The hypothesis

The basis for this book is simple: whatever else they may be doing individually, muscles also influence functionally integrated body-wide continuities within the fascial webbing. These sheets and lines follow the warp and weft of the body's connective tissue fabric, forming traceable ‘meridians’ of myofascia (Fig. In. 1). Stability, strain, tension, fixation, resilience, and – most pertinent to this text – postural compensation, are all distributed via these lines. (No claim is made, however, for the exclusivity of these lines. The functional connections such as those described at the end of this introduction, the ligamentous bed described as the ‘inner bag’ in Chapter 1, and the latitudinal shouldering of strain detailed in the work of Huijing et?al., also in Chapter 1, are all alternate avenues for the distribution of strain and compensation.)

Essentially, the Anatomy Trains map provides a ‘longitudinal anatomy’ – a sketch of the long tensile straps and slings within the musculature as a whole. It is a systemic point of view offered as a supplement (and in some instances as an alternative) to the standard analysis of muscular action.

This standard analysis could be termed the ‘isolated muscle theory’. Almost every text presents muscle function by isolating an individual muscle on the skeleton, divided from its connections above and below, shorn of its neurological and vascular connections, and divorced from the regionally adjacent structures.1-10 This ubiquitous presentation defines a muscle's function solely by what happens in approximating the proximal and distal attachment points (Fig. In. 2). The overwhelmingly accepted view is that muscles attach from bone to bone, and that their sole function is to approximate the two ends together, or to resist their being stretched apart. Occasionally the role of myofascia relative to its neighbors is detailed (as in the role that the vastus lateralis takes as an ‘hydraulic amplifier’ in pushing out against and thus pre-tensing the iliotibial tract. In fact, hydraulic amplification is occurring constantly all over the body.) Almost never are the longitudinal connections between muscles and fasciae listed or their function discussed (as in, for instance, the consistent attachment between the iliotibial tract and the tibialis anterior muscle – Fig. In. 3).

The absolute dominance of the isolated muscle presentation as the first and last word in muscular anatomy (along with the naïve and reductionistic conviction that the complexity of human movement and stability can be derived by summing up the action of these individual muscles) leaves the current generation of therapists unlikely to think in any other way.

This form of seeing and defining muscles, however, is simply an artifact of our method of dissection. With a knife in hand, the individual muscles are easy to separate from surrounding fascial planes. This does not mean, however, that this is how the body ‘thinks’ or is biologically assembled. One may question whether a ‘muscle’ is even a useful division to the body's own kinesiology.

If the elimination of the muscle as a physiological unit is too radical a notion for most of us to accept, we can at least assert that contemporary therapists need to think ‘outside the box’ of this isolated muscle concept. Research supporting this kind of systemic thinking will be cited along the way as we work our way through the implications of moving beyond the ‘isolated muscle’ to see systemic effects. This book is an attempt to move ahead – not to negate, but to complement the standard view – by assembling linked myofascial structures in this image of the ‘myofascial meridians’. We should be clear that ‘Anatomy Trains’ is not an established science – this book leaps ahead of the research – but at the same time, we have been pleased with how well the concepts play out in clinical practice and movement education.

Once the particular patterns of these myofascial meridians are recognized and the connections grasped, they can be easily applied in assessment and treatment across a variety of therapeutic and educational approaches to movement facilitation. The concepts can be presented in any of several ways; this text attempts to strike a balance that meets the needs of the informed therapist, while still staying within the reach of the interested athlete, client, or student.

Aesthetically, a grasp of the Anatomy Trains scheme will lead to a more three-dimensional feel for musculoskeletal anatomy and an appreciation of whole-body patterns distributing compensation in daily and performance functioning. Clinically, it leads to a directly applicable understanding of how painful problems in one area of the body can be linked to a totally ‘silent’ area removed from the problem. Unexpected new strategies for treatment arise from applying this ‘connected anatomy’ point of view to the practical daily challenges of manual and movement therapy.

Though some preliminary dissective evidence is presented in this edition, it is too early in the research process to claim an objective reality for these lines. More examination of the probable mechanisms of communication along these fascial meridians would be especially welcome. As of this writing, the Anatomy Trains concept is presented merely as a potentially useful alternative map, a systems view of the longitudinal connections in the parietal myofascia.

The philosophy

The heart of healing lies in our ability to listen, to see, to perceive, more than in our application of technique. That, at least, is the premise of this book.

It is not our job to promote one technique over another, nor even to posit a mechanism for how any technique works. All therapeutic interventions, of whatever sort, are a conversation between two intelligent systems. It matters not a whit to the myofascial meridians argument whether the mechanism of myofascial change is due to simple muscle relaxation, release of a trigger point, a change in the sol/gel chemistry of ground substance, viscoelasticity among collagen fibers, resetting of the muscle spindles or Golgi tendon organs, a shift in energy, or a change in attitude. Use the Anatomy Trains scheme to comprehend the larger pattern of your client's structural relationships, then apply whatever techniques you have at your disposal toward resolving that pattern.

These days, in addition to the traditional fields of physiotherapy, physiatry, and orthopedics, there is a wide variety of soft tissue and movement methods on offer, and a wider circle of osteopathic, chiropractic, and energetic techniques, as well as somatically based psychotherapeutic interventions. New brand names sprout daily in the field, though in truth there is very little that is actually new under the sun of manipulation. Our observation is that any number of angles of approach can be effective, regardless of whether the explanation offered for its efficacy ultimately prevails.

The current requirement is less for new technique, but rather for new premises that lead to new strategies for application, and useful new premises are a lot harder to come by than seemingly new techniques. Thus, significant developments are often opened by the point of view assumed, the lens through which the body is seen. The Anatomy Trains is one such lens – a global way of looking at musculoskeletal patterns that leads to new educational and treatment strategies.

Much of the manipulative work of the last 100 years, like most of our thinking in the West for at least half a millennium, has been based on a mechanistic and...