below, called t h e latissimus
Fascia of
• latissimus dorsi—the weightlifter's "lats." It attaches to
dorsi m.
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. T h e point of this fan converges
upward, obliquely crossing over the lower tip
of t h e shoulder blade. 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
Figure 17-1 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
Anterior arm and shoulder fascia.
b e h i n d the a t t a c h m e n t of the pectoralis
major.
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, relating t h e chest to t h e
shoulder and arm, to the head, and to the
l o w e r b a c k . T h e n e x t layer, w h i c h serves t o
Fascia of stabilize t h e position of t h e shoulder blade,
Fascia of
trapezius m.
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. In t h e
Acromion f r o n t , 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 , lies
t h e p e c t o r a l i s m i n o r (Fig. 17-3). T h i s is a n a r -
row small muscle that attaches to the middle
Scapula 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 -
Septum (dotted line) c o i d p r o c e s s . T h i s h o o k - l i k e p r o j e c t i o n for-
ward from t h e inside of the shoulder blade
Fascia of
latissimus 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 ,
dorsi m.
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.
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, m o v i n g t h e shoulder
b l a d e . 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 a h o o k on a suspended metal plate (the scap-
Posterior arm and shoulder fascia. ula). W h e n the h o o k is tugged near the top,
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 Coracoclavicular


ligament &
drawbridge. If the pectoralis m i n o r in front Subclavius m.

is habitually tight, 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 " Coracoid.
process
s c a p u l a e i n t h e b a c k (Fig. 17-4). T h e m e d i a l
margin of t h e shoulder blade will project Coracobrachialis .Pectoralis
m. minor m.
outward.
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.
(short head)
T h e short head of the biceps brachii (com-
m o n l y called simply t h e biceps) crosses b o t h
the shoulder and the elbow joints. Thus,
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 . 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, rein-
forcing t h e action of t h e biceps on the scapula
(Fig. 17-3). Figure 17-3
A ligament from the coracoid process to The deeper layer of the chest muscles; the arrows
indicate the line of force of these muscles. The
the underside of t h e clavicle contains t h e
focus here is on the coracoid process of the
subclavius muscle, a small muscle w h o s e
scapula and therefore includes lines of force of
function is traditionally considered m i n i m a l . the relevant arm muscles.
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.
17-3), 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 . T o us, t h i s
is n o t a l i g a m e n t , 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 h e action of t h e sub-
clavius 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 . 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 . 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. 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 . 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).
The action of t h e comparatively small tensor
Figure 17-4
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 In this pose, the pectoralis minor is contracted; the
thigh (Fig. 17-5). result is a "winged" scapula.
88 THE ENDLESS WEB

By identifying the muscles that connect


to t h e c o r a c o i d process, we c a n visualize
t h e fascial i n v o l v e m e n t s . F r o m t h e coracoid
process, t h e r e are strong c o n n e c t i o n s to t h e
m i d d l e ribs, t o t h e r a d i u s a n d u l n a o f t h e
Tensor forearm, to the humerus of the upper arm,
fasciae
Gluteus and to t h e middle clavicle. Tension on any or
latae
maximus 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.
M o v e m e n t t h r o u g h a fascial p l a n e is always
broader t h a n m o v e m e n t by an individual
Ilio-tibial
muscle.
tract
O n t h e b a c k , t h e s h o u l d e r b l a d e i s sus-
p e n d e d i n t h r e e p l a c e s . O n its s u r f a c e , 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 , pri-
m a r i l y a t t h e a c r o m i o n . A t a d e e p e r layer, 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 . A l s o i n t h i s d e e p e r layer, t h e t w o
teres muscles, m a j o r a n d m i n o r , c o n n e c t t h e
Figure 17-5
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. 17-6).
Connections between knee and hip.
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, 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, a n d from t h e upper
a r m b y w a y o f t h e teres. 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 . T h e
Levator . Trapezius 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 tight-
scapula - m.
m. , Supraspinal n 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. T h i s , in turn, will reduce t h e flexibility
Rhomboids. Teres minor/ of the neck and head, the upper back, and
m. infraspinatus
the arm.
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. W h e n the arm

Teres
m o v e s sideways, t h e distance b e t w e e n t h e
major arm b o n e a n d t h e scapula widens and the
v Trapezius m.
teres s h o u l d b e able t o l e n g t h e n . W h e n the
m.
m u s c l e s r e a c h t h e limit of their elasticity, 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 . Its
m o v e m e n t is stabilized by t h e elasticity of t h e
Figure 17-6 r h o m b o i d s . If the shoulder blade is winged
Scapular suspension. o u t , 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
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 , a w a y
f r o m t h e flat o f t h e r i b s . T h e t e r e s w e r e n o t
designed for this purpose, a n d so t h e y
shorten. T h e surrounding c o n n e c t i v e tissue
b e c o m e s overtense. W h e n t h e teres lose elas- Rhomboid m.'s
ticity, 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 .
M a n y people's teres are m u c h t o o s h o r t
and tight. 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 , t h e r h o m b o i d s , t h e n a r e less u s e d
and b e c o m e flaccid. Higher up, t h e levator
scapulae b e c o m e s extremely tight, f o r m i n g a
heavy pad. T h e a t t a c h m e n t of the levator on External iSerratus
the upper middle corner of the scapula is that abdominal anterior m.
oblique m.
p l a c e w h e r e , i f y o u press i t o n a l m o s t a n y o n e ,
h e o r s h e will s i g h , " O h , 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
serratus a n t e r i o r , 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. 17-7).
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
Figure 17-7
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 .
The subscapularis (not shown) lines the under-
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
surface of the scapula. Its direction of pull is
angles upward toward the medial border of roughly perpendicular to that of the serratus
t h e scapula, a t t a c h i n g just a d j a c e n t to t h e anterior.
attachment of the rhomboids. The subscapu-
laris 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 ,
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. 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 , f l o a t i n g t h e
Fascia of
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 trapezius m.
joint. Normally, 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 Acromion Clavicle
Fascia of
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 . Its f a s c i a deltoid m.
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 .
Two small muscles on t h e outer surface of
the scapula, the supraspinatus a n d infraspina-
Septum
tus (Fig. 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 . 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 ,
above a n d below t h e scapular spine. In pal-
Figure 17-8
p a t i o n , 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
The deltoid fascia interweaves with the septum
shoulder blade is in trouble. dividing the anterior (biceps) and posterior (tri-
We have been talking about h o w the ceps) areas of the arm.
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 - a yawn. Note that in this kind of stretch, the


ing m u s c u l a r slings. T h e a r m a n d shoulders shoulder blade is suspended from the arms.
also relate in this way. H a n g i n g d o w n , t h e T h e r e are t w o m a j o r factors to consider in
arm swings from t h e shoulder blade. W h e n arm m o v e m e n t — t h e m o v e m e n t of muscles
we reach up, t h e reverse is t r u e — t h e shoulder over t h e tip of the shoulder blade and m o v e -
blades h a n g from the arm. m e n t i n t h e a r m p i t . Ideally, t h e a r m c a n b e
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 raised w i t h o u t elevating t h e shoulder blade,
shoulder and arm is the deltoid muscle, w h i c h drops as a c o u n t e r b a l a n c e . In addition,
w h i c h covers the shoulder joint. This muscle t h e a r m m u s t b e able t o freely m o v e away
acts like a c o n t i n u a t i o n of t h e trapezius, e m - 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
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 , a c r o - blade.
m i u m , a n d s c a p u l a r s p i n e (Fig. 17-8). It T h e r e is no way t h a t we c a n freely use an
e x t e n d s muscular a c t i o n of t h e trapezius arm without opening the armpit, yet armpits
f r o m t h e h e a d a n d n e c k across t h e shoulder are t h e focus of a wide variety of e m o t i o n a l
and down into the middle of the upper arm. c o n c e r n s . W e h a v e all sorts o f r e a s o n s w h y w e
A t a d e e p e r layer, t h e b i c e p s b r a c h i i a n d d o n ' t w a n t to be, in effect, t h a t o p e n . Protec-
the coracobrachialis b o t h suspend the arm tive gestures, fearful gestures, h o l d i n g one's
from the coracoid process of the shoulder b r e a t h , 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
blade. In addition, there is the triceps brachii. t h e a r m s d o w n t o t h e r i b s . T h e s e are g e s t u r e s
O f its t h r e e a t t a c h m e n t s , t w o c o n n e c t t o 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 . W e are i n h i b -
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 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 :
h e a d — c o n n e c t s to the outside margin of w a r d i n g o f f a n g e r , fear, r e s e n t m e n t , e t c .
t h e shoulder blade just b e l o w t h e shoulder Trapezius, deltoid, pectoralis major, a n d
joint. latissimus dorsi are c o m m o n l y called t h e
These three muscles govern the lengthen- extrinsic (outer) m u s c l e s of t h e shoulder area,
ing out of the arm from the shoulder blade. c o n n e c t i n g t h e a r m a n d trunk. T o simplify,
T h e arm should be able to lengthen as it is we c a n t h i n k of t h e trapezius a n d deltoid as
raised u p w a r d a n d t o t h e side, s u c h a s w h e n a single, functionally c o n t i n u o u s structure
stretching your arms wide and up toward the (Fig. 17-9 A). T h e s e a r e t h e m u s c l e s t h a t raise
ceiling in t h e relaxing stretch that goes with t h e a r m . 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, (B) anterior shoulder, (C) posterior shoulder.
UPPER BODY 91

