©Copyright 2020 Of-CourseOnline.com, Tanya Thompson 1


Contents INTRODUCTION ................................................................................................................................................................................... 3

TERMINOLOGY ............................................................................................................................................................................... 5 Positional terminology .............................................................................................................................................................. 5 Directional terminology ............................................................................................................................................................. 5 Joint Movements ....................................................................................................................................................................... 5 Muscles can be categorised as: ................................................................................................................................................. 6

PLANES OF MOTION ....................................................................................................................................................................... 6 THE SPINE AND PELVIS ................................................................................................................................................................... 7 SKELETAL ANATOMY ...................................................................................................................................................................... 8

Upper extremity ........................................................................................................................................................................ 9 Lower extremity ........................................................................................................................................................................ 9

THE PELVIS.................................................................................................................................................................................... 10 NEUTRAL PELVIS ........................................................................................................................................................................... 10 PELVIC TILTS ................................................................................................................................................................................. 11

MUSCLES THAT AFFECT THE PELVIC TILT ................................................................................................................................ 12 VIDEO 2 ............................................................................................................................................................................................. 13

CROSS SECTION OF A MUSCLE ..................................................................................................................................................... 14 MOTOR UNIT ................................................................................................................................................................................ 15

Muscles that affect the neck ................................................................................................................................................... 16 TYPES OF MUSCULAR CONTRACTIONS ........................................................................................................................................ 17

Muscles that affect the spine and torso .................................................................................................................................. 19 Muscles that affect the pelvis ................................................................................................................................................. 20

CORE STABILITY ............................................................................................................................................................................ 21 Functions of the Transverse Abdominus ................................................................................................................................. 22 Posterior Support: back ........................................................................................................................................................... 22 ‘Pelvic core’: pelvic floor and deep sacral glutes ..................................................................................................................... 22 DIAGRAM 2.9 Pelvic floor and deep sacral glutes ................................................................................................................... 23

Pelvic Floor ...................................................................................................................................................................... 23 Piriformis ................................................................................................................................................................................. 23

STABILIZERS, INITIATORS AND MOVERS ...................................................................................................................................... 24 VIDEO 4 ............................................................................................................................................................................................. 25

MUSCLE ANATOMY ...................................................................................................................................................................... 26 Upper extremity ...................................................................................................................................................................... 27 Lower extremity ...................................................................................................................................................................... 30

Conclusion ......................................................................................................................................................................................... 34 References: .................................................................................................................................................................................. 35


INTRODUCTION

Outline of course: Functional Anatomy and Biomechanics Immerse yourself into Functional Anatomy and Biomechanics As a movement professional, it is vital that you have a comprehensive understanding of the biomechanics and anatomy of the human body. However, just knowing the names of muscles and where they are is not sufficient if you teach movement and exercise. You need a deeper understanding of how the muscles relate to one another and how they react on an individual. Each client can be viewed as a unique puzzle, and through a comprehensive understanding of the anatomy, all the parts of their puzzle will fit together perfectly. You are about to embark on a journey of anatomical discovery, which will enable you to teach with confidence. We are going to jump right back to the basics and start unfolding the amazing world of the human body in movement. Get ready to absorb all that there is to learn about YOUR amazing structure. Aim: This course will teach the professional about the Musculoskeletal system and how this system responds when moving. It will enable the professional to analyse movement on an anatomical level and therefore, allow the professional to teach classes that embrace a better understanding of their client’s bodies as they move. They will learn compensations due to muscular restrictions and by the end of this course will know the muscles, their names and the movements that they produce as well as their antagonists. Course description:

➢ Anatomical terminology relating to movement

➢ Planes of motion

➢ A look at the skeletal system

➢ A comprehensive look at the muscular system

Course requirements:

➢ Computer, Internet, Manual (to be printed off of website), stationery

Course agenda:

1. This course is done online at a time convenient for the candidate

2. The course is presented via a video so the candidate is able to watch the course and follow the presenter from the manual

3. The course is divided into 5 sessions and therefore, they can do one session at a time

4. The course duration is approximately 5 hours

5. At the end of the final session, you are to complete a test at your convenience

6. They will also receive the 1-page course summary

7. A certificate will be available once they have achieved 70% on the test


Anatomical terminology

The spine and pelvis

The Skeletal System

The Spine and Pelvis in relation to ‘core’

VIDEO 1


It is very important to know anatomical terminology as an instructor. It allows you to communicate and understand other practitioners and also informs them that you are serious and informed. It also allows us to understand professional literature and publications. Here are some basic terms to familiarise yourself with.

