Many people ask me, “What do you call what you do?” In short, Myomemory Transformation Advantage or simply M.A.T. It is an integrated, general systems, and functional approach to evaluating human posture and movement developed by me from over forty years of a clinical physical therapy practice treating acute and chronic musculoskeletal pain and over twenty years of participating in the sport of nordic ski jumping.
M.A.T.’s primary goal is to identify dysfunction within your nervous, skeletal, fascial, and muscular systems causing the dysfunction and symptoms of the body’s musculoskeletal system. Persistent and chronic pain is still the most common cause of disability in this country running at an annual cost of $650 billion dollars in healthcare and lost employment with chronic musculoskeletal pain being a big slice of this cost. Therefore, there needs to be a “paradigm shift” in how our medical system looks at musculoskeletal pain and M.A.T. fills that need.
To truly comprehend what I am talking about, look at your body when facing a mirror to get a quick look at your posture in standing. Focus on the position of your head and pelvic and shoulder girdles. The asymmetries most of you will demonstrate may be at the root of your pain complaints and need to be addressed. But even if you are not experiencing pain, these asymmetries should not be ignored. All these visible asymmetries give you clues which suggest dysfunction of your body’s nervous, skeletal, fascial, and muscle systems that if are not addressed, can lead to pain. The asymmetries you see in the mirror suggest areas of soft tissue tightness and weakness and structural abnormalities, like a long leg on one side. Because most people are right-side dominant you expect some of these asymmetries to develop over time.
However whenever discussing human posture and movement, the journey of course has to begin with gravity and ground reaction force (GRF). These constant and vertical forces of our environment experienced day in and day out stimulate and trigger your central nervous system (CNS) into action. They are recognized by your peripheral nervous system (PNS) becoming the circuit breaker in turning on your CNS to create enough internal force by the muscles and fascia to offset or cancel out the effects of these external forces. In doing this, your nervous system (PNS and CNS) establishes skeletal balance and equilibrium creating your vertical balance, stability, mobility, posture, and movement allowing you to function in this environment.
This internal force produced by your body’s nervous system is the product of your neuromuscular and fascial systems working together not in isolation, but in integration creating the holding patterns you learn to move within while performing your activities of everyday life. It is an intimate relationship between the muscles and fascia of your body that create your posture and movement.
These two systems are responsible for your skeletal structure being able to float and move against these outside, vertical forces by creating opposing tensile and compressive forces intertwined and interconnected down to the individual fibers of every skeletal muscle. Therefore, it creates a constant, dynamic dance that is ongoing between the fascial and neuromuscular systems everyday of your life.
The fascial and neuromuscular systems are constantly communicating with each other because when any skeletal muscle contracts producing tension or changes in length in response to gravity and GRF, it affects the tension and length of the global, integrated fascial web through what is called the “myofascia,” the fascia encapsulating the isolated, individual muscles fibers of any skeletal muscle.
It is this dynamic relationship between the isolated muscles and the global fascial web that gives us both views of seeing the body function in isolation and integration against these vertical forces. In fact, the term “myofascia” itself implies that the nature of muscle tissue (myo) and the accompanying web of connective tissue (fascia) encapsulating it is inseparable. M.A.T.’s major focus and goal is on altering or transforming these internal, tensile and compressive forces produced by these two very important and often times forgotten systems of the body responsible for your vertical balance, stability, mobility, posture and movement.
First and foremost, it is important to recognize that the gravitational field of the earth is the most powerful physical influence you experience in life in regards to your vertical balance, stability, mobility, posture, and movement. Ida P. Rolf Ph.D., a biochemist and creator of Structural Integration or “Rolfing,” once stated,“Some individuals may perceive losing their fight with gravity as a sharp pain in their back, others as the unflattering contour of their body, others as their constant fatigue, yet others as their unrelentingly threatening environment. Those over forty may call it old age. And yet all these signals may be pointing to a single problem so prominent that it has been ignored: they are off balance, they are at war with gravity.” It is easy to accept the presence of gravity on earth, but not recognize how essential it is to your functional posture and movement. Ida Rolf goes onto say, “Gravity is always there; You can never escape it. From the day that single cell is fertilized and develops, gravity is with us. The fetus in the woman’s womb is under the effect of gravity and until the undertaker gets the body and lays it away, it is under the effect of gravity.”
The vertical force of gravity drives everything towards the center of the earth, including you. When the acceleration of your body’s center of mass interacts with gravity, the equal and opposite reaction vertical force provided by the earth’s surface (GRF), creates a chain reaction within your nervous system. Under the same breath of gravity, you have to recognize that this opposite and vertical force is an essential component of your posture and movement. Your isolated joint motions in this kinetic chain reaction to GRF especially of the lower extremities causes lengthening and loading of your muscles.