major, acting together, bring the arm down true of very small m u s c l e s as of larger sheet-
(Fig. 17-9 B & C). T h e s e m u s c l e s of t h e o u t e r like o n e s . Part o f t h e w a y h e a v y i m m o b i l e
(extrinsic) layer c o u n t e r b a l a n c e e a c h other. 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
For e x a m p l e , w h e n t h e a r m i s r a i s e d t o t h e trying to use t h e muscle as a w h o l e instead of
side, 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 - sequencing through the muscle as b o d y posi-
toralis m a j o r a n d latissimus dorsi relax, allow- tion d e m a n d s . A m a j o r source of c o n f u s i o n in
ing the arm to extend away from the body. As the practical application of kinesiology is that
t h e a r m returns t o t h e side, pectoralis a n d no muscle exists in isolation. T h e c o n n e c t i v e
latissimus contract as trapezius a n d deltoid 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 -
lengthen. cle layers as well as b e t w e e n a d j a c e n t muscles.
T w o kinds o f m o v e m e n t are possible h e r e — These interfaces have t h e greatest potential
d r o p p i n g t h e a r m , w h i c h i s faster, o r s e q u e n - for adhesion, t h i c k e n i n g , a n d s h o r t e n i n g .
tially letting t h e a r m d o w n , w h i c h is slower. Elasticity of t h e c o n n e c t i v e tissue b e t w e e n
I n b o t h m o v e m e n t s , o n e set o f m u s c l e s c o n - structures is essential for an effective relation-
tracts. T h e difference b e t w e e n t h e two m o v e - ship b e t w e e n deep a n d superficial (intrinsic
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 a n d extrinsic) m u s c l e layers. In t h e front,
m u s c l e s . W h e n t h e m o v e m e n t i s fast, t h e 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 .
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 - Toward t h e center front, b o t h muscles affect
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 . W h e n t h e a c t i o n o f t h e ribs. I n t h e shoulder, t h e
a m o v e m e n t is slow and controlled, t h e pectoralis m i n o r attaches to the coracoid
antagonist muscle lengthens sequentially.
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 .
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 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.
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 . For e x a m p l e , a s t h e a r m i s
raised, 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.
As the arm comes further up, muscle activity
concentrates further d o w n t h e trapezius. 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.
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, 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 . A t t h e
deeper layer of fascia a n d m u s c l e , 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 Figure 1 7 - 1 0
through the plane of one muscle. This is as Common "knots."
92 THE ENDLESS WEB

mid-back place under


t h e lower tip of t h e
shoulder blade that is
so often painful.
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 attach-
m e n t of the latissimus
to t h e v e r t e b r a . (Fig.
17-10). 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 tis-
s u e . 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 call-
ing t h e dorsal h i n g e .
T h e p a r t o f t h e latis-
simus toward the
h u m e r u s lies i m m e d i -
ately adjacent to the
Figure 17-11 teres m a j o r . T h e teres
m a j o r is a b r i d g e
process while the pectoralis m a j o r attaches to b e t w e e n t h e lower tip of the scapula and the
t h e h u m e r u s . W h e n t h e fascial p a d b e t w e e n a r m b o n e . T h e latissimus c o n n e c t s the arm
t h e t w o b e c o m e s less p l i a b l e , t h e m u s c l e s n o b o n e t o t h e lower b a c k a n d t h e pelvis. W e
longer operate individually. T h e y are u n a b l 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
t o slide o n e a c h o t h e r . A s a r e s u l t , t h e s h o u l - b o u n d together, w i t h t h e result t h a t t h e lower
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 tip of t h e scapula is i m m o b i l i z e d . These inter-
in a n y gesture involving t h e front of t h e a 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
chest. give a partial picture of t h e effect of t h e c o n -
I n t h e b a c k , t h e r e are t w o places w h e r e this 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,
k i n d of c o n f u s i o n is likely to occur. T h e tra- s h o u l d e r blade, a n d ribs. For a m o r e c o m p l e t e
pezius overlies t h e r h o m b o i d s a n d levator a n d c o m p l e x view, w e r e c o m m e n d considera-
s c a p u l a e , 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 t 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
c r o s s w i s e t o e a c h o t h e r . A t t h e c e n t e r b a c k , all underside of t h e deltoid. This muscle overlies
attach to t h e vertebrae. T h e trapezius attaches 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 ,
laterally to t h e tip of t h e shoulder blade (acro- pectoralis major and minor, biceps brachii,
m i o n ) , while the r h o m b o i d s and levator scap- coracobrachialis, and infraspinatus.
ulae attach medially to the medial border of Our a n a t o m i c a l illustrations in this section
t h e scapula. W h e n t h e c o n n e c t i v e tissue b e d attempt to depict the interactions of muscle,
b e t w e e n these m u s c l e s loses elasticity, t h e b o n e , a n d c o n n e c t i v e tissue i n m o v e m e n t .
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 . Its o n l y o p t i o n 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 -
is to be shrugged u p . This is a factor in t h a t 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. 17-11).
EIGHTEEN
Axial Skeleton

We have n o t yet talked about t h e long mus- 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.


cles o f t h e s p i n e , w h i c h a r e a l s o a p a r t o f t h e 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
soft tissue layers o f t h e u p p e r b o d y . C o l l e c - t h e erector spinae is called t h e lumbo-dorsal
tively, 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 , f a s c i a (Fig. 18-2). It c o n t i n u e s u p w a r d to t h 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 n e c k a n d to t h e occipital ridge. Below, t h e
t h e skull t o t h e s a c r u m (Fig. 18-1). I n b o t h l u m b o - d o r s a l fascia is c o n t i n u o u s with t h e
a p p e a r a n c e a n d s t r u c t u r e , t h e y are m u c h l i k e sacral pad a n d e n d s o n t h e c o c c y x . T h i s fascia
a multistrand rope. T h e muscles closer to t h e is very heavy; it acts as an aponeurosis (broad
outer surface of t h e b o d y are longer; as we go a t t a c h m e n t ) , c o n n e c t i n g t h e latissimus dorsi
progressively deeper t h r o u g h t h e layers, m u s - t o t h e l o w e r h a l f o f t h e s p i n e . A b o v e , t h e fas-
cle segments b e c o m e shorter a n d shorter. T h e c i a i s less h e a v y ; i t lies u n d e r t h e m i d d l e m u s -
deepest muscular layer c o n n e c t s o n e vertebra cle layer ( r h o m b o i d s a n d levator scapulae).