Positional terminology Anatomical position Standing, feet and palms facing towards the front Supine Lying on your back Prone Lying on your abdomen

Directional terminology Anterior In front of / to the front Posterior To the back of / behind Lateral Toward the outside Medial Toward the centre Inferior Below / towards the feet Superior Above / towards the head Proximal Closer to the centre Distal Further from the centre Abduct Away from the midline Adduct Towards the midline

Joint Movements

Flexion: Movement in an anterior direction/ bending or folding of a joint

Extension: Movement in a posterior direction/ straightening of a joint

Abduction: Movement away from the midline or centre

Adduction: Movement towards the midline or centre

Medial or internal rotation: Rotation or turning towards the centre/ inward

Lateral or external rotation: Rotation or turning towards the side/ outward

Dorsi flexion: flexing the foot

Plantar flexion: pointing the foot

Hyperextension: Excessive movement in the direction of extension. Note that the agonist is working / shortened and that the antagonist is lengthened / weakened e.g. swayback knees or Lordotic posture (exaggerated arched lumbar spine) of the lumbar vertebrae. Circumduction: Combination of flexion, extension, abduction and adduction

TERMINOLOGY


Muscles can be categorised as:

Agonist - Primary mover (muscle) producing movement

Antagonist - Works opposite to the agonist Example: when flexing the forearm at the elbow, the agonist will be the Biceps Brachii, the antagonist is Triceps Brachii.

Synergist - Assists agonist, e.g. obliques, in chest lift.

Three planes of motion exist at right angles to each other.

▪ Sagittal plane – mid sagittal divides body equally into left & right for flexion and extension of our appendages and spine ▪ Coronal plane – mid coronal divides body equally into front and back for abduction & adduction of our appendages ▪ Transverse plane – divides body into upper & lower for rotation of the shoulder, hips and spine

DIAGRAM 1.1 planes of motion

An exercise can happen in any one of these planes or a combination of two or three of them. An example of all three would be chest lift on the mat with crisscross where the arms are in abduction and the elbows and legs are in flexion. As you do the crisscross your body will go into the transverse plane.

Exercise Plane

Pelvic curl

Chest lift

Wall glutes

Chest lift criss cross

PLANES OF MOTION

Sagittal plane Coronal plane Transverse plane

DIAGRAM 1.2 The spine


Movements of the spine and pelvis Flexion Movement in an anterior direction – bending over forwards Extension Movement in a posterior direction – bending over backwards Rotation The left or right turning of the torso / neck Lateral flexion Bending sideways or lateral movement of the torso / neck Pelvic Tilt Anterior pelvic tilt, posterior pelvic tilt or lateral pelvic tilt Please note that no abduction or adduction can occur with the spine. Notes: Spine (note the Anterior and Posterior Longitudinal Ligament)

24 Vertebrae: 7 cervical

12 thoracic 5 lumbar 5 sacral (joins the pelvis to the spine at the Sacroiliac Joint) 4 coccyx

12 ribs These attach to the thoracic vertebra T1 - T12

THE SPINE AND PELVIS

Cervical

Thoracic

Lumbar


SKELETAL ANATOMY

Skull

Spine

Gleno-humeral joint

Humerus

Iliac Crest of pelvis

ASIS

PS

Ischial Tuberosity

Femur

Metatarsals

Ribs

Radius

Ulna

Greater Trochanter

Patella

Tibia

Fibula

Phalanges

Phalanges

Metacarpals

DIAGRAM 1.3 The skeleton


Upper extremity

1. Scapula / shoulder blade

The scapula has an inferior and superior angle as well as a medial, lateral and superior border. It has various muscles attached to it that facilitate shoulder stabilization or humeral movement and rotation. It is a gliding joint and glides across the back of the rib cage.

2. Clavicle

This refers to the collarbone (collarbone attaches to shoulder blade).

3. Gleno-Humeral

joint

Shoulder joint, where the head of the humerus fits into the cup shaped glenoid cavity. A ball and socket joint which is shallow, allowing for the largest range of motion but the least stability. The glenohumeral joint works together with the scapulae for shoulder stabilisation.

4. Humerus

This is the upper arm bone. The head of the humerus fits into the glenoid cavity to form the ball and socket shoulder joint.

5. Ulna, radius

Parallel bones in forearm where the ulna ends at the elbow or decranon.

6. Olecranon

This is the anatomical word for the elbow. It is also named the decranon.

7. Carpals

2 rows of 4 bones in wrist which are followed by the metacarpals and then the phalanges (fingers).

Lower extremity

1. Pelvis This is formed by the fusion of the ilium, ischium and pubis. The sacrum and coccyx forms part of the pelvis and the pelvis attaches to the spine at the sacro-iliac Joint (SIJ).

2. ASIS

Anterior superior iliac spine. This refers to our hipbones on the anterior side of the body. This is one of our reference points when referring to neutral pelvis.

3. PS

Pubic symphysis. This refers to the pubic bone, a cartilaginous joint and important when referring to neutral pelvis.

4. Acetabulum

This refers to the hip socket, where the head of the femur fits deeply into the cup shaped acetabulum forming the ball and socket hip joint.

5. Femur

This is the upper leg bone and is the longest bone in the body. The head of the femur forms part of the hip joint and it is important to note the greater trochanter (lateral) and the lesser trochanter (medial).