Your body’s muscles react by adding active muscle force in response to this gratis complementary force or the passive force of GRF in order to effectively and efficiently accomplish any intended, functional task you chose to do during your life. In addition to turning the muscles on during functional tasks, GRF also stimulates your muscles to become torque sensors where torque is a measure of rotatory strength with which the body moves. This rotator force can act on any isolated joint and segment as well as on the integrated skeletal structure. For torque to be acting at any isolated segment and the integrated body, two forces that are equal in magnitude but opposite in direction referred to as force couples must be present.
In your body’s reaction to GRF, rotational or torque forces are created that need to be dampened and controlled to prevent injury to your body’s bones, joints, and soft tissues. Your body’s muscles involving the proprioceptive sensory input are able to sense the torque produced by GRF and use this information to orchestrate the proper combination of muscle contractions in order to successfully dampen and control the forces of torque in the execution of a desired functional movement. The production of a torque force is where your body gets its power no matter the activity.
As already mentioned, it is your nervous system that creates your vertical balance and equilibrium and more specifically your CNS. Therefore, M.A.T. is foremost a brain driven system relying on the brain’s innate ability to recognize and predict neuronal patterns. In posture and movement, your brain is designed to recognize a pattern of neuronal activation and know the correct way to respond in reaction to gravity and GRF.
This response is based upon the memory of your genetic and inherent neurodevelopmental sequence along with your life experiences living in this environment of gravity and GRF. During research of posture and movement, researchers have found distinct firing patterns of individual neurons the brain uses when forming these memories and are replayed when remembering the experience. Each neuronal pattern developed in your nervous system was found to be the underlying and foundation of all your future patterns. Therefore, if there is inefficiency in one neuronal pattern, it will affect all others. As an example, foundational to all your posture and movement patterns your brain develops overtime is breathing. Dr. Karel Lewit, M.D. emphasized this in his statement, “Respiration is our primary and most important movement pattern…and is also the most dysfunctional.”
These patterns of neuronal activation within the brain regarding posture and movement are defined in M.A.T. as its four neuromyofascial patterns including the deep and superficial anterior/posterior linear, side linear, diagonal, and spiral patterns.
M.A.T.recognizes that all posture and movement begins in your nervous system and more specifically in the brain and not the muscles. The PNS and CNS along with the muscles, fascia, and bones create your posture and movement and also the dysfunction seen with acute and chronic musculoskeletal pain. However, muscle has the capability to change its tone and length in the response to these vertical, external forces ultimately affecting the global fascia through the myofascia. That is the rationale behind M.A.T.’S exercises I give each patient.
Isolated muscles of your body are usually defined as pockets of tension and length within the global fascial web tied down at their insertions by their tendons. However, muscles actually don’t attach to the bones as most of us have been taught, but in fact the muscle cells are intertwined with the global fascial net or web through the myofascia and it is the fascia that attaches to the periosteum that pulls on the bone. Instead with 300 isolated muscles on each side of the body, Thomas Myer’s the author of Anatomy Trains states, “there really is one muscle; it just hangs around in 600 or more fascial pockets.”
Unfortunately though, muscles are still perceived as being just isolated motor units. Understanding muscle force in this manner ignores the longitudinal and global effects and the latitudinal and isolated effects of muscles and fascia now found in research. It is becoming more clear through this research that the fascia distributes laterally to the neighboring myofascial structures so that the pull on the tendon at one end of a muscle is not necessarily taken by the insertion at the other end of the muscle demonstrating both the isolated and global effect of your muscles on your structure.
As mentioned in a previous newsletter, we all enter this world of gravity and GRF as infants with un-compromised stability and mobility, and your nervous system will follow a natural, inherent and predictable progression of posture and movement patterns or neurodevelopmental milestones creating a foundation for your future posture and movement as your nervous system matures. With this neurodevelopment, you along with every other human being had to follow and experience a sequence in a hierarchy of posture and movement patterns.
From pre-natal positions and motions to cross-patterned walking everyone is genetically programmed to move through this descending and ascending hierarchy of neuronal patterning. Lateral dominance of the brain is also a factor and is basically innate, developing at around 9 weeks in utero as the “Moro Reflex” for survival appears.
At that time, it seems the developing embryo establishes “lead” functions such as a dominant hand, foot, eye, ear, and hemisphere of the brain in order to react quickly in a survival situation. Since survival is our most primary need, these functions become hardwired in the brain along with these neurodevelopmental milestones and determine how you will respond during life threatening or stressful situations. These patterns of so-called “lateral dominance” greatly influence the way you internally process sensory information including gravity and GRF to create your posture and movement.
