Healthcare and Medicine Reference
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to ribs to hip portion we have just covered) and its lower
track (the 'jump rope' around the arches we are about
to cover). Therefore, we often assess and consider these
two halves of the line separately.
Roundhouse: the anterior superior
iliac spine
The SPL passes over the anterior superior iliac spine
(ASIS), touching there as a station before passing down
the leg. The ASIS is of such central importance to struc-
tural analysis in general, and myofascial continuity
theory in particular, that we must pause here to note the
various mechanical pulls from this point. It could be
compared to a clock or a compass, but since we are
mired in train images for this topic, we will call it a
roundhouse (Fig. 2.12B, p. 69).
The internal oblique pulls the ASIS in a superior and
medial direction (Fig. 2.12A). Other internal oblique
fibers, as well as fibers from the transversus abdominis,
pull directly medially. Still other fibers of the internal
oblique fan, plus the restraining cord of the inguinal
ligament, pull medial and inferior. The sartorius, attach-
ing to the ASIS on its way to the inner knee, pulls mostly
down and slightly in. The iliacus, clinging to the inside
edge of the ASIS, pulls straight down toward the inner
part of the femur.
The rectus femoris, as we noted in discussing the
Superficial Front Line, does not attach to the ASIS in
most people; nevertheless it exerts a downward pull on
the front of the hip from its attachment a bit lower
on the AIIS. The tensor fasciae latae pulls down and out
on its way to the outer aspect of the knee. The gluteus
medius pulls down and back toward the greater tro-
chanter, the transversus abdominis pulls back nearly
horizontally along the iliac crest, and the external oblique
pulls up and back toward the lower edge of the rib
cage.
Getting all these forces to balance around the front of
the hip in both standing and gait involves an attentive
eye, progressive work, and more than a little patience.
This balance involves at least three of the Anatomy
Trains lines - this Spiral Line, the Lateral Line, the Deep
Front Line, and, by mechanical connection, the Superfi-
cial Front Line. Proper assessment involves weighing an
ever-shifting dance of pulls created by a host of myofas-
cial units across each semi-independent side of the
pelvis.
Because of the many pulls and tracks competing to
set the position of the ASIS, the SPL does not always win
out in communicating between its upper track (the skull
The lower Spiral Line
The lower SPL is a complex sling from hip to arch and
back to the hip again.
Continuing on from the ASIS, we must keep going in
the same direction to obey our rules. Rather than sharply
switching our course onto any of these other lines of
pull, we pass directly across, mechanically connecting
from the internal oblique fibers to the tensor fasciae
latae (TFL) from the underside of the ASIS and lip of the
iliac crest. Figure 6.10 shows how the TFL blends with
the anterior edge of the iliotibial tract (ITT), which, as
we noted when discussing the Lateral Line, passes down
to the lateral condyle of the tibia (Fig. 6.11).
This time, however, instead of jogging over to the
peroneals, as we did with the Lateral Line, we will keep
going straight, with a more obvious fascial connection,
especially for the anterior edge of the ITT, onto the tibi-
alis anterior (Fig. 6.12). This connection is easily dis-
sected (Fig. 6.13).
The 'violin' of the iliotibial tract
In the legs, lengthening this section of the SPL from the
ASIS to the outer knee can be accomplished through a
stroke, either up or down, designed to free and lengthen
the anterior edge only of the ITT. Usually the flat of the
ulna is used, with the client side-lying. In this position,
the ITT curves over the surface of the thigh like the
strings of a violin. Your ulna then acts like a bow: by
altering the angle of your arm, you can emphasize the
connection from the gluteus maximus to the posterior
part of the ITT, or (as suggested here for the SPL) con-
centrate on the anterior portion from the TFL to the tibi-
alis anterior just below the knee. Near the knee, the
anterior edge of the ITT is easy to feel; nearer the hip,
stay on a line from the ASIS to the middle of the lateral
part of the knee (DVD ref: Spiral Line, 25:53-29:32).
Since this area can be quite painful when first
approached, several repetitions in a more gentle fashion
will often answer well.
Fig. 6.10 The myofascial blend we call the
tensor fasciae latae muscle becomes the
iliotibial tract as the muscle attenuates to
nothing - but it is all one fascial sheet.
(DVD ref: Early Dissective Evidence)
136
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