Somatic Anatomy

VisuaKzingBonesin BodyMechanicsB y M a r y A n n

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Visuali/in^Bones

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Mechanics

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9 6 MASSAGE & BODYWORK •

I t's difficult to mas-sage a client whowants relief from

back pain whenyou're strugglingwith your ownpain. Sooner orlater, most mas-sage therapistsgo through thisdreadful experi-ence and discoverthat to sustain along and successfulcareer, it's crucial tolearn and use goodhody mechanics.

Many massage teach-ers cringe when they hearthe words hody mechanicsbecause it implies that the bodymoves like a machine. The termis used here to describe theoptimal aligimient ofadjacent bones duringfree-flowing movement.The human body isorganic by nature. Itcannot be reduced toseparate parts in anoverly mechanical orien-tation, which, whenimposed on the body,can lead to rigidity ofbody and mind. Still, anunderstanding of themechanical componentsof skeletal architecturecan provide us withinsights that will help uspractice massage withan ease and efficiency ofmovement that protectsus from unnecessarystress and pain.

In the last SomaticAnatomy article, welooked at the muscularchain that underliesgood posture ("Musclesand the Postural Flute,"October/Novemher

Visuatizing

Bones ,

Mechanics

Figures IA-D. Sample of Dr. Lulu Sweigard's imagesfor improving skeletal alignment.A. Imagine your trunk like a sandwich and watch the

back slice of bread slide down.B. Watch the rear pockets on your pants sliding

around to the front.C. During hip flexion, see your thigh like the blade on a

knife folding into your trunk.D. Imagine the greater trochanters like handles on a

wheel and turn them.

2006. page 76). Now weturn our attention to thebony struts and spacersthat the muscles act on.In this article, we willexamine key architec-tural features of theskeleton and thebody mechanics thatbest suit their design.

Imagery

The skeleton is awell-defined tissue

in tlie body, wliich makesit easy to visualize. In fact,

practicing clear visualizationsof the bones during slow, inten-

tional movement is a highly effec-tive tool when used to cliange faultybody patterns. The key to successfulvisualizations lies in using anatomi-cally sound images rather tlian

abstract ideas. This was thediscovery of physical educa-tor and researcher Dr. LuluSweigard, who used skeletalimagery to improve align-ment in her groundbreakingposture lab research.'Sweigard found tliat the brainis so good at adapting neuro-muscular pathways to an ideaof how tile body "should" bethat if an abstract imageelashes with joint mechanics,it can create more problemsthan it was designed to fix.

Sweigard was a student ofMabel Todd. author of theclassic text Tlie ThinkingBody and one of the firstphysical education profes-sors to stress the impor-tance of using imaginationto improve posture andcoordination.- The anatomi-cally-accurate images theydeveloped are still widelyused by dance and move-ment educators (see FigureslA-D).^' We will explore

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s o m a t i c a n a t o m y

Figure 2.The trabeculae of thepelvis arrange themselves alonglines of force transmission.

some of these therapeutic imagesas a way to visualize optimal bodymechanics during massage. Butfirst, let's examine the incrediblegeometry of bone tissue itself.

Bone Tissue

Bones comes in many shapesand sizes, yet they all shaTe

similar basic units of structure.The hard outer layer of compactbone tissue is made up of osteons.The porous inner layer of spongybone tissue is made up of trabecu-lae. The osteons and trabeculaearrange themselves exactly alonglines of stress, giving our bonessturdiness and bending resistance(see Figure 2).

Bone is living tissue with thecapacity to remodel itself to with-stand a great variety of loads with-out acquiring too much weight.Wolff's law describes the remodel-ing process, postulating that bonechanges its shape in response toeveryday loads placed on it byrearranging the orientation ofosteons and trabeculae.''

We sbould follow the lead of thebody's wisdom. If skeletal tissue

can adapt itself to accommodatethe direction and degree of forcein our movement patterns, surelywe can reshape our movementpatterns to match the structuraldesign of our skeletal architecture.