6. Tibia

This is the medial shin bone and ends in the medial malleolus (ankle bone). It is much thicker than the fibula. Note: This bone can be prone to tibial torsion where a person externally rotates from the feet / knee instead of from the hip. This puts pressure on the tibia and creates a shear force on the knee joint leading to knee problems.

7. Fibula

This is the lateral shin-bone and starts at the base of the knee and ends in the lateral malleolus. (anklebone).


Lower extremity continued

8. Patella This is the kneecap. It is a floating or sesamoid bone and can therefore be affected by the balance and strength between the medial and lateral quadriceps, as well as the tibia and fibula’s positioning

9. Calcaneus

Also known as the heel bone. The achilles tendon attaches to the calcaneus

10. Tarsals

The ankles and its bones, which are followed by the metatarsals and end in the phalanges or toes. It is important to have flexibility in the feet for an efficient gait cycle

NEUTRAL PELVIS

Ilium

Head of femur

Greater Trochanter

Lessor Trochanter

Spine

Sacroiliac joint

ASIS

AIIS

Sacrum

Ischial Tuberosity

Pubis

THE PELVIS

DIAGRAM 1.4 The pelvis


Two important to concepts to understand when teaching Pilates are; neutral pelvis and neutral spine. Neutral pelvis is when the two ASIS (Anterior superior iliac spine) are in the same transverse plane and the ASIS and the PS (pubic symphysis) are in the same horizontal plane when lying supine (coronal when erect). Therefore, they form a flat plate when lying supine and a 0° horizontal line when standing up. Once you achieve neutral pelvis, your spine follows its natural curves and this is neutral spine. Please note you can have a neutral pelvis position but not a neutral spine i.e. chest lift. Neutral pelvis allows the spine to follow its natural curves. It is important to note that each person has a slightly different neutral spine due to their spinal structure. However, the spine is best supported when the pelvis in in neutral. Please note that for some clients, a neutral spine might not be ideal due to past injury or operations i.e spinal fusion.

✓ Neutral pelvis encourages better posture ✓ It is injury preventative for the spine, especially the lumbar spine, and therefore a “protection mechanism” ✓ It allows for good alignment and therefore isolation into muscle groups, stabilising with one muscle group while

working another group simultaneously ✓ It allows for hip disassociation and hip-flexor abdominal co-ordination

Posterior tilt: PS is higher than the ASIS (tuck). Anterior tilt: ASIS is higher than the PS (arch). Lateral tilt: ASIS is higher than the other ASIS when viewed from the front or back.

TIP: When trying to figure out a pelvic tilt, ask yourself “where do the hip bones go?” If one of these tilts is permanently present then various muscle imbalances occur and this leads to a chain reaction throughout the body: Using the muscles given above, complete the table below.

PELVIC TILTS

DIAGRAM 1.5 Pelvic tilts


Below are muscles that affect movement of the pelvis (please note that there are more than the below muscles that affect the pelvis however, the below muscles are the primary movers): The pelvis is an extremely complex structure and forms the bridge between the upper and lower extremities. Due to its importance it has various muscle groups around it and within it to maintain its stability.

Abdominals: ▪ Internal oblique ____Posterior tilt________________________ ▪ Rectus Abdominus ______________________________________ ▪ External oblique

Back extensors:

▪ Multifidus ____Anterior tilt_________________________ ▪ Erector spinae (Spinalis ______________________________________

Longissimus & Iliocostalis) ▪ Quadratus Lumborum

Hip flexors:

▪ Iliopsoas (Iliacus, Psoas) ▪ Rectus Femoris

Hip extensors:

▪ Gluteus Maximus ____Posterior tilt________________________ ▪ Semitendinosis, Semimembranosus, ______________________________________ ▪ Biceps Femoris ______________________________________

Hip abductors:

▪ Gluteus Minimus ▪ Gluteus Medius ______________________________________ ▪ Tensor Fasciae Latae ______________________________________

Hip adductors:

▪ Gracilis ____Lateral tilt__________________________ ▪ Adductors (Longus, Magnus, Brevis) ______________________________________ ▪ Pectineus ______________________________________

Pelvic Tilt Concentric (shortened) Eccentric (lengthened) Anterior

Hip flexors Back extensors

Hip extensors Abdominals

Posterior

Hip extensors Abdominals

Hip flexors Back extensors

Lateral (left hip higher)

MUSCLES THAT AFFECT THE PELVIC TILT

Posterior Tilt

Anterior Tilt

Anterior Tilt

Posterior Tilt

Lateral Tilt

Lateral Tilt


Anatomy of the neck

Skeletal muscle and motor units

Types of muscle contractions: Isotonic and Isometric

VIDEO 2


Each skeletal muscle fiber is a single cylindrical muscle cell. Different types of muscles: Cardiac muscle (heart), smooth muscle (hollow organs and internal viscera) and skeletal muscle Skeletal muscle cells (fibers), like other body cells, are soft and fragile. The connective tissue covering furnish support and protection for the delicate cells and allow them to withstand the forces of contraction. The coverings also provide pathways for the passage of blood vessels and nerves.

