Healthcare and Medicine Reference
In-Depth Information
idea for several sessions running. An integrated spine is
your (and their) reward.
As stated in Chapter 2, Anatomy Trains is not especially
useful as a way to parse movement as a whole. Never-
theless, an analysis of simple walking may prove useful
- although walking is of course not so simple.
Taking a step forward, although it may be initiated
from the hip flexors of the DFL, such as the psoas and
iliacus, or by release of the extensors, certainly involves
the flexion at the hip, extension of the knee, and dorsi-
flexion at the ankle and metatarsophalangeal (ball of the
foot) joints necessary to walking forward, all of which
are created by the shortening of the myofascia of the
SFL. The muscles may fire or engage in a sequence, but
the leg portion of the SFL is also engaged as a fascial
whole throughout the 'reaching forward', swing
As the leg travels forward, its entire myofascia pre-
pares to receive the weight of the body and the ground
reaction. Muscles tense within the fascial web to handle
the precise amount of force expected. One has only to
step from one room into another in the dark with an
unexpected drop or rise of no more than a couple of
inches to realize how little is required to upset this prep-
aration, and how much shock is sent through the unpre-
pared musculoskeletal system when it is surprised in
this way.
Once the heel strikes and the roll over the foot begins,
the SBL myofascia takes over as the back of the leg
engages into hip extension and plantarflexion. Again,
no matter what the firing sequence of the muscles, the
entire lower section of the SBL is engaged fascially from
lower back to toes throughout this phase. During all
these phases, movement should be tracking through the
four 'hinges' of the leg in more or less a straightforward
fashion. The hip, of course, does some rotation during
walking, and the weight falls from lateral to medial
across the metatarsophalangeal joint, but in general, dif-
ferences in direction among these joints will result in
joint wear, ligamentous overstrain, and myofascial
imbalance (Fig. 10.21).
The Lateral Line's abductors, ITT, and lateral com-
partment of the lower leg provide stability that prevents
the hip falling inward (adduction), while the adductor
group and the other tissues of the DFL assist the flexion/
extension motions and provide stability from the
inner arch up the inside of the leg to the medial side of
the hip joint, preventing excess or unwanted rotation of
the hip.
It is important to understand that the pendulum of
the leg starts at the 12th rib and 12th thoracic vertebra,
with the upper reaches of the psoas and quadratus
lumborum. With this concept, the movements of the
innominate bones in walking become understandable,
combining a simultaneous pelvic rotation around the
vertical axis in the horizontal plane, a lifting (side shift
or side bend) of each innominate in the coronal plane
around the A-P axis, and a hemi-pelvic tilt in the sagittal
Fig. 10.21 Each step involves movement through four 'hinges' of
the leg, around which the soft tissue must be balanced for joint
longevity and efficient walking.
Fig. 10.22 The pelvis has movement in all three Euclidian planes
in proper walking - side-to-side around the A-P axis, rotating
around the vertical axis, and each innominate tilts sagittally around
the left-right axis. Too little movement in one plane often results in
excessive movement in another plane.
plane around the left-right axis in which the tilt of the
innominate mirrors the tilt of the femur in walking (Fig.
10.22). With this in mind, one can see that for the pelvis,
proper initiation of walking is a DFL coordination,
whereas the line that has to move through the most
range and provide the most adjustment and stability is
the Lateral Line.
Different patterns of walking mix differing amounts
of each of these three axial motions. Lack of one motion
will usually require an increase in one or more of the
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