Healthcare and Medicine Reference
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right shoulder forward, and pulling the right costal arch
over toward the left hip. In the legs, the left lower SPL
is pulled up in its posterior aspect from lateral arch to
hip, whereas the right lower SPL is shorter in the front,
drawing the ASIS down toward the medially tilting
inner arch.
The difference in the level of the hands is occasioned
by the tilt of the shoulder girdle, which again rests
on the tilt of the rib cage. Work with the rib cage position
is probably the most effective way of getting the arms
to even out, though some supplemental work with the
Deep Front Arm Line on the right, and Deep Back Arm
Line on the left will be helpful. The right Front Func-
tional Line is clearly shorter than its complement.
In the Deep Front Line, we see a shortness in the
right groin which is tied into the inner line of the right
leg all the way down to the inner arch. This shortness is
clearly pulling on the spine, creating compensatory
tension in the opposite quadratus lumborum and other
tissue of the left lower back. We can also imagine that
the deep tissue on the left side of the neck - the middle
and posterior scalenes in particular - is under eccentric
strain (locked long).
Client 2 (Fig. - I-I.-IOA-E)
Here we see a middle-aged gentleman, clearly active and
with his intelligence engaged with the world. He shows
basic good balance from front to back, good muscle tone
for his years, and solidly planted feet. Core support
through the pelvis is fundamentally good, and the struc-
ture is basically open. That said, we have some signifi-
cant compensations to usefully read from these photos.
Step 1
Looking from the front, the most prominent feature is
the rib cage tilt to the right that helps create a right shift
to the head. Bringing some detail into this picture, the
right lower leg is laterally rotated and the right leg is
shorter than the left (again, we do not know from a
photo whether this is anatomical or functional). In either
case, this creates a right tilt to the pelvis, and the whole
structure of the body seems to 'fall' into the right groin,
with the left hip being compressed.
Seeing this from the back, the medially tilting (pro-
nating) right foot and the twist in the tissues of the right
leg are prominent, the right tilt of the pelvis is again
visible, along with the tilt and shift of the rib cage to the
right. Coupled with this is the tilt of the shoulder girdle
to the right, a tilt of the neck to the right, and a compen-
sating tilt of the head back toward the left on the neck.
We can imagine - but would have to do palpation tests
to confirm - a slight left bend in the lumbars, a stronger
right bend in the upper thoracics, and a left bend in the
upper cervicals.
From the side, the head forward posture predomi-
nates, and we note the disparity between the shallower
lumbar curve and the deep posterior bend of the mid- to
upper cervicals. The shoulders are a bit posteriorly
shifted, anteriorly tilted to counterbalance the head.
Interestingly, the torso seems posteriorly shifted relative
to the femur in the left-hand view, but more aligned
over the femur in the right-hand view. This is countered
by the view from above (E), where very little rotation is
in evidence, even though we 'know' that the body
cannot have the shifts and bends he shows without
accompanying rotations.
Step 3
The story here focuses on the shortness in the right
groin; much of the other patterning in the torso derives
from compensations for this pulling down from the
right leg in standing. Whether the fallen medial arch on
the right foot pre-dates or post-dates the groin pulling,
the arch seems mild in comparison to the hip. The rib
and head shift, shoulder tilt, and torso rotation all
proceed from this shortening.
This rotational pattern, coupled with the strong head
forward posture, accounts for nearly all the compensa-
tory patterning we see in this gentleman.
Step 4
The soft-tissue strategy would begin with lifting the SFL
and dropping the SBL, paying particular attention to the
tissues of the neck to free the suboccipitals (one suspects
years of glasses or computer work). Letting go of the
fascial lamina that runs behind the rectus abdominis
would be important, and seeing the cervical curve
reduce and the head go up on the body should begin
with this SFL and SBL work.
The LL work has already been outlined above. On the
left side, work the tissues of the LL up from the shoulder
to the ear to lengthen the left side of the neck, but work
down from the shoulder to the ankle to settle that side
down. On the right side, the tissue needs to be lifted
from above the knee to ear, and repositioned downward
from mid-thigh to the lateral arch. We can surmise with
some assurance that the abductors on the left side will
be extra short and tight and require some opening
The left SPL will require lengthening from the left
ASIS across the belly to the right ribs, and around the
torso to the left side of the neck in back. The left upper
SPL should require substantially more work and move-
Step 2
Based on this sketch of the prominent features, we
observe that the SBL has been drawn up along its whole
length, but especially from the sacrum up to the shoul-
ders. The suboccipital muscles are also locked up. Cor-
respondingly, the SFL is pulled down all along its length,
somewhat similar to Client 1, though with a more male
On the left, the LL is pulled up from lateral arch to
shoulder, and then pulled down from the ear to the
shoulder. Work on this side should proceed out in both
directions from the shoulder area. On the right, the LL
is pulled down to just above the knee, and up from the
arch to the knee, so work on this side should proceed
out from mid-thigh in both directions.
The left upper SPL is clearly the shorter of the two
SPLs, pulling the head into left lateral tilt, pulling the
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