Issue link: https://www.massageandbodyworkdigital.com/i/77400
BODYREADING THE MERIDIANS Here, we offer a leg-up to the five-step method of structural analysis we use in the KMI Structural Integration school, in hopes that it will aid in forming your own successful strategies, whatever your modality. This system is designed to be simple, consistent, nonjudgmental, and easy to learn (though practice does help). The five steps are 1.) a description of the skeletal geometry, 2.) an assessment of the soft tissues creating or maintaining that position, 3.) the development of an integrating story that accounts for as much of the overall pattern as possible, 4.) the development of a short- and long-term strategy to help resolve the undesirable elements of the pattern, and 5.) evaluation and revision of the strategy in the light of observed results and palpatory findings. Only the first step—a map of skeletal positioning—will occupy us for this article.2 In subsequent articles and webinars, we will apply the second and third step, using the Anatomy Trains Myofascial Meridians as a map to soft-tissue patterning around these skeletal imbalances.3 Steps 4 and 5 are method-specific and are taught in our classes, or via our self-study videos. A POSITIONAL VOCABULARY FOR THE SKELETON In order to define the position of the skeleton in space, let us use a simple, intuitive, but unambiguous language, which has the advantage of making sense to (and thus empowering) clients, students, and patients, while being capable of bearing the load of sufficient detail to satisfy the most exacting practitioner. It has the disadvantage of not conforming to standard medical terminology, (e.g., protraction, varus and valgus knee, or a pronated foot), but, since these terms are often used in contradictory or imprecise ways, this disadvantage may prove an advantage. Our terms describe the relationship of one bony portion of the body to another, or occasionally to the gravity line, horizontal, or some other specified outside reference. The four terms employed are: tilt, bend, rotate, and shift. These terms are modified with the standard positional adjectives: anterior, posterior, left, right, superior, inferior, medial, and lateral. These modifiers refer to the top or the front of the named structure. In other words, in a left tilt of the head, the top of the head would point to the left. In a left rotation of the rib cage relative to the pelvis, the sternum would point more left than the pubic symphysis (while the thoracic spinous processes might have moved to the right in the back). This use of modifiers is, of course, an arbitrary convention, but one that makes intuitive sense. Right and left always refer to the client's right and left. One strong advantage of this terminology is that these terms can be applied in a quick, overall sketch description of the posture's major features, or used very precisely to tease out complex spinal, intra- pelvic, shoulder girdle, or intertarsal relationships. For this article, we are going to stick to the more obvious and visible problems; the more complex relationships are best taught in a class. We have included a few diagrams, but we strongly recommend that you learn the terms and test the patterns by putting your own body into the suggested positions. COMPARED TO WHAT? Because the terms are mostly employed without reference to an outside grid or ideal, it is very important to clarify exactly which two structures are being compared. To look at one common example that leads to much misunderstanding, what do we mean by "anterior tilt of the pelvis"? Imagining that we share a common understanding of what constitutes an anterior tilted pelvis (and there is really not a shared definition for pelvic neutral), we are still open to confusion unless the question, "Compared to what?" is answered. If we consistently compare the tilt of the pelvis to the horizontal line of the floor, for instance, this reading will not lead us to useful treatment protocols of femur-to-pelvis myofasciae since these tissues relate the pelvis to the femur, not the ground. Since the femur can also be commonly anteriorly tilted, the pelvis can easily be anteriorly tilted compared to the ground, while at the same time being posteriorly tilted compared to the femur. Or, a pelvis can be posteriorly tilted when compared to the femur, but anteriorly tilted when compared to the rib cage (see Image 1C). Both descriptions are accurate as long as the point of reference is agreed. To create this common pattern, let your pelvis shift forward over your toes, but scrunch your butt muscles to posteriorly tilt the pelvis and lean your chest back a bit over your heels. Look at yourself sideways in the mirror. Your pelvis may look anterior tilted, but it is really those posterior tilters—the deep lateral rotators—that need a break. Let's define the terms and then put them to use: Tilt. This describes simple deviations from vertical or horizontal, in other words, a body part or skeletal element that is higher on one side than another. Tilt is modified by the direction to which the top of the structure aims. Thus, in a left tilt of the pelvic girdle, the client's right hip bone would be 76 massage & bodywork march/april 2011