Figure 18-1
In these schematics of the erector spinae, the arrows indicate the direction and length of muscle groups.
The most superficial muscle groups are the longest, while the deepest are very short.
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 usu- 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. T h i s


ally 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 i c h is particularly apparent in the lungs, where
feels like a glass p l a t e w h e n it is in t r o u b l e . c o n n e c t i v e tissue surrounds t h e b r a n c h i n g
In the lower back, restriction in the l u m b o - system of trachea, bronchi, bronchioles, and
dorsal fascia will s h o w as a l o n g i t u d i n a l rope- even alveoli.
l i k e rigidity, s o m e t i m e s m o d i f i e d b y a 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
cross-pull f r o m t h e latissimus dorsi. 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 -
At t h e deepest level, t h e r e is a c o n n e c t i v e 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
tissue c o n t i n u i t y t h a t includes t h e j o i n t cap- 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
sules 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 c h e s t c a v i t y (Fig. 18-3). T h i s is c a l l e d t h e
b o n e . In t h e chest, this layer c o n t i n u e s b o t h mediastinum. It connects the underside of
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 sternum (breastbone) to the vertebrae of
t h e intercostal muscles b e t w e e n t h e ribs. This the chest region. The mediastinum contains
fascia is c o n t i n u o u s with t h e fascia position- t h e heart. It should be elastic e n o u g h that
ing the internal organs, not only surrounding heart m o v e m e n t can be accomplished with-
out inhibition. Furthermore, 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. W h e n
there is t e n s i o n a n d vertical shortening of the

Figure 18-3
Continuity of fascia within the body cavity. The
diaphragms of the body cavity: one at the clavi-
Figure 18-2 cles, the respiratory diaphragm, the two pelvic
Continuity of fascia of erector spinae and gluteals. diaphragms.
AXIAL SKELETON 95

mediastinum, both heart function and


b r e a t h i n g are h i n d e r e d . E x t e r n a l l y , 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 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, 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 . 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 .
A t its l o w e r m a r g i n , 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. The diaphragm is an approx-
imately 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. 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 -
Figure 18-4
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 .
The action of the respiratory diaphragm.
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 o p r o t r u d e i n t h i s way, i t m u s t s h o r t e n w h e n
The diaphragm attaches to the inner inhaling. This is a learned pattern, o n e that
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 is m e n t a l l y c o n t r o l l e d . M o v e m e n t s t h a t are
extends sideways to t h e tips of t h e free ribs, m e n t a l l y controlled lack adaptive flexibility.
the t e n t h , eleventh, a n d twelfth. It crosses T h e tendency is to over-focus on what has
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 b e e n learned. In this case, t h e a b d o m e n is
blends into the oblique muscles of the abdo- m o v e d i n p r e f e r e n c e t o t h e ribs.
men. The diaphragm is thus not quite hori- Exhaling involves the c o m b i n e d action
zontal across t h e b o d y ; it has an o b l i q u e angle of t h e d i a p h r a g m a n d o n e layer of t h e inter-
downward to the back. costal m u s c l e s b e t w e e n t h e ribs. In a n o r m a l ,
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 unforced exhale, muscle action originates in
t h a t b e l l i e s in t h e w i n d (Fig. 18-4). Its m i d d l e the diaphragm and continues to the abdomi-
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 n a l o b l i q u e s . T h i s b r i n g s t h e rib d o w n a n d
exhale (1); it flattens with every inhale (2). 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
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 d o m e shape up i n t o t h e pleural (lung) cavity.
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 . A s t h e ribs lift Air i s p u s h e d o u t o f t h e l u n g s . T h e s y s t e m
a n d e x p a n d t h e c h e s t , air e n t e r s t h e l u n g s . is n o t dependent on the presence of a lung.
Ideally, 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 Even people with only o n e lung can achieve
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 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.
inhalation. In order for this to h a p p e n , t h e Rib a c t i o n during b r e a t h i n g involves three
abdomen must lengthen when inhaling. separate types of rib m o v e m e n t . T h e s e are
Abdominal breathing is often depicted as well described in m o s t a n a t o m y a n d physi-
a pattern in which the a b d o m e n protrudes o l o g y texts. W e w o u l d like t o e m p h a s i z e t h e
in front with each inhale. M a n y disciplines 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
teach a type of a b d o m i n a l breathing that is freely. I f a n y o n e rib fails t o m a i n t a i n its p o r -
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 i o n o f t h e chest c o n t o u r , a d j a c e n t ribs a n d
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, expanding and
contracting w h e n breath enters the upper tip
of the lung. Since the scalenes attach to the
processes of the n e c k vertebrae, 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. And tension in the neck has
reached endemic proportions in our
overachiever culture.
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.
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, 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 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; the
m i d d l e layer includes t h e scalenes. T h e outer-
m o s t surface layer consists of t h e trapezius
and the sternocleidomastoid.
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). It often
b e c o m e s very p r o m i n e n t in older people from
o v e r u s e i n m o v i n g t h e h e a d . Ideally, t h i s pair
Figure 18-5
o f muscles o n l y stabilizes t h e m o v e m e n t s o f
Diaphragms of the body cavity.
nodding the head and turning the head from
side t o s i d e . 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. If p i t c h e d forward, as is t o o o f t e n t h e case, t h e
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 , t h e r e is a upper trapezius b e c o m e s a primary support of
general c o n n e c t i v e tissue response. This c a n the head. It is used to hold the head on, and
be felt as an overall rigidity in t h e c o n n e c t i v e 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
t i s s u e o f t h e c h e s t , w h i c h f e e l s a l m o s t like a movement. The sternocleidomastoid then
strait j a c k e t u n d e r t h e s k i n . takes on almost t h e entire f u n c t i o n of t h e
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 trapezius.
clavicle in front a n d t h e h e a v y musculature T h e c o n n e c t i v e tissue of t h e outer layer of
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 the neck is continuous with the connective
t h e s c a l e n e s (Fig. 18-5). T h e s e are t h e m u s c l e s tissue of t h e jaw. T h e pad over t h e angle of
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 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
t h e n e c k . T h e y a t t a c h t o t h e upper ribs. T h e (Fig. 18-6). 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
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 freedom of m o v e m e n t in the jaw and so
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 Figure 18-6
The connective tissue of the outer layer of the
h e a v y rope of c o n n e c t i v e tissue fibers. This is
neck.
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 addi-
Figure 18-7
tional strength because a l i g a m e n t is denser
The ligamentum nuchae forms a surface covering
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 .
for the muscles on both sides at the base of the
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 - skull. It then dives deep to form a septum between
tion by separating myofascia. the right and left muscle masses.
NINETEEN
Pelvis and Upper Legs

T h e r e are several ways in w h i c h t h e shoulder tract e n d s o n t h e lateral protrusions o f t h e


a n d pelvis differ f r o m o n e a n o t h e r . Initially, tibia a n d fibula, b e l o w t h e knee. In n o r m a l
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 , f u n c t i o n , t h e gluteus m a x i m u s acts between
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 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,
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 bypassing t h e femur. Very often, however, as
spread-eagled backward i n t o water. T h e arms t h e gluteus m a x i m u s passes over t h e h i p , it
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 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
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 aberrant drag o n t h e femur.
inside arch of t h e foot facing forward. (This T h e small t e n s o r fascia lata attaches on
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 t h e anterior superior iliac spine, w h i c h is t h e
structure.) By t h e t i m e a b a b y is born, t h e uppermost b o n y protrusion on the front of
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 the pelvic curve. T h e muscle angles d o w n and
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 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 -
b e n e a t h a n d in line with t h e trunk. T h e y are 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
rotated so that the knee, w h i c h originally b o n e . This tiny muscle balances the backward
pointed headward, is n o w facing forward. pull of t h e massive gluteus m a x i m u s on the
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 ilio-tibial tract. By design, t h e a c t i o n of the
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 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
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 weight-
bearing, 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 Figure 19-1
fibrous track called t h e ilio-tibial tract. This The suspension of the knee from the hip.
PELVIS AND UPPER LEGS 99

attachment below the knee. It is functionally 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 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 s t r e a m . T h e patella itself is n o t a stationary,
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 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
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 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 liga-
t h e stress o n t h e m u s c l e . ment (a sesamoid bone).
T h e sartorius is a t t a c h e d on t h e tip of t h e 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
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 the primary c o m p o n e n t of the V shape of the
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 fas- 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
cia 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 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
S shape, attaching to t h e tibia below t h e knee, 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
o n t h e i n s i d e o f t h e leg. muscle. T h e other, deeper adductors cross
Just deep to t h e sartorius, t h e rectus only the hip joint; they do not extend below
femoris attaches on t h e anterior inferior iliac 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 -
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 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
straight line, b l e n d i n g i n t o t h e upper part of pubic ramus. It continues to the knee, coming
the patellar t e n d o n above t h e k n e e . T h e t e n - 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
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 to t h e medial projection of t h e tibia b e l o w
the front of the tibia. T h e patella (kneecap) the knee joint.
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 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 sit-
ting 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 (me-
dial) 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 super-
ficial 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 glu-
teus 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 interac-
t 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 sus-
pension 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
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 .
Figure 19-2
The psoas connects the lumbar spine (deep) with It is our professional experience that knee
the lesser trochanter of the femur (superficial). problems originate in the knee only w h e n
100 THE ENDLESS WEB

Lateral pelvic tilt there has b e e n direct trauma to t h e knee.