Pelvis as Braced Atxh

Todd compares the human pelvisto a braced arch, where the

femoral heads buttress the ilia,which in turn wedge the keystoneof the arch—the sacrum—inwardand upward into the spine. A typi-cal arch made of stone blocks isforced together by the weight of theupper blocks, making the structureresistant to movement. Our pelvicbones form both a bony arch and ahorizontal ring, joining at thesacroiliac and coxofemoral jointsthat allow for movement (seeFigure 3).

Figure 3. Force transmissions in thebony arches of the pelvis.

The spine balances on the key-stone of this bony ring like a leglesslizard balancing on the edge of abowl. Underneath, the lower limbsattach at ball-and-socket joints,which serve as supporting columnswhen we are standing and swinglike pendulums when we walk. Tokeep the spine aligned and stable asyou work, imagine your trunk rest-ing atop two bony billiaid balls.

Bone is living tissuewith the capacity to

remodel itself towithstand a greatvariety of loads

without acquiringtoo much weight

When you lean over your client,bend at the ball joints in your liipsrather than sacrificing stability bybending in your spine (see Figures4A-B, page 100).

Both passive and active forcesstabilize tlie sacroiliac joints—tliebony form-closure of the hip bones(ilia) wedge the sacrum in placeand die tensional force-closure oflower abdominal muscles draw thepelvic halves together, respectively."To take advantage of tliis design,keep your legs under you whileworking, avoiding wide turned-outstances that increase diagonalforces between the sacnmi and twopelvic halves (see Figure 5, page102). Also, keep the lower abdomi-nal muscles contracted to avoid adownward drag from distended vis-cera (see Figure 6, page 102).

Alignment of Hips, Knees,and Ankles

The human body has evolvedan incredibly energy-efficient

posture. Standing upright stacksthe head, thorax, and pelvis overthe legs, placing the major weight-bearing joints in an extended posi-tion. Extension requires minimalmuscular effort and causes mini-mal stress to the joints. The key tothis energy economy lies in stand-ing with the center of gravity asclose to a plumb line as possible,stacking the long bones one atop ~

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n a t

Figures 4A.To pull efficiently, sit back into flexion atthe hips, keeping the spine extended.

Figures 4B. Avoid pulling with flexion that bends ofthe spine.

another so that the large musclescrossing them are in a restingposition (see Figure 7, page 104).

When asked where the hips'joints are, most people put theirhands on the sides of their pelvis.The actual sockets are about a fist-width apart, to either side of thepubic symphysis. To work with

optimal lowerlimb alignment,stand with yourknees under thehip joints andover the ankles,all facing front.To help get thisalignment, imag-ine the patellaeand hip socketswith headlightson them andshine their beamsstraight ahead.

The hips' jointsare made for rota-tion, but theknees and anklesare not. To keepyour headlightsshining straightahead, when youturn to the rightor left, rotate atthe hip joint.

Neutral forCentering,Starting, andResting

he anatomicalposition

aligns the weight-bearing joints inextension or neu-tral, being neitherflexed nor hyper-extended, and notrotated. Simplystanding in neu-tral with a senso-ry awareness ofbony alignment isa great way to

relax and center oneself at thestart of a massage.

Many teachers advocate thehorse stance, yet the additionalmuscle activity required for abent-kneed stance wastes energyand is tiring. In addition, it placesmore than normal stresses on theankle, knee, and hip joints." We

T!

don't do our usual daily activitiesin the horse stance; why use it formassage? It is a good idea to startyour massage session the way youwalk: simply stand close to thetable in a relaxed, aligned posture,then step foru-ard and place yourhands on your client. Also, in thesame way you let your car idle inneutral at a stop light, let yourbody pause at the end of eachstroke for a resting moment.

Exercise I. Images for Centeringin Neutral

• Stand upright and sense yourfeet as two tripods, balancingyour weight between yourheels, big toes, and little toes.

• Imagine your feet having rootsthat grow into the ground whileyour head floats toward the sky.

• Imagine your ankles as ball-bearings. Allow your body Cosubtly sway from the ankles asyou stand.

• Feel your heels extend behindyour ankle rather than underthe ankles.

• Imagine your tibias like sturdypillars supporting your femoralcondyles.

• Imagine your thighs spiraling intoward your knees.

• Imagine your pelvis as a bowl ofwater you keep level.

