Healthcare and Medicine Reference
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Fig. 9.49 In the lower legs, the Lateral Line and DFL are
antagonists: when the DFL is too short, the feet tend toward
supinated and inverted (A); when the Lateral Line becomes
chronically short, the feet tend toward the pronated and everted (B).
Fig. 9.51 In assessing the relative tilt of the pelvis, it is worthwhile
considering the anterior (medial) and posterior intermuscular septa
of the thigh as guy-wires that can exert a restriction on the flexion-
extension excursion of the pelvis.
Fig. 9.50 When the tensile
tissues on the inside or outside
of the legs are tightened, the
skeletal structure of the leg
responds like the wooden bow,
bending away from the
contracture, and causing strain
to the tissues on the convex
side. The type of interaction
between the DFL and the LL is
active in knock-knees and bow
legs (genu varus and valgus).
down toward the knee, and with bow-legged patterns, the
DFL tends to be pulled up the inseam of the leg into the hip.
In regard to pelvic position, it is helpful to consider the
septa themselves as structures worthy of consideration (Fig.
9.51). In an anteriorly tilted pelvis, the front septum is often
short and glued down to both adjacent muscle groups, and
requires lengthening along with adductor longus and brevis.
In this case, the posterior septum is under strain and lifted,
and its fascial plane should be induced to come caudally. In
a posteriorly tilted pelvis, the reverse is true: the anterior plane
often needs to be brought interiorly, and the posterior septum
certainly needs to be free from the pelvic floor, the deep lateral
rotators, and the adjacent muscle groups from each other. In
this way, the anterior septum can be thought of as an exten-
sion of the psoas, and the posterior septum an extension of
the deep lateral rotators, the piriformis specifically, and pelvic
floor, associated with the adductor magnus muscle.
medially rotated forefoot. Together, these myofascia help to
stabilize the tibia-fibula over the ankle, and maintain the inner
At the knee, the DFL and LL counterbalance each other like
bowstrings on either side of the leg (Fig. 9.50). When the legs
are bowed ('O' legs, laterally shifted knees, genu varus), the
DFL structures in the lower leg and thigh will be found to be
short, and the LL structures, the iliotibial tract and peroneals,
will be under strain. In the case of knock knees ('X' legs, medi-
ally shifted knees, genu valgus), the reverse will be true: the
lateral structures will be locked short, and the DFL structures
will be strained, or locked long. Pain will tend to occur on the
strained side, but the side that needs work is that with the
short bowstring.
In the thigh, the adductor muscles enclosed by the anterior
and posterior septa also act to counterbalance the abductors
of the LL, and any imbalance can often be seen by checking
the relative position of tissues on the inside and outside of the
knee, including the tissues of the thigh above the knee. With
knock-knee patterns, the adductor fascia tends to be pulled
Discussion 2
The middle of the Deep Front Line and
Visceral Manipulation
The endothoracic tissues of the DFL, from the diaphragmatic
crura to the thoracic inlet, are not available to be reached by
direct manipulative work. The entire rib cage forms a box in
which there is always a negative pressure, pulling the tissues
out against the ribs and attempting to pull the ribs in. These
areas are amenable to indirect work, however, via the scalenes
and neck fasciae from above, or via the peritoneum, the lower
edge of the rib cage, or the psoas from below.
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