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 .
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 origi-
nates in the hip, w h i c h t h e n modifies the
tracking of the knee. Over time, 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.
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.
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. 19-2). T h i s w a s Ida
Rolf's f a v o r i t e m u s c l e ; 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 . 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. 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, and we therefore define
it as an extrinsic, superficial structure. On t h e
Figure 19-3 inside of t h e pelvic b o w l , t h e psoas is in fact
The tilt of the pelvis changes/is changed by the t h e m o s t superficial tissue. It crosses t h e
t o n e of the psoas.
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.
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 verte-
brae. It crosses t h e pelvic bowl at an angle,
f o r m i n g a l m o s t a n S s h a p e . 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 . Its l o w e r a t t a c h -
m e n t is on the inside of the thigh, 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. 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. 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. 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.
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 . W h e n a p e l v i s i s t i l t e d side-
w a y s , t h e p s o a s will b e t i g h t e r o n o n e side
Figure 19-4
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. 19-3).
Psoas and iliacus fasciae c o m e t o g e t h e r at the
groin, forming the iliopsoas tendon. The iliacus T h e deeper layer of muscles in t h e h i p
fascia is continuous with the deep pelvic fascia, affects only t h e hip joint. These muscles
e.g. the obturator internus. 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
PELVIS AND UPPER LEGS 101

through t h e m sequentially in walking. In


a g e n e r a l way, 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. 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 . 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. 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.
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. 19-4). It l i n e s t h e i n n e r
pelvic bowl. It attaches along t h e entire i n n e r
curve of t h e ilium, just b e l o w t h e crest. In
some people, the attachment extends medi-
ally 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 Figure 19-5
The fascia of the adductor group (longus, gracilis,
thus o f t e n a factor w h e n t h e r e are sacroiliac
magnus) is continuous up into the pelvic bowl and
problems. T h e muscle c o n t i n u e s d o w n across
influences the urogenital and pelvic diaphragms.
the pubic b o n e in a funnel shape, crossing Tension is transmitted from inner thigh to pelvis
t h e hip b o n e n e x t t o t h e psoas. T h e iliacus a n d / o r vice versa.
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 - c o n t i n u e d o w n to t h e upper part of t h e inside
m o n t e n d o n . T h e iliacus lines t h e entire i n n e r of the femur. Of these, the adductor longus is
surface of t h e pelvic b o w l . A h a b i t u a l c o n t r a c - m o s t c o m m o n l y o v e r u s e d . I t c a n b e felt a s a
tion in this muscle creates a feeling of spasm 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 . Its
on t h e inside of t h e pelvis. B o t h iliacus a n d tightness is unrelenting; it almost never
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 relaxes.
pelvis a n d l u m b a r s p i n e . T h e adductor longus attaches to the in-
The term "lower back" includes the lumbar side u p p e r t h i r d o f t h e f e m u r , j u s t b e l o w t h e
s p i n e , t h e s a c r u m , a n d t h e t w o ilia. T h e ilia- a t t a c h m e n t s o f t h e iliacus a n d t h e psoas. T h e
cus 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 place- p e c t i n e u s , a n o t h e r a d d u c t o r , lies b e t w e e n t h e
m e n t of the ilium; the psoas is a m a j o r inner a d d u c t o r l o n g u s a n d t h e psoas. I t c a n b e felt
determinant of the placement of the lumbar on palpation of t h e groin region, in a depres-
spine. W h e n t h e psoas is glued d o w n o n t o sion b e t w e e n t h e t w o longer muscles. It is a
t h e iliacus, 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 s h o r t , flat, 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
b o n e s , as well as of t h e m u s c l e s , is lost. T h e r e 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 .
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 T h e largest of t h e adductors is t h e a d d u c -
lower back vertebrae, t h e pelvic bowl, or t h e 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
femur. T h e delicate rocking m o v e m e n t w i t h i n 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 . I t fills t h e
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 space d e e p t o t h e gracilis a n d e n d s b y wrap-
lacking. ping around the back of the femur, b e h i n d
On the inside of the thigh, three adductor a n d d e e p t o t h e h a m s t r i n g s (Fig. 19-6). T h e
muscles attach to the pubic ramus and the adductor m a g n u s is t h e basis for t h e c h a r a c -
f r o n t o f t h e p u b i c b o n e (Fig. 19-5). T h e y teristic shape t h a t is o f t e n seen on t h e i n n e r
102 THE ENDLESS WEB

side o f t h e t h i g h . Like t h e p e c t i n e u s , 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. 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 , t h e gracilis
takes over t h e f u n c t i o n of t h e adductor mag-
nus. 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 . I n a d d i t i o n , 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 , 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 stretch-
ing c a n relieve.
At t h e i n t e r m e d i a t e l e v e l , t h e r e is a f a n -

Figure 19-6 shaped muscle called t h e gluteus medius on


A midthigh cross section illustrating the major t h e side of t h e p e l v i s (Fig. 19-7). Its u p p e r
compartments: flexor, extensor (hamstrings), a t t a c h m e n t is on t h e crest of t h e ilium. It
adductor, and abductor (ilio-tibial tract). The rela- funnels downward and attaches on the top
tionships change higher and lower in the thigh.
of t h e greater t r o c h a n t e r of t h e femur. It is
partially covered by the upper margin of the
gluteus m a x i m u s . 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, the head of the femur is pushed into
t h e h i p s o c k e t , i m p e d i n g t h e free s w i n g o f
t h e leg. 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.
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 , 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. 19-8). 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, 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 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. 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 . 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.
T h e lowest of t h e lateral rotators is t h e
quadratus femoris. 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 contin-
ues to t h e pelvic ischial tuberosities. It forms
a part of t h e fold or crease of t h e buttocks,
Figure 19-7 underlying t h e posterior portion of the groin
The gluteus medius is influenced by the gluteus
b a n d . 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
maximus, which overlaps it. The fascia of the glu-
teus medius is continuous with that of the abdomi- f a s c i a l c o v e r i n g a r e t i g h t , t h i s is v i s i b l e as a
nal obliques at the iliac crest. This is the structural m a r k e d d i m p l i n g b e l o w t h e pelvis, w h i c h
basis for the more tenacious "love handles." a c c o m p a n i e s a "flat ass."
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, t h e o b t u r a t o r inter-


n u 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. 19-9). 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 , m i d w a y
b e t w e e n t h e ischial tuberosity a n d t h e tail-
b o n e . 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 , a t t a c h i n g a r o u n d t h e cir-
cular o p e n i n g called t h e obturator f o r a m e n .
The muscle body is on the inside of the
pelvis; 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 . 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 , 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 . A very tight obturator internus in
m e n tends to show as an extreme narrowness Figure 19-8
o f t h e pelvis a t t h e b o t t o m , w i t h a c o r r e s p o n - The rotators of the hip include the piriformis,
ding winging-out of the upper margin of the quadratus femoris, internal and external obtura-
tors, and the superior and inferior gemelli. For
pelvis.
clarity we have omitted the lines of force of the
T h e piriformis, also a lateral rotator, minute gemelli; the obturator externus is not visi-
attaches to t h e b a c k part of t h e greater ble from this angle. We are including the lines of
trochanter, slightly above t h e obturator in- force of the gluteus minimus to complete the pic-
ternus. It angles headward to attach to t h e ture of this fascial layer.