From the greater understanding of neurophysiology recently revealed, it is realized that your brain is basically a “meaning maker.” All parts of your body supply raw information that your brain uses to learn about your outside world. It takes that information from the sensory receptors and filters it according to what you believe is real and makes meaning of the information. The eyes, ears, hands, and feet are part of your magnificent adapted sensory system. In fact, recent research is showing that all your higher cognitive processes are grounded in your bodily experiences, such that your brain’s lower-level sensory and motor circuits do not just feed into what you perceive and your awareness, but rather they become your conscious thought.
As a result, you favor one hand over the other, and even one ear over the other in creating your posture and movement. When it comes to your brain, you also tend to favor one brain hemisphere over the other. This tendency to prefer one side to the other is referred to “lateral dominance”and plays a significant role in your posture and movement.
Innately, humans are asymmetrical with the human heart shifted toward the left side and brain centers for control of language functions reside in the left hemisphere of the brain and motor control areas of the left hemisphere regulate movements of the right hand. Although individual researchers have reached different conclusions, the overall results from family and twin studies found that handedness has a number of determinants one of which is genetic. However, other factors such as biological and social are in the mix of causes. Keeping that in mind, 85-90% prevalence of right hand use for one-handed tasks is a worldwide phenomenon. Even examinations of archeological artifacts indicate that the human bias toward the right side has existed since the Neanderthals 200,000 to 28,000 years ago. However, these artifacts also reveal that prehistoric human groups included a left-hand minority. Archeological evidence shows that human ancestors displayed both right and left handedness for millennia.
Humans are unique in showing an extreme majority population bias favoring the right side of the body. Speech and language are also unique human abilities, and the brain centers for language are also located in the left hemisphere of the brain that controls the movements of the right hand. Researchers now believe that right-hand-left brain hemisphere language connection accounts for the evolution of a right-handed majority among humans.
Along with lateral dominance, humans will follow a natural, inherent, and predictable progression of neurodevelopmental milestones. Each position and motion learned facilitates the next phase of your neurodevelopmental growth with each layer of this growth built on the layer that occurred prior. Therefore, it is critical each stage be experienced and fulfilled.
These primitive neuronal patterns of your neurodevelopment experienced as an infant are foundational to the neuronal patterns of your posture and movement that develops as the CNS matures. The primitive and lower neurodevelopmental positions and motions provide the necessary strength, stability, mobility, and coordination required for more challenging physical activities as the CNS matures giving you the foundation needed to be successful at a higher skill level involving your posture and movement.
The very first neurodevlopmental milestone, neuronal pattern integrated within the CNS involves head and neck flexion and extension control in the sagittal plane and bilateral upper extremity movements usually occurring at 6 weeks progressing to the prone (on stomach) positioning at 8 weeks.
This milestone was initiated and integrated in the CNS before an infant can progressively move onto more challenging posture and movement skills. Each postural and movement developmental pattern learned served as a stepping stone for the next movement in this neurodevelopmental sequence and it is these neurodevelopmental milestones that become the foundation of your “myomemory” creating your posture, and movement.
Through 3-18 weeks the infant learns to roll and 2-7 months the act of grasping. However at 7 months when the infant learns to sit is when the journey of finding vertical balance and equilibrium truly begins.
This integration of stimulation and response up and down the CNS creates your vertical balance which can also be referred to as the beginning of your vertical perception which is an important and vital factor of your health, well-being, learning, and most of all your survivability.
Integration being this sense or linkage of the differentiated elements of the body structure and its relationship with gravity which is the summation of all sensory and motor output creating your vertical balance, posture, and movement. This neurodevelopmental sequence helped build your vertical balance, posture, and movement against the vertical forces of gravity and GRF from an infant with un-compromised stability and mobility to a mature adult. For those of you who are fortunate enough to be around children you can identify with the terms such as head control, rolling, and crawling as being rooted in these early stages of childhood exploration and learning. Remember, before you learned to walk, you had to crawl. Keep this in mind as you continue learning about M.A.T.
