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F r e e S O A P n o t e s w i t h M a s s a g e B o o k f o r A B M P m e m b e r s : a b m p . u s / M a s s a g e b o o k 107 VERTEBRAL MOTION DISPARITIES Coupled-motion biomechanics is a set of principles that have influenced numerous manual therapy disciplines, including osteopathic manipulation, physical therapy, Rolfing structural integration, rehabilitative massage, and other manual therapy modalities. 5 At the risk of oversimplification, I'll attempt a brief overview. The spine's overall mobility is determined by the combined smaller motions between individual vertebrae. This motion between vertebrae can be restricted by their surrounding ligaments and myofascia (Image 2), and in the thoracic spine, by soft tissues surrounding the costovertebral joints (Image 3). When these soft tissues are elastic and differentiated enough to allow unrestricted vertebral motion, normal activities like breathing, walking, and bending will cause the vertebrae to move in all three dimensions in relationship to their neighbors. Most biomechanics authors (though not all) agree that due to their bony shapes and complex soft-tissue interconnections, these movements are often coupled so that movement in one plane is automatically accompanied by motions in the other two planes (Image 4). 6 According to one moderately large study (n=369), physiotherapists of diverse backgrounds view coupling biomechanics as an important part of their hands-on approach, with more than 85 percent of therapists surveyed indicating that lumbar coupling biomechanics were ''very important'' or ''important'' in their application of manual therapy. 7 Interestingly, in spite of the importance placed on biomechanical coupling by many practitioners, there Normal vertebral mobility can be diminished by inelastic or undifferentiated soft tissues around the spine and ribs. In addition to the spinal ligaments and joint capsules shown in Image 2, muscles and myofascial structures of the spine (such as the thoracolumbar fascia, the multifidi, erectors, etc.) can also affect vertebral mobility. Images courtesy Primal Pictures, used by permission. 2 Watch Til Luchau's technique videos and read his past articles in Massage & Bodywork's digital edition. The link is available at www.massageandbodywork.com, www.abmp.com, and on Advanced-Trainings.com's Facebook page. "Vertebral Mobility" 3 Ligamentum flavum Posterior longitudinal ligament Anterior longitudinal ligament Capsule of zygapophyseal joint Supraspinous ligament Interspinous ligament