The connective tissues of the muscle extend beyond the muscle to form the tendon that will then attach the muscle to the bone. Skeletal muscles have a large blood supply and nerve supply. This supports it primary function of contraction. An impulse from a nerve cell is sent to the muscle in order for it to contract. At least one artery and one vein supply each nerve and penetrates the epimysium. There are approximately 434 voluntary muscles in the body but only 75 pairs are involved in general posture.

CROSS SECTION OF A MUSCLE

Endomysium. Connective tissue that wraps an individual muscle fibre. Perimysium. Connective tissue that wraps bundles of muscle fibres - the "bundles" being known as fasicles or fasiculus. Epimysium. Connective tissue that wraps the entire muscle. Fascia (or "deep fascia") covers the entire muscle and is located over the layer of epimysium.

Endomysium

Perimysium

Epimysium

Fascia

Tendon Bone

DIAGRAM 2.1 Cross session of a muscle

http://www.ivy-rose.co.uk/References/glossary_entry645.htm


Muscles are named by: ▪ How many / grouping e.g. triceps and biceps. ▪ Action e.g. adductor magnus ▪ Fibre organisation e.g. VMO ▪ Location or relative position e.g. rectus femoris or serratus anterior ▪ Structure, size & shape e.g. gluteus maximus.

MOTOR UNIT

A motor unit can be defined as the neuron and the muscle fibres it innovates. The groups of muscle fibres innervated vary from 3 to 100’s. It contracts on the all / nothing principle. This is where a muscle fibre will not contract partially, it contracts fully. The amount of force is produced by the amount of muscle fibres that contract. Force is gauged by the number of units innovated. Larger muscles have more motor units & more muscle fibres creating a greater force.

DIAGRAM 2.2 A motor unit


DIAGRAM 2.3 Neck anatomy

Muscles that affect the neck

1. Scalenes Anterior Medius Posterior

Lateral neck flexion on the same side & rotation. It is important that you teach a client how to stretch these muscles correctly to relieve tension in the neck. Remember to ensure good thoracic and neck alignment whenever doing a neck stretch and never too much pressure of the neck.

2. Sternocleidomastoid

Lateral neck flexion on same side, neck flexion & rotation to opposite side. It is important that you always teach good neck alignment to avoid overworking this muscle. You can also do gentle stretching of this muscle as it can be the culprit of headaches.

3. Trapezius

Upper Middle Lower

In Pilates we often focus on stretching / release of the upper trapezius and strengthening of the middle and lower trapezius. Upper fibres elevate scapula, middle fibres facilitate scapula adduction and lower fibres depress scapula. When this is tight, it also restricts full concentric activation of the serratus anterior.

4. Levator scapulae

This is situated on the superior angle of the scapulae and attaches to C3, C4 and C5. This is also important to stretch to relieve neck tension as it elevates the scapula. When this is tight, it also restricts full concentric activation of the serratus anterior.

5. Longus Capitis 6. Longus Colli

Facilitates neck flexion and rotation and is referred to as the deep neck flexors. We focus on these when a client is noted as having a poking chin.

7. Splenius Capitis

Extend neck (bilaterally) & lateral neck flexion & rotation on same side and is situated underneath the trapezius.

8. Splenius Cervicis

Extend neck (bilaterally) & lateral flexion on same side and is situated underneath the trapezius.

Scalenes Sternocleidomastoid Trapezius

Levator Scapula Longus Capitis Longus Colli Splenius Capitis


Isometric contraction (Static) - Contraction of a muscle maintaining a static position, e.g. maintaining shoulder flexion while doing moving squats (deltoid). Maintaining a deep squat (quadriceps)

Isotonic contraction (Moving) - “Moving contraction”

Contraction of muscle through partly or the full range of motion against resistance ▪ Concentric – positive movement / shortening contraction. Angle decreases. ▪ Eccentric – negative movement / lengthening contraction. Angle increases.

TYPES OF MUSCULAR CONTRACTIONS


Anatomy of the back and pelvis

Core stability

VIDEO 3


Muscles that affect the spine and torso

1. Multifidus

Runs from sacrum to cervical spine and spans 2 to 4 vertebrae, therefore it acts as a stabilizer. Due to this it is categorized as one of the core muscles. It also facilitates rotation contralaterally.

2. Rotatores

Runs from the transverse process of one vertebra to the spinous process of the vertebra above it (It looks like a Christmas tree). It facilitates extension of vertebral column and rotation contralaterally as well as local extension of the spine. It will also work when you do segmental spinal extension and acts as a proprioceptor for the vertebra.

3. Erector Spinae:

Spinalis Longissimus, Iliocostalis

Runs from the sacrum up to the cervical spine. It facilitates back extension, aids as a synergist in spinal lateral flexion as it controls spinal flexion eccentrically. Segmental back extension is performed by the spinalis. The erector spinae also pull the pelvis into an anterior pelvic tilt through facilitating lumbar extension.

4. Quadratus Lumborum

.

