Healthcare and Medicine Reference
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than the medial side, so that the front of the bone faces
more medially, it would be termed - consistently but a
bit counter-intuitively - a 'medially rotated calcaneus
(relative to the tibia or the forefoot)'. Such medial rota-
tion and /or medial tilt often accompany a so-called pro-
nated foot, fallen arch pattern. Shifting the Superficial
Back Line 'bridle' around the calcaneus is vital to arch
restoration, as well as lengthening the outside of the foot,
along the lateral band of the plantar fascia.
This language requires only a few hours of practice
to manage, and only a couple of weeks of regular use of
the notation for reasonable facility with the process. Of
course, more usual language such as Tow arches' or
'pronated feet' can be used when it meets the needs of
the moment, but reversion to our terminology can be
used for argument, or for simplicity and accuracy in the
resolution of ambiguity. It also has a pleasing neutrality:
'medially shifted knees with laterally rotated femurs'
may be a mouthful, but for the client it is less demeaning
than 'knock knees' and less distancing than 'genu valgus'
(see Fig. 11.6C).
Once the skeletal geometry of the client's standing
resting posture has been described to the satisfaction of
the practitioner, and noted down, either verbally or pic-
torially on such a form as can be found on the DVD for
the reader's use, we proceed to the second stage.
of the left Spiral Line: Are the right ribs closer to the left
ASIS than vice versa, as in Figure 11.6A? Perhaps length-
ening of the left internal and right external obliques and
their accompanying fascia will allow the work on the
serratus to hold and integrate.
Perhaps, however, we find that the scapula is not
being pulled into a lateral and inferior shift by a short
serratus, but rather that the scapula is medially rotated
(which often involves some lateral shift). In this case, we
might suspect the pectoralis minor (which pulls down
and in on the coracoid process to create a medial rota-
tion or anterior tilt or both). If treatment of the pectoralis
minor and associated fascia does not solve the problem,
we might be drawn into working on either the Superfi-
cial Front Line, the Deep Front Arm Line, or the Front
Functional Line to see if 'feeding' the pectoralis minor
from its lower trunk connections might help the local
work be successfully absorbed.
It is important to keep in mind that portions of
lines may be involved without affecting the entire
meridian. It is equally important to keep the broad
meridian view, since, in our teaching experience, prac-
titioners from almost all schools tend to fall into the
mechanist's habit of trying to name the individual
muscles responsible for any given position. This is, of
course, not wrong, merely unnecessarily limited and
ultimately frustrating, since it leaves out the fascia and
effects over distance.
This 'bodyreading' process of Step 2 is modeled
below using client photographs. Although many possi-
ble ways of analyzing soft-tissue distribution could be
used at this point, we have an understandable prejudice
toward employing the Anatomy Trains myofascial
meridians schema here. This five-step process, however,
can stand independently of any particular method.
By increasing familiarity with the system, it becomes
a matter of a minute or two to analyze which lines might
be involved in creating the pattern you have observed
in Step 1. Trunk and leg rotations generally involve the
Deep Front Line or Spiral Line, or both. Arm rotations
involve either the Deep Front Arm Line or the Deep
Back Arm Line. Side-to-side discrepancies often involve
portions of the Lateral Line on the outside and Deep
Front Line in the core. The balance between the Super-
ficial Front and Back Line elements is always assessed
and noted. If it appears that individual muscles are cre-
ating a pattern, we note in which lines this muscle is
also involved. The relative positioning among the lines
is also important (e.g. the SFL is inferior relative to the
SBL, the DFL has fallen relative to the more superficial
lines, etc.).
In summary, analysis of the soft-tissue patterning
in Step 2 usually takes note of where tissues seem to be
short or fixed, where tissues seem to be overlong,
and where the biological fabric of the lines has lost its
natural draping, i.e. the common pattern where the
Superficial Back Line has migrated upward on the skel-
eton while the Superficial Front Line has migrated
downward, independent of standing muscle tonus.
These elements can also be noted on the bodyreading
form in practice.
Step 2: an assessment of the soft tissues
The second step is to apply a model to the soft tissues
to see how the client's skeletal relationships, as described,
might have been created or are maintained. The Anatomy
Trains myofascial meridians is one such model, the one
we will apply here, but single-muscle strategies or other
available models could be employed as well. 6-1 0
Step 2 begins with the question: 'What soft tissues
could be responsible for pulling or maintaining the skel-
eton in the position we described in Step 1?' A second
question, 'What myofascial meridians do these myofas-
cial units belong to, and how are they involved in the
pattern?' follows immediately.
For example, if it is determined that the pelvis has an
anterior tilt (as in Fig. 11.4B), then we could look at the
hip flexors for the soft-tissue holding - for example, the
iliacus, pectineus, psoas, rectus femoris, or tensor fasciae
latae myofasciae. Limitation in any of the first three
would lead us toward the Deep Front Line; the rectus
femoris might guide us to look at the Superficial Front
Line; the sartorius (unlikely; it is too small and thin for
postural maintenance) might lead us to the Ipsilateral
Functional Line; and the tensor would suggest Spiral or
Lateral Line involvement. Alternatively, the pelvis is
being pulled up from behind by the erectors (Superficial
Back Line) or the quadratus lumborum (Deep Front
Line or Lateral Line).
If the shoulder on the right side lives farther away
from the spinous processes than the one on the left, we
could look to see whether the serratus anterior is locked
short. If treatment of that single muscle results in a
stable repositioning of the scapula, all well and good;
but if not, we are guided toward assessment of the rest
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