Do you remember the song “Head, Shoulders, Knees, and Toes?”
I happen to live with a four year old who loves all things bone, so these songs
are very much a part of my consciousness.
I always find it remarkably funny how much these “body” songs are connected
to the work that I do.
“Head, Shoulders, Knees, and Toes” is clearly a song about the first
scan in a postural assessment.
First,
I see if the head is even between the shoulders, I look to see if one shoulder
is higher than the other, I see if the knee caps are pointing straight forward,
I check where the toes are pointing, and then I look back at the knees to see
if they line up with the toes.
There you have it: head shoulders knees and toes, knees and toes! Throw
in some pelvis alignment and we’ve got ourselves a kid’s song!
Of course there’s more to it, but
that’s where I start.
These bony
landmarks are a great way to assess the relationships within the
musculoskeletal system, which brings me to this week’s installment of “how do
you remember all that?” Last week I talked about the
Latin names of muscles as pneumonic devices that actually make it easy to remember them, this week I’ll
talk about remembering muscular relationships because in actuality there would be
no “Head, Shoulders, Knees and Toes” without the relationship between fascia,
muscles, and bone.
I’ll finish
with a story about a client who benefited directly from knowledge of these
relationships.
The following memory tricks are based on the work of
Tom Myers who developed
Anatomy Trains as a way of analyzing muscle relationships
in function.
When you are
remembering relationships, muscular names are not necessary to achieve great
function.
Tom Myers would go so far
as to say that perseverating on the actions of individual muscles might even
impede healthy function.
In real
life no muscle acts alone, so isolating individual muscles does not create
functional strength.
In general
when I think of muscle groups I think Back, Front, Side, Inside and
Spirals…These of course correlate to Tom Myers’ Superficial Front Line,
Superficial Back Line, Lateral Line, Deep Front Line, and Spiral Line (along
with his arm line and functional lines) The lovely thing about Tom Myers’ work
is that while the theory can explain incredibly complex ideas with great detail
and accuracy, it’s simplicity can also be broken down for anyone to understand
and use for greater movement efficiency.
When I think of the Back
of the Body (Superficial Back Line), I think of the bottom of the foot, the
back of the lower leg, the back of the thigh, the back of the hips, the spine,
the back of the neck and the skull wrapped around to the forehead. These body parts work together to
propel the body forward, hold the body upright, and bend the body backwards.
When I think of the Front
of the Body (Superficial Front Line), I think of the top of the toes, the
front of the shins, the front of the thighs, the belly, the chest, the front of
the neck, and the face. These body
parts curl the body into a ball, help us bend forward, and pull our body
forward through space.
When I think of the Side
of the Body (Lateral Line), I think of the bump on the side of the ankle
(lateral malleolus), the side of the lower leg, the side of the thighs, the
side of the hip, the waist, the side of the ribcage, and the side of the
neck. These muscular relationships
help us bend to the side, and transfer weight so that we can lift one foot
while walking.
When I think of the Inside
of the Body (Deep Front Line), I think of the deep fascia in the foot, behind
the bones of the lower leg, the inner thighs, the inside of the pelvis, right
along the front of the spine, and believe it or not the tongue. These muscular relationships are our
center or our core. They move the
legs, stabilize the pelvis, and hold us up from the inside (think of a tent
pole).
When I think of Spirals
in the Body, I imagine a rubber band or string that connects the right ear
to the left shoulder blade, then it wraps around the left side of the ribcage, and
runs across the abdomen to the right hip.
Then this rubber band continues down the right inner thigh, moves around
the front of the right lower leg, wraps around the bottom of the foot from the
inside of the ankle to the outside of the ankle. Our imaginary rubber band
continues to move up the side of the lower leg, and then up the back of the
thigh. Phew…I like to think of
these Spiral relationships as the balancers in the body. Imagine this scenario: If imbalances on
the inside of the body cause the
ribcage to rotate to the right, then the spirals
in the body can adjust the head neck and shoulders so that anyone with this
spinal rotation doesn’t have to spend his or her life walking around in a
circle (yay for homeostasis).
Now of course these descriptions are quite simplified. Basically
I reduced
Anatomy Trains into five paragraphs, which in many ways is a
travesty to the depth of information in this fabulous book.
But if you’ll forgive me, I want to
explain how I used the simplicity of this in depth theory with a client
recently.
This person returned to
The Pilates Studio after a time away, and as she was communicating the “status”
of her body, she talked about a shoulder that was causing pain.
After some conversation, we both
determined that probably there was some sort of impingement in the shoulder,
and I certainly had a few movement recipes in mind for her shoulder.
Then she said something that gave me
pause.
She talked about feeling
tightness over her entire body.
She has some scoliotic rotations in the spine, which we had worked with
in the past, but the stiffness she spoke of was not something I had heard from
her before.
This led me to a
different strategy with her, even though I knew what I wanted to do for her
shoulder I decided to postpone shoulder specific exercises for a few sessions.
First we worked with the relationship of the back of the
body to the front of the body. We bent forward and backward, we released tight
spots and strengthened weak spots.
We played with flexion and extension of the spine. We worked to make the bottom of the
feet malleable, and we played with flexion and extension of the ankle and the
hip. Then we began working with
the side of the body and the inside of the body. We flexed the spine from side to side. We strengthened the side of the hips. We
lengthened the muscles that run in front of the spine. And finally we played
with spirals. I used the very
simplified information as a structure to choose Pilates exercises, and my only
goal was to relieve the feeling of stiffness. The funny side effect was that well, her shoulder started
feeling better before I ever addressed it directly. It wasn’t perfect, but the range of motion improved, and the
pain decreased. By the time we
started working with shoulder motion directly, we were working with a shoulder
that was not as acute as the beginning of her sessions.
Now one of my pet peeves is using an anecdotal story (like
the one I just told) and then spouting causal relationships as if the anecdote
of one person’s movement experience proves anything. I could list so many other things that could
have contributed to this client’s decrease in shoulder pain. There was no “control” in our work
together, we were simply two people problem solving and moving together. We allowed ourselves to be creative, and
now I have another anecdote that I can add to the plethora of anecdotes that
have shaped my practice over the years.
Well then what do I know? I do know that working with
muscular relationships rather than isolating individual muscles will create a
powerful movement experience for any person. I also know that if you watch a baby rolling around on the
floor, you will see that we are born with this innate knowledge that somehow
disappears. I also know that “Head
Shoulders Knees and Toes” has been running through my head since I started
writing this post, and I hope that I have not passed that onto you. But beyond that I am simply a mover
that is teaching other people to move, and if you’re still wondering how I
remember all that…Just think about all of the connections in your world that
allow you to remember all that you do, and well that’s how I remember all that.