This runs from the Iliac crest diagonally towards the spine and onto the last rib, therefore it plays a role when we breath. It also facilitates lumbar back extension, lateral trunk flexion, lateral hip raise and pulls the pelvis into an anterior or lateral pelvic tilt.

5. Transverse Abdominus

Deepest abdominal layer, that is like a broad band that wraps the torso like a corset from ribs to pelvis. It also works on expiration. It aids in lower trunk stability, supports the abdominal viscera, narrows waistline and closes the ribcage on expiration. It is not a spinal or pelvic mover!

6. Internal Oblique

Fibres run diagonally upward from the lateral pelvis towards the proximal ribs. Facilitates trunk rotation towards the direction of rotation, lateral spinal flexion and assists in trunk flexion.

7. Rectus Abdominus

Divided into compartments by connective tissue creating the ‘8 blocks’. It runs from the ribs to the pubic symphysis. It facilitates trunk flexion and pulls pelvis into a posterior tilt. It is also a synergist in lateral flexion of trunk. The rectus abdominus is capable of upper or lower torso isolation which is important for posture improvement.

8. External Oblique

Fibres run diagonally downward from the ribs toward the pubic symphysis. It facilitates trunk rotation away from the direction of rotation, lateral spinal flexion and assists in trunk flexion.

Multifidus Rotatores Erector spinae Quadratus lumborum Rectus Abdominus & Obliques

DIAGRAM 2.4 Spine and torso anatomy


Muscles that affect the pelvis

1. Pelvic Floor – PF (stabiliser)

This forms a hammock within the pelvis. It stabilises and compresses the SIJ. It resists intra-abdominal pressure and forms a brace for all our organs from the inferior portion of our pelvis.

2. Iliacus

This attaches pelvis to femur and it runs from the anterior Iliac crest to lesser trochanter of the femur. It facilitates hip flexion.

3. Psoas Major and

Minor

This attaches lumbar spine to femur (lumbar spine to lesser trochanter) and acts as a stabiliser of the spine and pelvis. It also facilitates hip flexion (very important when relating to hip disassociation with the gait cycle). The psoas minor facilitates a slight posterior pelvic tilt.

4. Rectus Femoris

This runs from the anterior inferior iliac spine to the quadriceps tendon that attaches onto the tibia. It facilitates hip flexion (especially when other hip flexors are weak) and it facilitates knee extension.

5. Gluteus Maximus

This attaches from the sacrum at the area of the sacroiliac joint and medial iliac crest to posterior greater trochanter. It covers a broad area of the posterior pelvis and it facilitates hip extension, hip abduction and lateral / external hip rotation. This is weak in many clients and therefore causes hip stability imbalances.

6. Gluteus Minimus and Gluteus Medius

Gluteus minimus runs from the anterior ilium to the greater trochanter while gluteus medius runs from the medial to posterior ilium to the greater trochanter. They both act as medial hip rotators, hip abductors and hip stabilizers. However, the gluteus medius is also active during lateral rotation of the hip. These are our main hip stabilizers.

7. Hamstrings

Biceps Femoris Semimembranosus Semitendinosus

Biceps femoris: Lateral hamstring, runs from ischial tuberosity and attaches to fibula. It has two heads where one ends mid femur and the other runs from ischial tuberosity to fibula. Semimembranosus and semitendinosus: Medial hamstrings, run from ischial tuberosity and attaches to tibia. Facilitates knee flexion, hip extension, medial (medial hamstrings) and lateral (lateral hamstring) knee rotation.

Pelvic Floor Iliacus Psoas Rectus Femoris Gluteus Maximus

Gluteus Medius Gluteus Minimus Biceps Femoris Semimembranosus Semitendinosus

DIAGRAM 2.5 Pelvis, hip and knee anatomy


Core stabilization refers to the stability that occurs at the musculature of the trunk, but specifically those muscles that are responsible for deeper stability (pelvic floor, transverse abdominus, multifidus and psoas). Research has shown that the psoas also plays a role in stabilization as well as the diaphragm. The core is a controversial subject that has led to endless research and it is imperative that an instructor understands the anatomy and how the muscles work and activate. The only ‘core’ muscles that are movers are the psoas and multifidus. The transverse abdominus and the pelvic floor facilitate no joint change and therefore cannot be viewed as muscles that can cure all back ache when stronger because they do not change pelvis or spinal position.