underside of the sacrum. 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. W h e n this muscle is cramped or chron-
i c a l l y t e n s e d , 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.
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 . T o u s , 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 . 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.
Tightness in t h e lateral rotators as a group
provides the dimple in the back of the but-
t 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 . Ac-
tually, 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 , w i t h f e e t a n d legs s p l a y e d s i d e -
ways. An a t t e m p t to correct t h e situation by
Figure 19-9
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 Note the relation of the fascia of the obturator
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 internus to the deep pelvic fascia.
104 THE ENDLESS WEB

be stable. In actuality, 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. As o n e muscle or group of
muscles is called into action to induce move-
m 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. Muscles
are h e l d in readiness (tonus) a n d c a n t h e n
contract or lengthen as needed.
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 .
Ideally, 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 . 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. 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 .
In walking, this fascial tightness in t h e h i p
Figure 1 9 - 1 0
results in a gait t h a t is initiated in t h e lower
Fascial continuity: adductors -> obturator internus
-> iliacus -> internal abdominal obliques -> b a c k , 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.
diaphragm. 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 , a larger
t h e tightness o f tissue i n t h e h i p . W h e n t h e bowl on t o p of a smaller o n e . T h e upper,
h i p is tightly b o u n d , forcing t h e feet to track greater bowl, w h i c h is t h e i n n e r surface of
straight forward puts a t o r q u e i n t o t h e leg t h e ilium, is lined by t h e iliacus m u s c l e a n d
that peaks at the knee. its f a s c i a . T h e l o w e r , s m a l l e r b o w l i s l i n e d o n
In discussing m o v e m e n t of the arm at the 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 fas-
shoulder (Section 17), we described the nec- c i a . 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 , i t
essary s e q u e n c i n g of muscles as t h e a r m is is easy to visualize t h e fascial c o n t i n u i t y
r a i s e d . 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 - between the obturator internus and the
taneously. Each must be called into action as iliacus (Fig. 19-10).
the arm reaches the angle where that muscle About halfway d o w n t h e lower bowl, a
( 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 . T h i s sling-like a r r a n g e m e n t of m u s c l e a n d fascia
allows for precise c o n t r o l c o m b i n e d w i t h divides it i n t o upper a n d lower parts. This
flexibility in t h e shoulder joint. i s t h e p e l v i c floor, a l s o c a l l e d t h e p e l v i c dia-
In t h e h i p , t h e usual c o n c e p t is t h a t t h e leg p h r a g m . 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 -
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 der, r e c t u m , a n d i n w o m e n t h e u t e r u s a n d
PELVIS AND UPPER LEGS 105

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

W h a t we h a v e tried to do in our considera-


tion 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,
focusing in t h e greatest detail on the trunk
a n d pelvis. 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. 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.
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.
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. T h e lower-
m 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. T h e urogenital d i a p h r a g m is below,
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.
There is t h e respiratory diaphragm in t h e
trunk separating the abdominal cavity from
t h e chest cavity. 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
Figure 20-1
of the lungs.
The connective tissue establishes the spaces of the
In addition to this system of horizontal body.
myofascial structures, 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. 20-2). 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
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, a n d t h e m e d i a s t i n u m . 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 , 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.
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 ver-
tical c o n n e c t i v e tissue p a t h w a y s . T h i s results
in a generalized tension through t h e inner Figure 2 0 - 2
aspect of the body that is characteristically The plumb line.
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 . 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.
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 ,
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 . T h e y are f i l l e d w i t h organs, c o n -
nective tissue, muscles, etc. 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. W h e n this is out
of b a l a n c e , c o n n e c t i v e tissue filling t h e inter-
v 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 s e are s e c o n d a r y f u n c t i o n a l struc-
tures. 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.
For e x a m p l e , 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 . 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
adjacent to the vertebral c o l u m n , it sends
Figure 20-3 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
It is obvious from this diagram that changes in any
p a r t o f t h e s a c r u m (Fig. 20-3). J u s t l a t e r a l t o
part of the abdomen and pelvis will affect all of
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 , t h e p s o a s
the abdomen and pelvis.
penetrates these crurae and extends up to
attach to the lower vertebrae in the chest
c a v i t y . I n t h i s way, 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 bor-
der of t h e d i a p h r a g m . 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, which then blends
i n t o the diaphragms in the pelvis. In t h e
back, 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.
O n t h e sides, 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. In the front, 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 .
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 dia-
phragm and the pubic bone. The abdominal
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
Figure 2 0 - 4
Fascial connection between pubic bone and diaphragm d o w n to t h e crest of t h e ilium,
humerus. continuing into the pelvic diaphragms by
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. These connections tend to be
in broader and longer sheets, covering more
o f t h e body. 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, 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. 20-4). F a s c i a l s h e e t s o n t h e sur-
face 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.
20-5). I n t h e b a c k , 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
a r m . T h e o f t e n leathery covering of t h e erec-
Figure 2 0 - 5
Fascial connection from front of abdomen tor spinae c a n immobilize the vertical play of
to upper back. a n y o r all o f t h e d i a p h r a g m s .
TWENTY-ONE
Reciprocity of Movement

S p i n a l c u r v e s are r e c i p r o c a l . T h e c u r v e o f t h e restriction in your breathing. Notice that


lumbar spine is reflected in t h e curve of t h e 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 b r e a t h i s
cervical spine. If t h e lumbar spine is curved b o t h shallower and more labored. If y o u o n c e
t o o far f o r w a r d , t h e c e r v i c a l s p i n e will a l s o b e a g a i n let y o u r h e a d b e v e r y easy, a l o n g w i t h
c u r v e d t o o far f o r w a r d . I f t h e l u m b a r s p i n e i s t h e rest o f y o u r b o d y , y o u c a n f e e l a g r e a t e r
t o o flat o r s t r a i g h t , t h e c e r v i c a l s p i n e will b e ease in b r e a t h i n g . T h e r e is m o r e fullness of
t o o flat o r s t r a i g h t . b r e a t h w i t h less e f f o r t .
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 Another example of this can be seen in
spine by the way a person holds himself w h e n walking. Allow your head and shoulders to
h e i s s t a n d i n g still. I n a c t u a l i t y , t h e s p i n e i s be as limber and loose as possible. If you can
like a s p r i n g , 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 e v e n let t h e m flop a bit, this will give y o u an
t h e person m o v e s a n d b r e a t h e s . T h e true diag- e x a g g e r a t i o n . T h e n , w h i l e still w a l k i n g , h o l d
n 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 y o u r h e a d still. C o n c e n t r a t e o n a t h o u g h t ,
its q u a l i t y o f m o v e m e n t . N o p a r t o f a m o v i n g 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 rigid-
s p i n e s h o u l d b e q u i e t o r still. I f o n e s e g m e n t ity in t h e w h o l e b a c k . You will n o t i c e an
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, increased heaviness on your heels as you
freedom of m o v e m e n t throughout the spine w a l k . A f t e r w a l k i n g i n t h i s m o r e stressful
will b e i n h i b i t e d . p o s i t i o n , a g a i n let y o u r h e a d g o easy, n o d -
W h e n w e talk a b o u t m o v e m e n t , w e usually d i n g g e n t l y y e s (or n o , i f t h a t ' s y o u r a t t i t u d e ) .
t h i n k o f large g e s t u r e s like w a l k i n g , d o i n g 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
work, picking up t h e baby, w a s h i n g t h e w i t h greater ease. Your step will b e c o m e
d i s h e s , d r i v i n g t h e car. Yet m o v e m e n t c a n m u c h softer.
be as subtle as slow breathing during sleep. 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
A b o d y never stops m o v i n g . Even t h e smallest 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
m o v e m e n t creates a ripple t h r o u g h o u t t h e b o d y . 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 . W e all
entire o r g a n i s m . T h e tissue t h r o u g h w h i c h have holding patterns in our bodies that
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 are i n v o l u n t a r y . W h e t h e r t h e h o l d i n g i s o f
tissue. W h e n c o n n e c t i v e tissue is in t o n e , it a single m u s c l e or of a larger part, t h e w h o l e
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 b o d y will b e affected. W h e n y o u h i t t h e side
cello. It transmits vibrations; it transmits of a table, t h e resonance of t h e blow vibrates
m o v e m e n t . S o m a y b e w e s h o u l d say t h a t t h r o u g h t h e entire table. Similarly, a n y ges-
w h e n w e are p r o p e r l y i n t o n e , w e h u m — t o ture vibrates t h r o u g h o u t a living body. We
each person his or her characteristic t o n e . 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
W e c a n d e m o n s t r a t e this for ourselves b y u n i 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
t w o a w a r e n e s s e x e r c i s e s . Sit o r s t a n d , l e t t i n g interference with our resonance.
your head and arms be very loose, and sense 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
, a highly
your breathing. Be aware of your breathing tempered, very l o n g spring coil of steel. O n e
with your b o d y relaxed as m u c h as possible. of t h e t h i n g s t h a t a Slinky will do is pull itself
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 d o w n s t a i r 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 o t h i n k a b o u t s o m e t h i n g ) , y o u will s e n s e a t h e coil d o w n o n e step, e a c h circle in t h e coil
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. T h i s i s a n e x - t i s s u e o f t h e b a c k , a l t e r n a t i n g f r o m o n e side
ample of m o v e m e n t reverberating through a to t h e other of the vertebral c o l u m n .
structure. A l t h o u g h it is n o t m a d e of steel, t h e 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
elasticity a n d organization of t h e c o n n e c t i v e f a s c i a l s h e e t , t h e l u m b o - d o r s a l fascia, w h i c h
tissue reverberates like a Slinky in t h e body. 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
This kind of reciprocity of m o v e m e n t is on the sacrum and coccyx. From the sacrum,
especially apparent in the spine. Because the t h e fascia c o n t i n u e s diagonally across t h e
superficial m u s c l e s are t h e longest, h o l d i n g 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 i b i a l b a n d (Fig.
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 21-1) T h u s , 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
e x p a n s e of t h e b a c k . H o l d i n g at deeper levels 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
affects smaller s e g m e n t s . Usually, h o l d i n g in b a c k all t h e w a y u p t o t h e h e a d . C o n v e r s e l y ,
an area occurs at m o r e t h a n o n e level, a n d to 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
a different degree at e a c h level. Sideways cur- 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 .
vatures of t h e b a c k , as in scoliosis, are a c c o m - 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
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 h e l a t i s s i m u s d o r s i , t h e l u m b o - d o r s a l fascia

