Healthcare and Medicine Reference
In-Depth Information
must be close for this technique to be supportable for
the practitioner and to work for the client.) Put your
open fists out on the lateral rib cage, just outside of or
just on the lateral border of the scapula and the lateral
edge of the latissimus dorsi. Your proximal phalanges
are resting on, and parallel to, the client's ribs, and your
elbows are as wide and forward as you can comfortably
position them. Peel the tissue around the rib cage toward
your chest and his back, bringing the latissimus and
scapula with you toward the posterior midline. Do not
dig into the rib cage, but rather bring the entire shoulder
structure around the ribs. At the same time have the
client lift his chest in front with a big, proud inhale. This
will stretch the myofasciae of the serratus anterior, and
encourage the rhomboids to assume proper tone, with
a bit of practice (DVD ref: Spiral Line, 16:00-20:28).
If there is a right-left difference between the two
scapulae, use the same positioning, but merely empha-
size the pressure to create change on the one side while
stabilizing both the client and the practitioner with the
other.
The converse pattern is less common, but still encoun-
tered frequently, where the rhomboids are locked short
and the serrati locked long. In these patterns, the scapu-
lae tend to be held high and close to the spinous
processes, a pattern which often accompanies a flat
(extended) thoracic spine.
To address this pattern in the SPL, have your seated
client bend forward a little (not so far that he can rest
his elbows on his knees) to expose the area between the
thoracic spine and the vertebral border of the scapula.
Standing behind, work out from the center line toward
the scapula using your knuckles or elbows, lengthening
in both directions away from the spine. The client can
help in two ways: by pushing up from the feet into your
pressure, the client will help keep the back sturdy and
create more of a roundness (flexion). To get extra stretch
out of the rhomboids, have the client reach out in front
and bring the arms across each other as if giving someone
a big hug (DVD ref: Spiral Line, 20:28-25:53).
To emphasize one side more than the other, merely
increase the pressure on the shorter side. Alternatively,
cross your hands over each other, with one against
several thoracic SPs, and the other against the vertebral
border, and by pushing your hands apart, induce a
stretch in the rhomboids and trapezius.
Serratus anterior
Portions of the external and internal oblique
Fig. 6.8 The next set of continuities in the Spiral Line carries it
from the serratus anterior onto the external oblique, on through the
linea alba, and over to the anterior superior iliac spine via the
internal oblique.
Fig. 6.9 The Spiral Line connections in the abdomen in action.
Note that it is the left Spiral Line (running from the fellow's right
ribs to left pelvis) that is being contracted, while the other side is
being stretched. Consistent postural positioning of one set of ribs
closer to the opposite hip is a red flag for Spiral Line treatment.
(Reproduced with kind permission from Hoepke 1936.)
The internal and external
oblique complex
From the lower attachments of the serratus, our way
forward is clear: the serratus anterior has strong fascial
continuity with the external oblique (Figs 6.7 and 6.8).
The fibers of the external oblique blend into the lamina
of the superficial abdominal aponeurosis, which carries
over to the linea alba, where they mesh with the oppos-
ing fibers of the internal oblique on the opposite side
(Fig. 6.7). This carries us to our next station, the ASIS
(anterior superior iliac spine) and an opportunity for a
brief sidetrack, or, in this case, a roundhouse (see
'Roundhouse: the anterior superior iliac spine' below).
In the abdomen, one set of external/internal oblique
(abdominal ribs to opposite pelvis) complex may be
visibly shorter than the other (Fig. 6.9). Position the
fingertips into the superficial layers of abdominal fascia
and lift them diagonally and superiorly toward the
opposite ribs {DVD ref: Spiral Line, 12:28-16:00). This will
usually serve to correct this imbalance, although more
complex counterbalancing patterns often involve the
psoas as well (see Ch. 9).
135
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