Healthcare and Medicine Reference
In-Depth Information
Fig. 7.11 The DFAL runs down the periosteum of the radius and
crosses over the inside of the wrist to join the thumb and its
associated intrinsic thenar muscles.
Coracobrachialis
Biceps
brachii
and outer bags' in Ch. 1). Spirit or not, such a fastening
is a practical necessity when we consider the stabilizing
function of this line and its corresponding Deep Back
Arm Line. The periosteum of the radius and ulna is of
course continuous with the interosseous membrane
spanning between them. The bones are nevertheless
capable of sliding on one another (to reassure yourself
of this, put the thumb and forefinger of your left hand
on the radial and ulnar styloid processes at the wrist of
your right hand. Ad- and abduct the wrist (radially and
ulnarly deviate if you prefer) to feel the limited slide of
the radius on the ulna. In order to stabilize this move-
ment, both of these lines must fasten to the periostea of
these bones and (by implication) to the interosseous
membrane.
From the wrist, we traverse the radial collateral liga-
ment over the thumb-side carpals, the scaphoid, and the
trapezium, to the thumb itself (Fig. 7.11). Although the
extensor pollicis brevis and abductor pollicis longus
tendons accompany these tissues, these muscles arise
from the ulna as part of the Deep Back Arm Line - one
of the many examples of crossover between the lines
discussed at the end of this chapter. The thenar muscles
are included as part of the DFAL (DVD ref: Shoulders and
Arm Lines, 47:35-49:16).
Brachialis
Supinator
A
B
Fig. 7.10 The biceps brachii forms an express muscle (A), which
covers three joints. Deep to the biceps lie three local muscles (B),
each of which duplicates the biceps action on the individual joints.
(Compare to the 4th hamstring, Fig. 6.20.)
This provides a very clear example of an organizing
express arrayed over a series of differentiated locals. All
of these muscles are part of the DFAL.
The practical point of this distinction is that postural
'set' is often more determined by the underlying locals
than it is by the overlying express. Thus, while in
extreme cases the biceps might have a role in chronic
humeral adduction or elbow flexion, the therapist is far
more likely to get results from addressing the underly-
ing locals than from work on the biceps itself.
The long head of the biceps, as well as its other 'foot',
the tendon of Lacertus or bicipital aponeurosis, are
examples of 'crossovers', and are dealt with in that dis-
cussion at the end of this chapter.
The 'thumb line'
Practitioners of Shiatsu or any other technique employ-
ing pressure through the thumb need to stay aware of
the DFAL, which ends at the thumb. Good body mechan-
ics for a long-term practice require that the DFAL stay
open and lengthened, with the arms in a rounded posi-
tion (elbows bent) while putting the pressure on the
thumb (see Fig. 10.43, p. 225). Those practitioners who
report pain as a result of this kind of pressure in the
thumb itself or the saddle joint at its base will almost
invariably show a collapsed DFAL, frequently at the
area of the upper arm-coracoid or coracoid-ribs connec-
tions and frequently accompanied by extended elbows.
(See the section on the pectoralis minor above.)
The lower arm
Both the short head of the biceps and the supinator
attach to the radius. In the lower arm, we are inclined
to include the pronator teres in this line because with
the supinator it clearly controls the degree of rotation of
the radius, and thus the thumb (see Fig. 7.4 or 7.11 -
pronator and supinator form a 'V converging on the
radius), even though strictly speaking pronator teres is
a crossover from the Superficial Back Arm Line. From
all these radial attachments, we pass along the perios-
teum of the radius to its styloid process at the distal end
on the inside of the wrist (DVD ref: Shoulders and Arm
Lines, 45:48-47:34). The fascial fabric below the distal
ends of the two rotators is adherent to the periosteum
of the radius, which is very reluctant to separate from
the bone in dissection (see Fig. 7.4 distal to the 'V')- This
long 'station' violates the spirit of the Anatomy Trains
idea of longitudinal fascial continuities separable from
their underlying bones (see the discussion of the 'inner
The Superficial Front Arm Line
The Superficial Front Arm Line (SFAL) overlies the
DFAL in the shoulder, beginning with a broad sweep of
attachments, which in this line includes several muscles.
The pectoralis major, which has a broad set of attach-
ments from the clavicle down onto the middle ribs,
begins this line in the front (Fig. 7.12 and DVD ref: Shoul-
ders and Arm Lines, 18:25-25:03). The latissimus dorsi
(which begins its embryological life as 'latissimus
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