Figure 21-1 Figure 2 1 - 2 Figure 21-3


The superficial fascia of the As we include the fascia of Still at a superficial level,
back is layered. It starts the latissimus dorsi, the the fascia of the trapezius
with the continuity of the change in directional pull adds yet another dimen-
whole back with the leg. converges over a wider sion.
The change in direction area.
converges on the sacrum.
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. 21-2). 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.
21-3). 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 Fascia of
( 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 i erector
spinae m.
spinal restriction in this area. In short, 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 . 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 Fascia of
Fascia of H quadratus
allow restrictions to be generalized over t h e psoas m. lumborum m.
w h o l e structure. T h i s c a n give s h o r t - t e r m
relief i n a c u t e t r a u m a , 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.
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. In t h e l u m b a r region,
there is the psoas, w h i c h attaches to m o s t of
the lumbar vertebrae. 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. 21-4). 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 , 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 Figure 2 1 - 4
inside a n d outside of t h e b o d y at t h e waist. The deep muscles of the lumbar region.
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 , q u a d -
ratus l u m b o r u m , a n d p s o a s a r e c o n t i n u o u s
(Fig. 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 . 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 .
I n t h e l u m b a r r e g i o n , m o v e m e n t s are o b -
viously n o t straight forward or straight back-
ward. 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 , l e a n i n g over, 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 . W h a t i s desir-
able is a balance of the twisting on t h e t w o
sides. 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
Figure 2 1 - 5
side s o m e w h e r e i n t h e m i d - t r u n k . S t a n d i n g
This diagrammatic cross section of the abdomen
r e l a t i v e l y still, o n e h i p a n d leg h a b i t u a l l y is in the region of the lumbar spine. The continuity
stand slightly forward of t h e other, while t h e of the fascia as it ensheathes the muscles and the
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 vertebra is emphasized.
112 THE ENDLESS WEB

(Fig. 21-6). 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, w h i l e t h e t o p half goes in
t h e o t h e r . I n w a l k i n g , 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 o p p o s i n g l e g a n d h i p , w h i c h are
s l i g h t l y b e h i n d , h a v e t o w o r k h a r d e r a n d tra-
v e r s e a g r e a t e r d i s t a n c e . 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 . T h e dif-
f 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. O v e r
y e a r s o f c o n s t a n t u s e , 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. O n e
side w i l l s h o r t e n , 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 . V e r y s l i g h t dif-
f 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 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
Figure 2 1 - 6
will be m o s t a p p a r e n t at t h e waist, w h i c h
Habitual rotation of the body.
thickens and shortens. 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 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 . 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. As t h e lower back unro-
tates a n d lengthens, a waistline m a y miracu-
lously appear. This c a n result in ecstasy a n d
a n e w wardrobe for w o m e n . M e n m a y experi-
e 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 path-
w 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 .
Nevertheless, t h e y t o o will h a v e a m o r e ami-
a 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.
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 . 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 lat-
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 .
Figure 2 1 - 7
T h e flexors on t h e front of t h e neck balance
For clarity, we have depicted the deep muscles of
the neck separated on the two sides. The compos- t h e e r e c t o r s p i n a e i n b a c k , w h i c h are e x t e n -
ite of the two sides make up the total myofascial sors o f t h e n e c k . A t t h e d e e p e s t l e v e l are t w o
complement. 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
RECIPROCITY OF MOVEMENT 113

t h e transverse processes of t h e cervical verte-


brae. 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 . These flex t h e
h e a d o n t h e t o p cervical vertebrae. T h e sec-
o 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. These muscles flex t h e
n e c k o n t h e t r u n k (Fig. 21-7).
At a slightly m o r e superficial level, f a n n i n g
o u t t o t h e side, 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 .
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 . 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 . A t t h e m o s t s u p e r -
ficial l e v e l , o n t h e f r o n t o f t h e n e c k , are t h e
sternocleidomastoid muscles (Fig. 21-8).
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 Figure 2 1 - 8
Superficial fascia of the neck.
vertebrae o n t h e trunk. 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 . I n t h e
n e c k , 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 r e n o t v e r y a p p a r e n t . I t w a s I d a Rolf's c o n v i c -
a n d extensors as well as b e t w e e n layers, creat- 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 -
ing problems in t h e freedom of m o v e m e n t of lizing t h e c o n c a v e curves of t h e spine. T h e
the neck and head. psoas stabilizes t h e c o n c a v e i n n e r surface of
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 the lumbar spine; the longus colli a n d longus
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 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
forward. W h e n this is t h e case, m o s t h e a d surface of t h e n e c k p o r t i o n of t h e spine. In
movements must be controlled by the sterno- Dr. Rolf's v i e w , t h e d o r s a l c u r v e o f t h e s p i n e
cleidomastoid. T h e erector spinae and the 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
trapezius are t h e n used a l m o s t exclusively to rhomboids. This is an unusual view of body
hold the head on. Their function as extensors m e c h a n i c s , 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
in b a l a n c e with t h e flexors on t h e front of on questions of balance, movement, and
t h e n e c k i s r e d u c e d . W h e n t h e h e a d i s t o o far transmission of weight.
forward, these f l e x o r s o n t h e front o f t h e n e c k Spinal curves are always c h a n g i n g . W i t h
(longus colli a n d longus capitis) lack t h e span every m o v e , including breathing, these
to f u n c t i o n properly. T h e sternocleidomastoid curves undulate, going f r o m m o r e curved
then becomes both the chief flexor and exten- to straighter a n d back. If there is fluidity of
sor o f t h e n e c k . T h i s i s a n a w k w a r d s i t u a t i o n 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
a n d o n e t h a t leads t o very restricted m o v e - c o l u m n , t h e rest o f t h e b o d y w i l l r e a d i l y
ment of the head. arrange itself i n t o appropriate b a l a n c e for
In the chest region, prevertebral muscles t h e person, time, a n d gesture.
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 w h e n a joint is distended with too m u c h


m o s t interesting focus for t h e w a y different 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 -
densities in c o n n e c t i v e tissue affect a n d deter- 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
m i n e m o v e m e n t . T h e differences a m o n g 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. T h i s c a n
j o i n t s is t h o r o u g h l y described a n d classified be accomplished without the need to touch
in anatomical texts. Our interest is in discov- t h e actual distended area.
ering t h e ways j o i n t s are similar t o e a c h o t h e r T h e joint capsule is m a d e up of fibers that
a n d in analyzing t h e overall f u n c t i o n of joints have formed in the e m b r y o in response to
w i t h i n t h e c o n n e c t i v e tissue b e d . In t h e tradi- directional tension lines between bones. A
tional classification of joints, there is the 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
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 isola- a c c o m m o d a t e the different rotations of m o v e
tion. Our attitude throughout this b o o k has m e n t . T h e result is an interweaving of fibers
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 around the end of the bones. This encloses
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 . 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 , a n d
T h e elements of a joint are: 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. 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
• Two or m o r e b o n e s ;
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
• T h e relatively nonresilient t e n d o n s
increasingly calls for m o r e stability. W h e n
and ligaments;
t h e j o i n t i s w e l l - b a l a n c e d a n d h a s full r a n g e
• T h e fluid-filled j o i n t capsule;
• 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.

