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Using Anatomy Illustrations to Assess Restrictions.

I have taken on a new project to teach anatomy for yoga. I am in the process of building an anatomy section for a quicker, practical understanding of musculoskeletal anatomy and physiology. I will be expanding my posts on the origin, insertion, function and trapped bones.  When I talk to yoga teachers, the illustrations seem to help them to understand the restriction in a certain movement more easily.

I wrote about the basics of these illustrations in this post. Origin in blue. Insertion in green. Trapped in tan. Combinations in teal.

Here is an example to show you how these help yoga teachers and bodyworkers understand their clients:

Goddess Squat from popsugar.com

A client came in with problems in her shoulder. She could not get the shoulder to retract (move back toward the spine) like the other shoulder. This happens in poses like the Goddess Squat. Also, she had little pain in the front of the shoulder.

Okay, let’s track down the muscles that keep her from getting her shoulder back.

First of all, look closely at this pic. You’ll see that this woman’s left shoulder also does not retract as well as the right one. I wonder if hers hurts too. There are a lot of things that could hurt in this position, but trigger point assessment targets the problem. Trigger points produce predictable sensations on the stretch, but we don’t need the trigger point info to figure this out, we can do it with just looking at the anatomy.

Is it the rotator cuff? Everybody goes there when there’s a shoulder problem. If you click on the image to the left, you’ll see that the rotator cuff can create shoulder pain in this position. As you can see, rotator cuff muscles originate on the scapula and insert on the head of the humerus. They are all about securing the movement of the humeral head in the socket. Well, we can twist the arm in the socket and move it back and forth and up and down and the pain does not change. It hurts when we retract the shoulder blade and it just won’t go back as far as the other side. It is probably not the rotator cuff.
Is it from the pain pattern in this post about the clavicular section of pectoralis major? Pectoralis major protracts the shoulder and might be creating a restriction while retracting. Again, let’s look at the simple anatomy. If we take the elbow forward to shorten the clavicular pec, the scapula still doesn’t retract.

By the way, the clavicular division can be stretched a little more by modifying the posture. When we move the elbow back, there is no change in the pain. It becomes clear that it really involves retracting the scapula.

Something will not lengthen to allow the shoulder to retract. So what else pulls the scapula forward?

Illustrations like this one show a group of related muscles.  These are the deep extrinsic chest muscles, They originate on the anterior (front of the body) ribs and insert on the scapula.  The clavicle gets trapped in the middle.

We have quickly narrowed it down to this group. It is one of these three muscles; subclavius, pectoralis minor or serratus anterior.

It turns out to be pec minor. We can single it out when the person lays on their back. Pec minor pulls the shoulder forward off the mat like you see in this serene beach version of yoga nidra. The right shoulder doesn’t lay on the mat like his left. Classic pec minor. That rascal. If you want to look through the blog, you’d see that this post on pec minor talks about the shoulder pain but that they may also complain about pain in the forearm just below the elbow and it is more likely to occur on reaching up than to the side.

Anyway, there’s a heads-up on where these blog posts are headed. You’ll see a lot of anatomy posts and the associated trigger point posts to allow people to assess postures. There will be some extra anatomy posts to match the trigger point posts that are already out there. They will be organized into groups by tags so that you can look at things like all the rotator cuff muscles or all the shoulder pain patterns to help you.  If you’ve got a comment, suggestion or see an error, send an email to me at the address below.

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Tony Preston has a practice in Atlanta, Georgia where he sees clients.

He has written and taught about anatomy, trigger points and cranial therapies since the mid-90s.

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