CORE

Many people tend to think that if their “blocks” are strong then so is the core. It is important to encourage the stabilisers and emphasize them specifically during a high load or difficult exercise. It is imperative that each individual understands a true core contraction versus a high load abdominal contraction. Especially if they are training for a specific sport. As stated, the focus of the core has changed. It is for this reason that some of the core stabilisers cannot correct our posture. Instead they assist in stabilising and protecting the spine by alleviating pressure off of the back and pubic bone, by drawing the abdomen in and taking load off of the back. It allows the appendages to move freely and efficiently, producing a stronger movement. There are various other muscles which produce movement that are imperative when correcting posture. This module discusses the stabilisers and mobilisers, both of which work together to create a strong torso and healthy spin

CORE STABILITY

Pelvic floor Transverse Abdominus Psoas Multifidus

DIAGRAM 2.6 Core


Functions of the Transverse Abdominus

▪ It is the deepest layer of abdominals ▪ Assists in stabilizing the lower trunk ▪ Compresses & supports abdominal viscera, acts like a corset to narrow the waistline ▪ Alleviates pressure off of the lower back when the abdomen is larger ▪ Works on expiration and brings ribs closer to each other ▪ Think of 30% effort to work, you are looking for a light but deep contraction ▪ Draws navels towards spine or narrows the waistline (essential for toning) ▪ It assists with lumbar back support because of its attachment into the thoracolumbar

fascia

Posterior Support: back

DIAGRAM 2.8 Back extensors

Multifidus ▪ Stabilizes vertebrae and spine ▪ Spinal rotation contralaterally

Rotatores

▪ Stabilize vertebrae ▪ Assists with local (isolated) extension, segmental back extension and rotation of vertebral column ▪ Acts as a proprioceptor for the vertebra

Erector Spinae

• Extends the spine

• Controls flexion

• Assists with lateral flexion

Serratus Posterior Inferior

• Spinal rotation

• Works during breathing

Multifidus Rotatores Erector Serratus Posterior Inferior

DIAGRAM 2.7 Transverse abdominus


‘Pelvic core’: pelvic floor and deep sacral glutes

DIAGRAM 2.9 Pelvic floor and deep sacral glutes

Pelvic Floor

Note: It is a feeling of zipping up at the area of the perineum from front to back or it is a feeling of pushing the coccyx up to the SIJ or pulling the Ischiums in towards each other.

▪ Pubococcygeus ▪ Iliococcygeus referred to as the Levator Ani muscles ▪ Puborectalis

Coccygeus - Forms part of the pelvic floor

Posterior Pelvic Floor or deep sacral glutes Obturator Internus

▪ Laterally rotates hip ▪ Abducts hip when hip is in flexion

Piriformis

▪ Laterally rotates hip ▪ Abducts hip

Gemellus Inferior and Superior

▪ Laterally rotates an extended hip ▪ Abducts a flexed hip

_______________________________________________________________________________________

Psoas Major and Minor have an attachment to the fascia of the pelvic floor ▪ Hip flexion ▪ The only muscle that joins the femur to the lumbar spine, an important pelvic and spinal stabiliser


Every movement & exercise we do can be divided into muscles that produce the movement and muscles that stabilize the movement. The muscles are equally important in maintaining the integrity of the exercise. Together with the mover & stabilizer, there is an initiator. This is the first muscle group that will work at the start of the exercise and is extremely important for the correct recruitment of muscles. The initiator is often also the primary mover. Always focus on the stabilizers as Pilates is based on this principle and remember that a muscle can have a dual purpose. If you are able to understand initiators, movers and stabilizers then you are able to understand compensations as they occur.

STABILIZERS, INITIATORS AND MOVERS


Anatomy of the upper and lower extremity anatomy

VIDEO 4


DIAGRAM 3.1 upper extremity anatomy

MUSCLE ANATOMY

Levator Scapula

Supraspinatus Groove

Posterior Scapula

Rhomboid Minor

Rhomboid Major

Upper Trapezius

Middle Trapezius

Posterior Deltoid

Infraspinatus

Teres Major Lower Trapezius Teres Minor


Upper extremity

1. Subscapularis

Situated on the anterior border of the scapulae and attaches to the anterior humerus. Facilitates medial rotation and adduction of the humerus. Holds humeral head in the glenoid cavity and therefore forms part of the rotator cuff.

2. Supraspinatus

Synergist to the deltoid in shoulder abduction (1st 30 degrees) and works with the other rotator cuff muscles to hold humeral head in its socket and facilitates lateral shoulder rotation.

3. Infraspinatus

Situated on the posterior border of the scapula and attaches to the posterior upper humerus. It is responsible for external rotation of the humerus as well as humeral head stabilization.

4. Teres minor

Situated on the posterior, inferior border of the scapula and attaches to the posterior upper Humerus. It is responsible for external rotation of the humerus as well as humeral head stabilization.

5. Teres major

Situated on the inferior posterior scapula and attaches to the anterior part of the humerus. Facilitates internal rotation and adduction of the humerus.

6. Rhomboids

Situated between the shoulder blades at the medial borders of the scapula. Facilitates adduction of the scapula and rhomboid minor facilitates scapula elevation. This is important to strengthen if a clients’ posture is kyphotic.

Rotator cuff

Subscapularis Supraspinatus Infraspinatus

Teres Minor and Major Rhomboids

Teres minor

Teres major

DIAGRAM 3.2 Anatomy of the shoulder


Upper extremity continued

1. Serratus anterior

Situated on the anterior medial border of the scapulae to the anterior ribs. It abducts or protracts the scapula as well as keeps it flat on the ribs. This muscle forms a vital part of shoulder stability.