At t h e deepest level, by m e a n s of t h e
fibrous joint capsule, the periosteum of o n e
b o n e is continuous with the periosteum of
the next b o n e . W i t h i n the joint capsule,
b a t h i n g t h e e n d s of t h e b o n e s , is j o i n t fluid.
It is very similar in c o m p o s i t i o n to the inter-
c 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 . 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 tra-
ditionally classified as freely m o v a b l e . 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 .
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. 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 , 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. 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 , irri- Figure 22-1
t a t i o n of s o m e k i n d will result. Conversely, The joint capsule matures.
J O I N T S 115

of m o v e m e n t , this wrapping will be sufficient has created is simply h e a v y tissue p a d d i n g


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

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

Practical Applications
TWENTY-THREE
Doing Bodywork Based on the Connective Tissue Concept

A s o u r i d e a s h a v e g a i n e d clarity, w e r e a l i z e where does it hurt; point with o n e finger.


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

knee. Thus this very small muscle controls t h e k n e e tissue against ever-greater k n e e flex-
the interosseus m e m b r a n e between these ion a n d e x t e n s i o n . This allows t h e client to
t w o b o n e s . Tibial rotation is manifest at t h e 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
ankles. T h e degree of tension in t h e Achilles degree of m o v e m e n t .
t e n d o n is an i n d e x of severity of rotation It should be r e m e m b e r e d that o n e cause
between t h e tibia a n d calcaneus. of i n t e r m i t t e n t acute pain in t h e knee is a
Evaluation is a s e q u e n c e f r o m visualization m e n i s c a l tear. 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 -
to m o v e m e n t to evaluation by touch. As we indication to work; cautious easing of the
m o v e t h e part, w e are starting t o evaluate b y j o i n t will b e h e l p f u l . U l t i m a t e l y , h o w e v e r ,
touch. It is almost impossible to know w h e n t h e r e m a y h a v e t o b e surgery. A n a b s o l u t e
evaluative touch ends and treatment touch contraindication to manipulation of the knee
starts. If t h e p a i n is acute, it is p o t e n t i a l l y (except by an expert) is a tear in o n e of the
hazardous to treat t h e acutely painful area c r u c i a t e l i g a m e n t s . S u c h a t e a r m a y b e felt a s
directly. It s h o u l d be possible to ease t h e pain hypermobility of the knee in the anterior-
with educated intervention above and below. posterior direction and is obvious with even
Your knowledge of a n a t o m y a n d y o u r careful s l i g h t m o v e m e n t . A f r a c t u r e is, a g a i n , a n
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 . S o m e - absolute contraindication to bodywork except
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 in t h e h a n d s of an expert. If t h e client is able
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 to walk i n t o your office w i t h o u t crutches, it is
reported p a i n or p r o b a b l e areas of dysfunc- unlikely that either of these two catastrophes
t 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 , has occurred.
p. 126). Before we go m o r e extensively into
first i n t e r v e n t i o n , w e n e e d t o a d d a f e w c o m - First Intervention—
ments on treatment of acute knee problems. Example: chronic neck ache
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 S o m e practitioners are m o r e e x p e r i e n c e d with
t o work o n t h e fascial wrapping o f t h e k n e e visual evaluation a n d s o m e with palpation.
itself. 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 Furthermore, 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 , 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 .
In part, this is because bodyworkers c o n t i n u -
ally evaluate as t h e y work. Evaluation is n o t
an endpoint, it is an o n g o i n g process.
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 . W o r k i n g superfi-
c 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.
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. 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 . Early i n p r a c t i c e , 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.
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 create unnecessary problems and usually
Superficial muscles of the thigh. creates m o r e pain.
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 t h e tissue "layers" a n d direction of fascial


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 fibers. As y o u work, t h e fiber d i r e c t i o n u n d e r
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 y o u r h a n d s will tell y o u w h a t level o f tissue
a t a n a n g l e . G o i n g s t r a i g h t i n a l l o w s t h e tis- i n t h e b o d y y o u are w o r k i n g o n . T h e r e c a n b e
sue n o e s c a p e , n o m o v e m e n t ; t h e t i s s u e i s times w h e r e n o d o m i n a n t tissue directionality
trapped. G o i n g straight in also often causes is apparent; this is c o m m o n in the most
bruising. In practical terms, this m e a n s that superficial s u b c u t a n e o u s layers.
tissue i s m o v e d i n a d i r e c t i o n , t o w a r d a n I d a R o l f w a s w o n t t o say, " I f t h e t i s s u e
intended endpoint. O n c e again, a knowledge doesn't m o v e w h e n you go in o n e direction,
of a n a t o m y is essential. 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
In the neck and shoulder assembly, t h e of t h u m b t h a t has stood us in g o o d stead for
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 . I t m a n y years. It should be pointed out that
fans out from t h e occiput, t h e cervical verte- 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
brae, and the upper thoracic vertebrae, across e x a c t p a t h o f t h e associated m u s c l e fibers.
the shoulder blades to the collarbones a n d 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
the acromion. The sternocleidomastoid mus- e x e r t e d o n t h e m ; m u s c l e fibers a r e o n e t y p e
c 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 of pull, b u t t h e r e are o t h e r s . For e x a m p l e , t h e
process to t h e sternum and t h e clavicle. Poste- fascia superficial to t h e trapezius has m u l t i p l e
riorly a n d d e e p e r , t h e l e v a t o r s c a p u l a e sus- fine layers in m u l t i p l e directions. It is n o t
pends the shoulder blade from t h e cervical necessary or possible to organize each of these
vertebrae. At a similar d e p t h , t h e scalenes fascial sheets. C r e a t i n g order in o n e t e n d s to
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 organize sheets above and below. Direction
(Fig 23-2). of work m a y be toward a joint, away from a
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 - joint, along the plane of the muscle, or even
volved in chronic neck ache makes it obvious across t h e m u s c l e fibers. W i t h a t t e n t i v e n e s s
t h a t t h e associated fascia is a w e b ; t h e m u s c l e s a n d delicacy o f t o u c h , y o u r h a n d s will tell
a r e n o t l a y e r e d like a c a k e , b u t i n t e r w o v e n y o u w h a t t o d o . W h a t y o u are h o p i n g t o
like a m e s h . 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 achieve, the feeling you want under your
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 h a n d s , is t h e feeling of elasticity.

Figure 2 3 - 2
Fascial tensions in the neck and back.
122 T H E E N D L E S S W E B

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


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 i s c h i u m , o r s a c r u m . A l t h o u g h t h e y are s m a l l ,
that they do work. t h e y are short a n d deep; t h e y powerfully
To finish up t r e a t m e n t of n e c k pain, the i n f l u e n c e t h e basic structure of t h e pelvis
deepest structures u n d e r t e n s i o n will be t h e w h e n t h e y are i n s p a s m . T h e y a r e a m a j o r
levator scapulae a n d t h e layers of t h e cervical factor in sciatic pain. T h e y c a n be readily
muscles closest to t h e vertebrae. T h e small influenced by wedging the space b e h i n d the
transverse muscles at t h e atlanto-occipital 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
junction can be so contracted as to be barely external rotation (Fig. 23-3).
p a l p a b l e . W o r k i n g i n layers t o e a s e t h e s e i s T h e ischial tuberosity is the b o t t o m m o s t
the answer. I n addition, t w o m o v e m e n t m a - edge of t h e hip assembly; it provides an end-
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 p 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 .
(like a n o d ) a n d t u r n i n g t h e h e a d . W h e n W h e n t h e h a m s t r i n g s are tight, t h e y pull
turning the head, the m o v e m e n t is initiated d o w n w a r d on t h e i s c h i u m . As a result, t h e
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, sacrum is overworked with any m o v e m e n t .
w h i c h is a way of creating precise m o v e m e n t Release m u s t necessarily i n c l u d e work to
b e t w e e n t h e atlas a n d axis. release t h e h a m s t r i n g s .
H o w to k n o w where to start? Observing
How to Go Deeper— n o r m a l m o v e m e n t is usually helpful—walk-
Example: chronic sciatica i n g , s i t t i n g , s t a n d i n g . O n e o f I d a R o l f ' s first
A t t h e d e e p e r level, a n a t o m i c a l k n o w l e d g e i s principles was "take t h e part to n o r m a l a n d
e s s e n t i a l t o a c c u r a c y . S c i a t i c p a i n arises f r o m m a k e it m o v e . " We w a n t to evaluate t h e bal-
t e n s i o n o n t h e s c i a t i c n e r v e , u s u a l l y a t its anced m o v e m e n t of the j o i n t — t h e initial
outlet, w h i c h is variably located near the mid- 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 . For
dle o f t h e s a c r o i l i a c j u n c t i o n . S c i a t i c p a i n i s t e s t i n g p u r p o s e s o n l y , i n t h e h i p a n d leg, t h e
most c o m m o n l y a radiating pain, extending
t o t h e t h i g h , leg, o r f o o t , 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 . Piri-
formis pain, on t h e other h a n d , is local to 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 . I n piri-
formis pain, it is usually possible to palpate
the taut rope of the muscle t h r o u g h the over-
lying gluteus m a x i m u s . 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.
T h e relationship of the piriformis to the
sciatic nerve is variable. Piriformis t e n s i o n
can contribute to sciatic nerve pain. T h e
nerve is not entrapped by b o n e but by the
ligamentous bindings of the sacroiliac junc-
t i o n . 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 , 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 . T h i s i s i n f a c t
Figure 23-3
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 .
Rotators of the hip.
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 is a variable m i d - b a c k l o c a t i o n where shoul-