The Rocker Base

The same mechanics we use ingait apply to massage. While

walking, the body's weight rollsfrom heel to toe in one foot afterthe other. In massage, this actiontranslates into establishing a rock-er base by standing with one footahead of the other, facing thedirection of the massage stroke(see Figure 8, page 104). Step overthe front foot to extend yourstroke; step back to return thestioke or to lighten pressure. Byfacing your stroke and steppingtoward and away from it, youmove over the feet in tlie same —•

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s o m a t i c a n a t o m y

Massage and particularly deep-tissuework requires using the hands andarms in a weight-bearing capacity

back heel to engageintrinsic muscles andavoid overstretchingthe Achilles tendon.

Figure 5.Wide stances stress trie sacrumwedging it between diagonal forces.

plane in which your hands aremoving.

The ankle and knees are hingejoints designed for flexion andextension in the sagittal plane; theyare susceptible to injuries from lat-eral or twisting forces. Given thisdesign, when stepping forward orbackward, always keep a support-ing foot under your pelvis. Avoidwide stances and lateral weightshifts tliat place your knees andankles under torsion stress.

Apply pressure from a rockerbase by using your body weiglit.Simply step onto the front foot andlean into your hands, then pushwith the back foot as you wouldwhen walking. To apply deeperpressure, push with the toes onyour back foot the same way youpush off while walking (see Figure8, page 104). Remember to lift your

by

Force andLeverage

The leverage tliat

N works best in

i massage is the sameleverage that worksfor all activities.When pushing aheavy door, a child'sstroller, or even a carout of the snow, weinstinctively maxi-mize leverage by lean-ing and pushing withthe whole body. Byleaning from the feet,the ankles become thefulcrum and the

whole body works as a lever arm.Given this, all massage strokes, nomatter how small, should be donewith a full-body movement thatmaintains a neutral spinal align-ment and involves leaning, push-ing, and pulling from the feet (seeFigure 9, page 104).

Massage and particularly deep-tissue work requires using thehands and arms in a weight-bearingcapacity. Humans gave up theirupper body weight-bearing capacityin exchange for mobility long ago,so it is crucial to align the joints sotliat compression passes throughthe center of each joint, from thehands to the feet, l l i is greatly mini-mizes damage to the upper limhsfi"om the ravages of imeven aim-pression by distributing forcesalong a chain of bony articulations,from the hands tlirough tlie spine

to the feet. Since compressive andtensile forces have trouble passingaround comers, avoid applyingdeep pressure with bent or locked

Figure 6. A distended abdonrtinalwall puts a downward drag on theskeleton.

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Figure 7. Standing uprightextends the joints in a neutralalignment.

joints, particularly in die vul-nerable joint of the fingers,wrists, elbows, and knees.

Shoulder Girdle as aDraped Yoke

The shoulder girdle resem-bles a draped yoke bal-

anced across the rib cage,from which the hanging armsare suspended as side loads(see Figure 10). Each arm isdelicately balanced by awheel of tensional supportsmade up of the muscles thatact on the glenohumeraJ joint.The shoulder muscles worklike a harness, with muscularreins that scat the gleno-humeral joint in the center ofthe socket. When one reinpulls harder than another, ahorse veers to one side.Likewise, uneven muscularpulls will tip the balance ofthe yoke and pull the shoul-ders off center.

The humerus moves independ-ently of the scapula up to sixtydegrees of abduction or ninetydegrees of flexion," Given this fact,the scapulae should remain rela-tively stable while we give mas-sage, resting flat against the ribcage (avoid "winging") with theirinside edges parallel to the spine.To keep your scapulae quiet asyou work, imagine sandbagsanchoring them toward the iliaccrest. Also, have a knowing part-ner place her hands on themwhile you massage and give youfeedback about when they move.

Ideally, compressive and tensionalforces from massage transfer fromtlie anns through the center of theshoulders into the trunk and spine.Unlike the hips, there is no directskeletal pathway between the aimsand spine. Tlierefore it is crucialwhile practicing massage to work

Figure 8, Staggering thefeet in the direction ofthe stroke creates arocker base.

Figure 9. Unes of forcetravel from hands tofeet when pushing withthe whole body.