2. Pectorals

This is divided into the pectoralis major and pectoralis minor. Pectoralis major runs from the clavicle to the upper anterior humerus to the ribs. Pectoralis minor runs from the scapula (coracoid process) to the ribs. This is often tight in many people and creates shoulder stability issues. Pectoralis minor rolls the shoulder blade forward and it anteriorly tilts the scapula. It is important to test which pectorals are tight to get the maximum results from stretching and optimal results when performing shoulder stability. Pectoralis major performs shoulder flexion, medial rotation of the humerus and horizontal shoulder adduction.

3. Latissimus dorsi

Situated at the upper anterior humerus to the lumbar fascia. This is responsible for extending, adducting and medially rotating the humerus. It can also pull the humerus away from its socket when forced scapula depression is emphasized which then weakens the shoulder joint over a long period of time.

4. Deltoid

This is for flexing, abducting and extending the humerus. It can be divided into the anterior, medial and the posterior deltoid.

5. Biceps brachii

Works with the brachialis to facilitate elbow flexion and the short head which is attached over the shoulder joint to the coracoid process assists the anterior deltoid in shoulder flexion.

6. Brachialis

Situated from the mid humerus to over the elbow joint and lies beneath the biceps brachii. This also facilitates elbow flexion.

7. Triceps brachii

Situated from the upper posterior humerus to over the elbow. The long head is situated over the shoulder joint (attaches to the scapula) and therefore the long head of the tricep assists the latissimus dorsi with shoulder extension as well as shoulder adduction but the triceps primary function is elbow extension.

Serratus Anterior Pectoralis Minor Pectoralis Major Latissimus Dorsi Deltoids

Brachiallis Biceps Brachi Triceps Brachii Short head Triceps Brachii Long head

DIAGRAM 3.3 Anatomy of the shoulder and arm


DIAGRAM 3.4 Lower extremity anatomy


Lower extremity

1. Iliopsoas

Situated from the lumbar vertebra to the lesser trochanter (psoas). Iliacus runs from the iliac crest to the lesser trochanter. It facilitates hip flexion and an anterior pelvic tilt. Psoas also acts as a stabilizer together with the core.

2. Rectus femoris

Situated from the AIIS (anterior inferior iliac spine) to over the knee at the quadriceps tendon. Facilitates knee extension as well as hip flexion.

3. Vastus medialis oblique

(VMO)

Situated on the medial femur to over the knee at the common quadriceps tendon. Facilitates knee extension and is essential for knee stability, especially if the lateral side of the thigh / knee is hypertrophic (overactive / overdeveloped).

4. Vastus lateralis (VLO)

Situated on the lateral femur to over the knee at the common quadriceps tendon. Facilitates knee extension and is essential for knee stability if the medial side of the thigh / knee is hypertrophic (seldom).

5. Sartorius

Situated from the ASIS to the medial superior tibia. Facilitates knee flexion with lateral rotation and hip flexion as well as hip abduction (ballet attitude position).

6. Tensor fasciae latae

Situated from the lateral pelvis onto the lateral femur followed by the iliotibial band that attaches to the lateral tibia. Facilitates hip flexion, medial hip rotation and hip abduction (it can compensate for the gluteus medius in hip stability).

7. Gluteus Minimus

Situated just underneath the gluteus medius more anteriorly on the hip. It is responsible for assisting the gluteus medius with hip stability and it medially rotates the hip. It steadies the pelvis on the leg when opposite leg is raised.

Iliacus Iliopsoas Psoas major & minor Rectus Femoris Vastus Medialis Oblique

Vastus Lateralis Oblique Sartorius Tensor Fasciae Latae Gluteus Minimus

DIAGRAM 3.5 Anatomy of the hips and knees



1. Gluteus Medius

Situated underneath the Gluteus Maximus on the lateral part of the pelvis, attaching at the greater trochanter. Facilitates medial and lateral hip rotation, hip abduction and is a synergist to hip flexion and extension. It steadies the pelvis on the leg when the opposite leg is raised (multifunctional).

2. Gluteus Maximus

Situated on the posterior pelvis by the iliac crest, to the sacrum and over to the greater trochanter. It is the most superficial glute muscle. Facilitates hip extension, lateral hip rotation, hip abduction and raises the trunk from a flexed position.

3. Piriformis

Situated from the sacrum to the femur at the superior, posterior region of the greater trochanter. Facilitates external rotation and abduction of the hip. Aids in stability of the hip joint.

4. Obturator internus and

gemelli

Situated from the posterior ischium to the posterior greater trochanter. Facilitates lateral rotation of an extended hip and abducts a flexed hip. Gemelli also facilitates hip adduction and hip extension.

5. Quadratus femoris

Situated from the external border of the ischial tuberosity to the intertrochanteric crest of the femur. Facilitates lateral rotation and adduction of the hip joint and steadies the femoral head in the acetabulum.

