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Fig. 1.44 The ligaments we see separated and detailed in the
anatomy books are really just thickenings in the continuous
encircling 'bone bag' part of the musculoskeletal double-bagging
system. (Reproduced with kind permission from Williams 1995.)
call muscle, which is capable of changing its state
(and its length) very quickly in response to stimulation
from the nervous system. The containing bag itself
we call the deep investing fascia, intermuscular septa
(the double-walled part between our hands at the end),
and myofascia. Within this conception, the individual
muscles are simply pockets within the outer bag, which
is 'tacked down' to the inner bag in places we call 'muscle
attachments' or 'insertions' (Fig. 1.45). The lines of pull
created by growth and movement within these bags
create a 'grain' - a warp and weft - to both muscle and
fascia.
We need to remind ourselves once again at this point
that muscle never attaches to bone. Muscle cells are
caught within the fascial net like fish within a net. Their
movement pulls on the fascia, the fascia is attached to
the periosteum, the periosteum pulls on the bone.
There really is only one muscle; it just hangs around
in 600 or more fascial pockets. We have to know the
pockets and understand the grain and thickenings in the
fascia around the muscle - in other words, we still need
to know the muscles and their attachments. All too
easily, however, we are seduced into the convenient
mechanical picture that a muscle 'begins' here and
'ends' there, and therefore its function is to approximate
these two points, as if the muscle really operated in such
a vacuum. Useful, yes. Definitive, no.
Muscles are almost universally studied as isolated
motor units, as in Figure 1.46. Such study ignores the
longitudinal effects through this outer bag that are the
focus of this topic, as well as latitudinal (regional) effects
now being exposed by research. 8 7 It is now clear that
fascia distributes strain laterally to neighboring myofas-
cial structures; so that the pull on the tendon at one end
is not necessarily entirely taken by the insertion at the
other end of the muscle (see Fig. 1.7). The focus on isolat-
Fig. 1.45 This image, redrawn after a photo of the plastinated
bodies in the Korperwelten project of Dr Gunter van Hagens,
shows more clearly than any other the connected nature of the
myofascia and the fallacy (or limitation, at least) of the 'individual
muscle connecting two bones' image we have all learned. To
connect this image to this chapter, the 'inner bag' would be the
ligamentous bed surrounding the skeleton on the left, and the
'outer bag' would be surrounding (and investing) the figure on the
right. To prepare this specimen, Dr van Hagens removed the entire
myofascial bag in large pieces and reassembled them into one
whole. The actual effect is quite poignant; the skeleton is reaching
out to touch the 'muscle man' on the shoulder, as if to say, 'Don't
leave me, I can't move without you'. (The original plastinated
anatomical preparation is part of the artistic/scientific exhibition
and collection entitled Korperwelten (BodyWorlds). The author
recommends this exhibition without reservation for its sheer
wonder as well as the potency of its many ideas. Some taste of it
can be obtained through visiting the website ( www.bodyworlds.
com) and purchasing the catalog or the video.) The Anatomy
Trains tracks are some of the common continuous lines of pull
within this 'muscle bag', and the 'stations' are where the outer
bag tacks down onto the inner bag of joint and periosteal tissue
around the bones.
ing muscles has blinded us to this phenomenon, which
in retrospect we can see would be an inefficient way to
design a system subject to varying stresses. Likewise,
we have focused on individual muscles to the detriment
of seeing the synergetic effects along these fascial merid-
ians and slings.
43
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