Healthcare and Medicine Reference
In-Depth Information
fiber directions. The SPL track as described above passes
primarily through the lower part of the serratus anterior
muscle. The serratus originates on the profound side of
the medial border of the scapula and passes to attach-
ments on the first nine ribs, but the part that attaches to
ribs 5 through 9 provides the spiral continuity we are
following (see Discussion 2, the Upper Spiral Line and
Forward Head Posture, p. 144, to follow another of the
directions within the serratus). In dissection, the fascial
continuity with the rhomboids is very clear. If we could
fold the glenoid section of the scapula back to expose
the serratus, we would see clearly that there is one
muscle - the rhombo-serratus muscle, so to speak - with
the medial border of the scapula glued into its fascia
about halfway in its journey from the upper thoracic
spinous processes to the lateral ribs (Fig. 6.6). If the
scapula is cut away from the underlying tissues, the
connection between the rhomboids and serratus remains
very strong (Fig. 6.7).
side imbalance that can be corrected manually. Taking
the medial to lateral differences first: a common pattern
is that the rhomboids are locked long (overstretched,
eccentrically loaded) with the serrati locked short (con-
centrically loaded), pulling the scapula away from the
spine. This pattern will show up commonly in body-
builders, and those with a tendency to the kyphotic
spine (anterior thoracic bend). In these cases, the thera-
pist wants to lengthen the serrati while the client engages
the rhomboids.
Seat your client on a low table or a bench with his
feet on the floor and the knees lower than the hips. Have
him bend slightly forward at the mid-chest. Move in
behind him so that your chest is close to his back. (Use
a pillow between you if this is uncomfortable, but you
General manual therapy considerations
The SPL cuts across many of the other lines as a 'para-
site', meaning that most of the structures involved in the
SPL also take part in other lines as well. Techniques for
the splenius capitis, tensor fasciae latae, and fibularii
(peroneals) can be found in Chapter 5 (or the teral Line
DVD). There is more on the rhomboids with the Deep
Back Arm Line in Chapter 7, on the biceps femoris and
erector spinae in Chapter 3 (or the Superficial Back Line
), and on the tibialis anterior and abdominal muscles
in Chapter 4 (or the Superficial Front Line DVD). Here in
this chapter we focus on additional techniques aimed at
areas exclusive to the Spiral Line.
Common postural compensation patterns associated
with the SPL include: ankle pronation/supination, knee
rotation, pelvic rotation on feet, rib rotation on pelvis,
one shoulder lifted or anteriorly shifted, and head tilt,
shift, or rotation.
The rhombo-serratus muscle
The rhombo-serratus muscle (the rhomboid-serratus
anterior sling) often shows medial to lateral or side-to-
Fig. 6.6 If we fold the scapula back, we can see how there is
really a 'rhombo-serratus' muscle with the medial border of the
scapula essentially 'glued' into the middle of this myofascial sheet.
Fig. 6.7 The same specimen as Figure
6.4, viewed from the profound side. The
peritoneum and transversalis fascia, as well
as the remnants of the falciform ligament,
can be seen in the lower part of the
specimen. The attachments of the serratus
and external obliques to the ribs can be
seen, as well as the stark fact of the
stronger attachment that both muscles
have for each other than either has for the
ribs.
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