Gluteus Medius Gluteus Maximus Piriformis Obturator Internus

Gemelli Quadratus Femoris

DIAGRAM 3.6 Anatomy of the hips and pelvis


Anatomy of the lower extremities

Conclusion

VIDEO 5



1. Adductor Longus

Situated more medially and superiorly on the pubis to the mid femur medially. Facilitates adduction and flexion of the hip.

2. Adductor Magnus

Situated from the pubis to the medial length of the femur. Facilitates adduction of the hip joint as well as flexion and extension of the hip as it has anterior, medial and posterior fibres. It is also the largest of the adductor muscles. Therefore, you will feel the adductors work when you walk up the stairs

3. Adductor Brevis

Situated from the pubis to the superior medial femur. Facilitates adduction and hip flexion of the hip joint.

4. Pectineus & Gracilis

Pectineus is situated from the superior section of the pubis (top of the sunglasses) to the medial superior femur. Gracilis is situated from the inferior medial border of the pubis to the tibia medially and they both facilitate hip and hip flexion adduction. Pectineus also assists with lateral hip rotation.

5. Biceps femoris

Situated from the ischial tuberosity to the lateral anterior fibula. This is our lateral hamstring muscle which has two heads. It facilitates knee flexion minimal lateral knee rotation as well as hip extension. The hamstring group dominates hip extension if the gluteus maximus is weak.

6. Semimembranosis,

Semitendinosis

Situated from the ischial tuberosity to the medial anterior tibia. The semitendonosis is situated on top of the semimembranosis and these form our medial hamstrings which are responsible for knee flexion, hip extension and slight medial knee rotation.

Adductor Longus Adductor Magnus Adductor Brevis Pectineus

Gracillis Biceps Femoris Semimembranosis Semitendinosis

DIAGRAM 3.7 Anatomy of the hips and knees continued



1. Gastrocnemius

Situated on the posterior inferior femur to the mid tibia and fibula over the soleus muscle and ending in the achilles tendon which attaches to the calcaneus. This has 2 heads and is responsible for foot plantar flexion especially when the knee is extended.

2. Soleus

Situated underneath the gastrocnemius from the superior tibia and fibula ending in the Achilles tendon. This is also for foot plantar flexion especially when the knee is flexed.

3. Tibialis anterior

Situated at the upper tibia to the medial foot under the arch of the foot. Facilitates dorsi flexion and inversion of the foot therefore causing supination of the foot.

4. Tibialis posterior

Situated at the posterior mid fibula to medially at the calcaneus and under the foot. This is responsible for the inversion of the foot and is important to strengthen if a client pronates their feet therefore facilitates supination of the foot.

5. Peroneus longus

Situated at the lateral superior fibula to the lateral ankle to under the foot. Facilitates foot eversion therefore causing pronation if excessively used. This is important to strengthen if a client supinates their foot.

6. Peroneus brevis

Situated from mid lateral fibula to the lateral maleolus continuing to under the foot. Facilitates foot eversion therefore causing pronation if excessively used. This is important to strengthen if a client supinates their foot.

Conclusion Knowing and understanding your anatomy plays a vital role in teaching any movement or exercise. It enables you to design programs that meet your clients needs and it enables you to lead them comfortably towards their goals. This introduction to anatomy will give you a strong base to continue this journey into a more detailed discovery of anatomy.

Gastrocnemius Soleus Tibialis Anterior Tibialis Posterior Peroneus Longus Peroneus Brevis

DIAGRAM 3.8 Anatomy of the lower leg


References:

Diagrams and images

Diagram number Source Page

1.1 Planes of motion Anandi Gerber 2019 14

1.2 The spine Canstockphoto 15

1.3 The skeleton Anandi Gerber 2019 17

1.4 The pelvis Canstockphoto 19

1.5 Pelvic tilts Anandi Gerber 2019 20

1.6 The pelvic floor Canstockphoto 22

1.7 Transverse abdominus Canstockphoto 22

1.8 Multifidus Canstockphoto 23

1.9 Psoas minor and major Canstockphoto 23

2.1 Cross section of a muscle Anandi Gerber 2019 25

2.2 Motor unit Anandi Gerber 2019 26

2.3 Neck anatomy Canstockphoto 27

2.4 Spine and torso anatomy Canstockphoto 29

2.5 Pelvis, hip and knee anatomy Canstockphoto 30

2.6 Core Canstockphoto 34

2.7 Transverse abdominus Canstockphoto 35

2.8 Back extensors Canstockphoto 35

2.9 Pelvic floor and deep sacral glutes Anandi Gerber 2019 36

3.1 Upper extremity anatomy Anandi Gerber 2019 39

3.2 Anatomy of the shoulder Canstockphoto 40

3.3 Anatomy of the shoulder and arm Canstockphoto 41

3.4 Lower extremity anatomy Anandi Gerber 2019 42

3.5 Anatomy of the hips and knees Canstockphoto 43

3.6 Anatomy of the hips and pelvis Canstockphoto 44

3.7 Anatomy of the hips continued Canstockphoto 46

3.8 Anatomy of the lower leg Canstockphoto 47

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