together, ankles touching, heels about an der m o v e m e n t a n d b o d y support intermesh.)
i n c h apart. In this position, a shallow knee 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 liga-
b e n d will graphically reveal t e n s i o n s i n t h e m e n t are anterior aspects of sciatic pain.
sacrum and groin. In the knee bend, the knee W h e n t h e r e are true physical deficits such
should c o m e straight forward over the second 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 -
toe; the b a c k is kept straight. A s e c o n d m o v e - bra, 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 -
m e n t , leaning over to t o u c h the toes, shows w o r k . 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
t h e ability of t h e hamstrings to l e n g t h e n a n d a week or even o n c e a m o n t h . It can m e a n
the ischial tuberosities to appropriately a b a t c h of work every couple of years. T h e
widen. client is the best judge of what he/she needs.
T h r e e m a i n strategies interact in this deep U n d e r stress, 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 ,
level of work; traction, tissue stretching, a n d t h e b o d y will t e n d t o return t o pattern. This
client m o v e m e n t . Traction c a n be passive or 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
active on t h e client's part. Active traction effective. Generally speaking, renewed work
involves stretching to t h e limit of t h e gesture. w i l l b e easier, less u n c o m f o r t a b l e , a n d p r o g -
For e x a m p l e , a h e e l stretch activates t h e ress w i l l b e faster.
Achilles t e n d o n , t h e back of the knees, t h e
hamstrings, a n d up into the ischial tuberosity. How to Touch—
This can be combined with other movements, Example: carpal tunnel syndrome
e.g. 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. 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
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 about t o u c h from prior sections.
give m a x i m u m assistance to tissue stretching. (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 —
A guiding principle in soft tissue w o r k is accident, repeated injury, or repetitive use
" w h a t ' s d o n e i s d o n e . " Dr. R o l f u s e d t o say, " I f u n d e r stress. C a r p a l t u n n e l s y n d r o m e i s a
a t first y o u d o n ' t s u c c e e d , g e t t h e h e l l o u t . " 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.
m o r e long-winded way of saying the same 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 -
t h i n g is t h a t w h e n tissue in an area w o n ' t ter use. T h e gesture includes tensely staring
s t r e t c h , 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 . at a small (usually t o o low) screen while over-
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. focusing t h e eyes a n d thrusting t h e head
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 f o r w a r d . T h i s sets u p a n i m b a l a n c e a t t h e
to work n e x t . Partly this is a m a t t e r of experi- s h o u l d e r — t h e s c a p u l a rides u p , t h e c l a v i c l e
e n c e . W o r k c a n proceed contiguously: sacroil- a n d a c r o m i o n are elevated, a n d t h e a r m has
iac j u n c t i o n — l u m b a r area—lower ribs. W o r k l o s t its b a s e o f s u p p o r t . E v e n i f t h e s c r e e n i s
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 . O n e n o t t o o low a n d t h e keyboard position is ade-
non-obvious sequence involves looking at the quate, prolonged eye tension a n d head thrust
c o u n t e r b a l a n c i n g structure. In t h e case of t h e c r e a t e a p r o b l e m . T e n s i o n a n d o v e r u s e are
hip, this would be t h e spine a n d t h e bridge t h e culprits here. From this brief analysis it
would be the psoas. Just as the position of the is obvious that there cannot be m u c h help
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 for carpal t u n n e l s y n d r o m e w i t h o u t work
pelvis f r o m below, so does t h e position of t h e o n t h e shoulder, n e c k , a n d occipital ridge.
s p i n e fix t h e p e l v i s f r o m a b o v e . T h e h o l d i n g (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 .
pattern can originate in the lumbar spine, at 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
t h e d o r s a l h i n g e , o r e v e n t h e o c c i p u t . (As w e o n s u r r o u n d i n g a r e a s . T h e i d e a i s t o give t h e
have explained in t h e text, t h e dorsal h i n g e tissue u n d e r s p a s m relief before w o r k i n g on
DOING BODYWORK BASED ON THE CONNECTIVE TISSUE CONCEPT 125

i t directly. I n a c u t e c a r p a l t u n n e l p a i n , i t i s s h e a t h a r o u n d t h e wrist, responds well to this


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

c h a n g e is recent, the comparison is most


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

acromion 15-1, 17-2, 17-8. levator scapulae m. 8-8, 17-6.


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

acromion 73, 86, 88, 92, 121, 124 midchest band/strap 5 3 - 5 8 , 65


adductor magnus m. 2 3 , 99, 101-102, 119 Odent, Michel 22
atlanto-occipital junction 68, 70, 123, 126 pelvic diaphragm 1 0 4 - 1 0 5 , 106, 107
belly band/strap 74-75 piriformis m. 103, 123
calcaneus 115, 120 primitive streak 6, 7, 8
cervico-dorsal junction 29, 6 5 , 67 proprioception 4 9 - 5 0 , 8 3 - 8 4
cervical-thoracic junction 73 psoas m. 4 2 - 4 3 , 63, 1 0 0 - 1 0 1 , 107, 111, 113, 124,
chest band/strap 58-60, 62 125
chin band/strap 68, 70-71, 73, 74 pubic band/strap 62, 75-77, 102
Cohen, Bonnie Bainbridge 65, 66, 67 Reich, Wilhelm 44
collar band/strap 73-74, 76 Rolf, Ida P. vii, ix, 2, 15, 27, 28, 36, 38, 4 3 , 6 5 , 100,
dorsal hinge 54, 57, 58, 67, 74, 92, 111, 124, 126 113, 115, 116, 121, 123, 124, 126, 131
ectoderm/ectodermal 11 sacro-coccygeal junction 6 5 , 67, 75
endoderm/endodermal 10, 11, 12 sacro-iliac junction 34, 77, 98, 123, 124
eye band/strap 67, 68-69, 74 sphenoid b. 67, 68, 6 9 - 7 0
fibrocartilage 25 Sutherland, W.G. 69, 70
flexures 16, 25, 67, 69 tendon/ligament formation 3, 5, 13, 14, 15, 4 3 , 44,
groin band/strap 62, 75-77, 102 53, 57, 58, 73, 76, 77, 8 5 , 87, 9 5 , 97, 99, 101,
inguinal band/strap 15, 61-65 103, 116, 123
LeBoyer, Frederick 21, 22 umbilical band/strap 74-75
lumbo-dorsal junction 65, 67, 75 urogenital diaphragm 76, 105, 106
lumbo-sacral junction 65, 67
About the Authors

R. Louis Schultz, Ph.D., trained as a Rolfer in 1 9 7 3 . 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 Struc-
t 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 ) . 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 Ger-
m a n y , Italy, E n g l a n d , Brazil, a n d A u s t r a l i a . I n 1 9 7 2 , Dr. 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, 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.
He is t h e author of over forty scientific publications. He received his Ph.D. in
physiology from the University of Wisconsin in 1 9 5 5 ; currently he practices
R o l f i n g i n N e w York C i t y .

R o s e m a r y Feitis, D . O . , 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 . S h e i n i t i a l l y w o r k e d w i t h Dr. 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 . She worked intensively w i t h
Dr. R o l f f o r a n u m b e r o f y e a r s , " 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 s Dr. R o l f
o n c e said, 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 . I n 1 9 7 8 , 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 , s h e e d i t e d Rolfing and Physical Reality, 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.
Rolf's l e c t u r e s . S h e a n d L o u i s S c h u l t z are c o - e d i t o r s of Remembering Ida Rolf,
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 . Dr. 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.

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 . 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.

Ronald T h o m p s o n has b e e n a Rolfer for twenty-five years. Before t h a t he did


considerable work in underwater photography. 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 prac-
tices Rolfing in T a m p a , Florida.