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sometimes due to overstretching or overmanipulating,
layers that should be intrinsic to the local stations
become too communicative, requiring extra myofascial
tightening elsewhere to maintain some form of integrity
at the sacroiliac joint.
The superior end of the ligament is likewise firmly
joined to the sacrum, but has more superficial connec-
tions to the other fasciae in the area, specifically down
to the coccyx and up onto the posterior spine of the
ilium. In dissection, it is possible to lift the superficial
communicating fibers of the sacrotuberous ligament off
the body maintaining their strong connection with the
hamstrings and erector spinae fascia (as in Fig. 3.3).
myofascia. If this is not effective, delve further into pos-
sible strains deriving from foot position, pelvic torsions,
or the Spiral Line (see Ch. 6).
Hip to sacrum
If we are still thinking in terms of muscles, it is difficult
to see how we can continue from here using the Anatomy
Trains rules, for no muscle attaches to the ischial tuber-
osity in a direction opposite to the hamstrings. The
gluteus maximus goes over the hamstring attachment,
but it clearly runs in a more superficial fascial plane.
Going onto the quadratus femoris, the adductor magnus,
or the inferior gemellus, which are on a similar plane,
would all involve a rule-breaking radical change of
direction. If we think fascially, however, we are not
stymied at all: the sacrotuberous ligament arises from
the back of the tuberosity, demonstrably as a continua-
tion of the hamstrings, and passes across to the lateral
border of the sacrum, just above the sacrococcygeal
junction (Fig. 3.21).
The inferior end of the ligament is continuous with
the hamstrings. In fact the tendon of the lateral ham-
string, the biceps femoris, can actually be separated in
dissection and traced up to the sacrum. (This part of the
ligament is probably a degenerated muscle; we have
only to look at our close mammalian relative, the horse,
to see a biceps femoris muscle that runs all the way up
to the sacrum. A horse sacrum, of course, bears less
proportionate weight than our own and is allowed a
good deal more freedom of movement than a human
sacrum could possibly enjoy.)
The sacrotuberous ligament
The following, then, does not address the sacrotuberous
ligament per se, but rather the tissue of the SBL that
passes over the sacrotuberous ligament on its way from
the hamstrings to the sacral fascia. Because the medial
edge of the gluteus maximus attaches over the tissue we
want to access, enter from the medial side of the heavy
ligamentous line from the lower lateral aspect of the
sacrum down, drawing the tissue down and laterally to
the ischial tuberosity, or vice versa, depending on the
This tissue should generally be carried in a down-
ward direction for those with an anterior tilt to the
pelvis, and carried upward in those with a flat lumbar
spine or a posterior tilt to the sacrum (DVD ref: Superfi-
cial Back Line 35:03-36:35). Use a deep, firm, and consis-
tent pressure, without chopping or digging.
Let us be clear about fascial communication at the 'sta-
tions', or attachments. Here we pause again for a fuller
explanation, as this is a good example of the general
functioning of an Anatomy Trains 'station'. We are not
saying that the entire sacrotuberous ligament is an
extension of the hamstrings. The very strong, almost
bone-like tensile connection between the sacrum
and the ischial tuberosity is absolutely necessary to
upright human posture and pelvic integrity. Without it,
our 'tail' would pop up into the air, painfully and irre-
trievably, every time we bent over. The ligament is abso-
lutely tacked down to the bones and cannot slide
significantly as a whole toward the hamstrings or the
sacral fascia.
What we are saying is that the more superficial layers
of fascia are continuous with the myofascia on either
side, and are, or should be, able to communicate both
movement and strain across the fascial fibers adjacent
to the surface of the ligament (see Fig. 2.9). How many
layers are able to communicate and how many are stuck
down varies from person to person and depends on
the person-specific mechanical needs of the area. In
extremely stuck cases, the dermis of the skin will be tied
down to other layers (sometimes creating a dimple), a
sure indication of a station that is not communicating.
In extremely loose cases, usually after some trauma, but
From sacrum to occiput
From the superior end of the sacrotuberous ligament,
our rules require that we keep going in roughly the
same direction, and we have no trouble doing that: the
erector spinae arise from the layers of sacral fascia con-
tinuous with the sacrotuberous ligament (Fig. 3.22) (DVD
ref: Superficial Back Line, 1 :04:24 -1 :06:52). The erector
spinae span the spine from sacrum to occiput, with the
expresses of the longissimus and iliocostalis complex
overlying the ever deeper and shorter locals of the spi-
nalis, semispinalis, and multifidus (Fig. 3.23). The deepest
layer, the transversospinalis group, provides the short-
est one-joint locals, which reveal the three basic patterns
followed by all the erector muscles (Fig. 3.24). The func-
tional anatomical details of all these muscle complexes
have been ably covered elsewhere. 1- 3
The most superficial 'express' layers of fascia in this
complex tie sacrum to occiput. We should note that
even though the erectors are part of what is termed the
Superficial Back Line, several layers of even more
superficial myofascia overlie the line here in the form of
the serratus posterior muscles, the splenii, the rhom-
boids, the levator scapulae, and the superficial shoulder
musculature of the trapezius and latissimus dorsi. These
muscles form parts of the Spiral, Arm, and Functional
Lines, and are addressed in Chapters 6, 7, and 8
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