Exercise 2. Cues for Leveling the Shoulder Girdle• Imagine your shoulder girdle as a suit jacket resting on a hanger.• Keep your clavicles horizontal like an oxen's yoke.• Imagine your hands and forearms like buckets hanging from a yoke,

keeping them weighted while you work.• Imagine your lungs like balloons filling with air. expanding your armpits,

and floating your shoulder girdle as you breathe in.> If your shoulders creep up. rather then pulling them down, relax them

first, then lengthen your spine and lift your sternum underneath them.

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Figure 10.The shoulder resembles a yokefrom which the arms hang as side loads.

with the shoulder yokelevel and seated on therib cage.

Head and Thoraxas Top Loads

Let's finish our tour ofskeletal architecture

at the top. It can be achallenge to keep one'shead on top while work-ing. For some reason,the head likes to migratetoward the hands, asthough the neck were alimb, craning closer to acomputer screen, a trig-ger point, or whatevertask is at hand. Oneneed only look aroundat customers in a typical

restaurant to see how com-mon it is for most people toreach the head toward thetable rather than bringing thefood toward the mouth.

Most neck and thorax mis-alignments are associated witha head-forward posture. Thisposture is so common in officeworkers tliat it is now beingcalled "computer neck." Thehead-forward posture is dead-ly to massage form, causingthe converging forces crashingin the upper back of manybusy practitioners to feel (andlook) like a train wTeck.

The top load of the head andthorax passes into the pelvisand legs through axial com-pression of the vertebral bodiesand discs along the front of thespine. To test cervical align-ment, ̂ entl^ push down on thetop of your head and see if youcan feel the compression inyour spine (see Figure 11). Tomaintain the integrity of thecervical-tlioracic junction, keepyour spine and shoulders bal-anced in a dimensional crossby lilting your head to lengtlienyour neck along the vertical

Figure 11.When the head is balanced over the thorax,compression stress transfers through the spine and isabsorbed by the discs.

axis and widening your shouldersfront and back across the horizontalaxis.

Exercise 3. Cues for Aligning theHead and Neck

• Use peripheral vision as much ascentra! vision. Look around ratherthan narrowing your focus toyour hands. Systematically scanyour client's entire body everyother minute.

• Lift and lengthen your head andneck the way a person lifts theface back from text that is tooclose to read.

• Imagine your chin and occiputbalanced like children on a see-saw. Lift your occiput withoutlowering your chin.

• Imagine eyes in the back of yourhead and keep them level.

• Imagine your head floating uplike a balloon.

Faulty body patterns can be hardto break. They creep up on many anearnest practitioner focused out-wardly on the massage. Countertheir staying power by equippingyourself witli images tliat work bestfor your particular patterning needs,and use these images to self correct

as you massage. Anatomiaillysound visualizations can onlyenhance our ability to developbody mechanics that move insj-nc with tlie clear articulationsof tlie skeletal architecture. IHEU

Notes1. Lulu Sweigard. 77K Huiiiat^ Movement Potential:

Idtokhmtic Fadlaotion (New York: Harper & Row,

2. Mabel Todd. The Thinking Body^A Study of rfieBalatKoig Fofces ofDynoinic Mo'i (Prtnceion, N]: DanceHoriion5.l '937.reprint 1968).

3. Eric Franklin. Dynamic Afignnienl Through Imagtry(Champaign, IL : Human Kinetics. 1996).

4. Ar thur Steindler,Kif>i;jiofoj[y of the Humon Badf(Springfield IL : Churles C.Thomas Publisher. 19SS.reprint 1977).

5. Diane Lee. The Pdm G»die:An Approach to theEjfominiilioti and Trcotmenl of the iumbo-pelnc-hlpRegion, ^nd ed. (Philadelphia: Churchill Uvingswne,I999|.

i. C Norkin and F> Levange.Joint Scruclure andfurKIio>i:A Comprehensive Analyza. 2TMi ed.(Philadelphia: F.A. Davis Co.. 1991).

7 Ibid. Al to, ihe ratio of moveitienc benveen iheglenohumersl and icapulodiorack |omts is known asdie zcapulohumerol rliytiim,

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