Healthcare and Medicine Reference
In-Depth Information
Adductor
magnus
Adductor
hiatus
Fig. 9.10 The DFL passes behind the knee, in a deeper plane of
fascia than the Superficial Back Line, with the popliteus,
neurovascular bundle, and fascia on the back of the knee capsule.
Fig. 9.12 From the medial epicondyle, two fascial planes emerge,
one carrying up and forward with the adductor longus and brevis
(the lower anterior track of the DFL), and another with the
adductor magnus and minimus (the lower posterior track). Both
ultimately surround the adductors, and both are connected to the
linea aspera, but each leads to a different set of structures at the
superior end.
The thigh - lower posterior track
At the top of the deep posterior compartment, we pass
over the back of the knee with the fascia which com-
prises the anterior lamina of the popliteus, the neuro-
vascular bundle of the tibial nerve and popliteal artery,
and the outer layers of the strong fascial capsule which
surrounds the back of the knee joint (Figs 9.10 and 9.11).
The next station of this line is at the medial side of the
top of the knee joint, the adductor tubercle on the medial
femoral epicondyle.
From this point, the fascia surrounding the adduc-
tors, although it is itself a unitary bag tying the adduc-
tors to the linea aspera of the femur, presents us with a
switch, or choice point, as the heavy fascial walls on the
front and back of the adductors head off in different
directions, which will not rejoin again at the lumbar
spine (Fig. 9.12). We will term these two fascial continu-
ities the lower posterior and lower anterior tracks of the
DFL.
The posterior track consists of the adductor magnus
muscle and the accompanying fascia between the ham-
strings and the adductor group (Fig. 9.13). If we run
behind the adductor group from the epicondyle, we can
follow this posterior intermuscular septum up the thigh
to the posterior part of the ischial ramus near the ischial
Fig. 9.11 The fascia surrounding the popliteus and the posterior
surface of the ligamentous capsule of the knee links the tibialis
posterior to the distal end of adductor magnus at the medial
femoral epicondyle.
These lower DFL tissues are very useful in easing
stubborn arch patterns, both 'fallen' and 'high' arch pat-
terns (DVD ref: Deep Front Line, Part 1, 26:26-30:33), as
well as bunions (DVD ref: Deep Front Line, Part 1,
30:33-32:26).
Search Pocayo ::




Custom Search