The simple narrative will describe how this brain driven system of posture and movement and neuronal patterning works in your everyday function, “the brain listens to the eyes, middle ear, muscles, and fascia through the visual, vestibular, and proprioceptive sensory input regarding the vertical forces of gravity and GRF.”The sensory input regarding these vertical forces is fed to the spinal cord by the PNS which is relayed to the brain CNS where it is integrated and processed causing a response. This response is communicated back to the muscles again through the PNS telling them what to do
This direct communication between your brain and muscles of your musculoskeletal system is also what becomes part of your “myomemory” or the “path of least resistance” within your nervous system to create skeletal balance and equilibrium becoming the habits and behaviors of your posture and movement. Because humans are grown from a seed and not a machine, this process of your posture and movement needs to be viewed not as an isolated linear, cause and effect, but rather a more integrated “global and circular view.” A view of relationships between the various systems of your body working together in integration and synergy with its primary goal “to keep you alive, your survivability.” Understanding isolated proprioceptive muscle spindle and golgi tendon organ actions within a pattern and also altering visual and vestibular sensory input are the keys to transforming a dysfunctional myomemory.
M.A.T provides exercises altering this triad of sensory input in order to transform the isolated tone and length of muscles and their myofascia within a dysfunctional neuromuscular pattern thereby altering the effects of the global fascial web. By transforming the dysfunctional myomemory and inhibiting the path of least resistance within the nervous system, it allows your CNS to achieve “ideal skeletal alignment” and synergy once again which is compatible with its inherent design.
Again with M.A.T., I have identified four intrinsic neuromyofascial patterns affecting your posture and movement at the subconscious level including the deep and superficial anterior/posterior linear, side linear, diagonal, and spiral patterns. These four neuromyofascial patterns generate a dynamic and constant interplay between stability and mobility of your skeletal structure. It is a dynamic process describing your body’s never-ending dance in managing your body’s vertical balance, stability, mobility, posture, and movement in three planes.
Human movements are described in three dimensions based on a series of planes and axes. There are three planes of position and motion that pass through the human body including the the sagittal plane, frontal plane, and transverse plane. The sagittal plane which we have already mentioned in the neurodevelopmental sequence with flexion and extension of the head and neck, lies vertically and divides the body in right and left halves. The frontal plane also lies vertically and divides the body in anterior and posterior halves. Finally, the transverse plane lies horizontally and divides the body superior and inferior halves.
Positions and motions of the sagittal plane involve forward and backward movements. These include flexion and extension and dorsiflexion and plantar flexion. In addition, an anterior and posterior shift can occur. Positions and motions of the frontal plane involve abduction and adduction, elevation and depression as well as lateral flexion, side bend, and a lateral shift. Finally with the positions and motions in the transverse plane, it involves internal and external rotation, horizontal abduction and adduction, inversion and eversion, and radial and ulnar deviation.
An axis on the other hand, is a straight line around which an object rotates. Movement at a joint takes place in a plane and axis so there are three axes of rotation. The sagittal axis passes horizontally from posterior to anterior and is formed by the intersection of the sagittal and transverse planes. The frontal axis passes horizontally from left to right and is formed by the intersection of the frontal and transverse planes. Finally, the vertical axis passes vertically from inferior to superior and is formed by the intersection of the sagittal and frontal planes.
Up until 7 months of the neurodevelopmental sequence, the focus has been with the sagittal and transverse planes. However at that time, the infant usually begins to sit involving the frontal plane. plane that involves M.A.T.’s side linear pattern.
Keep in mind though that at any given moment in time no matter what you are doing, the vertical forces of gravity and GRF are imposed upon your structure creating a response by your brain involving these neuromyofascial patterns in all three planes simultaneously. Gary Gray, an athletic trainer, physical therapist, educator, and movement specialist refers to this as “triplane logic.”
Simply, you affect one plane and it will affect the other two planes. It has been my clinical experience in using M.A.T. the same applies to its neuromyofascial patterns. You affect one pattern and it will affect the other patterns as well. That is because physiologically and biomechanically, your body is an extraordinary complex entity in which its different isolated parts are integrated and linked with each other three dimensionally through the nervous, muscle, and fascial systems.
All four of M.A.T.’s neuromyofascial patterns are designed to work in synergy, a term used extensively over the last decade when studying the body’s nervous and muscular systems. A muscle synergy pattern is the activation of a group of muscles contributing to a particular posture and movement, thus reducing the isolated, linear cause and effect most of us have been taught regarding muscle function.
I do not like to sound like a broken record, but Ida Rolf has another quote that puts this process of synergy and integration in perspective regarding M.A.T., “This is an important concept: that practitioners are integrating something; we are not restoring something. This puts us in a different class from other therapists that I know of. It takes us out of the domain designated by the word “therapy,” and puts us in the domain designated by the word “education.” It puts our thinking into education: how can we use these ideas behind Structural Integration?” She goes onto say, “How do we put it together so that it’s a unit, an acting, energy efficient unit? One of the differences between Structural Integration practitioners and practitioners of medicine, osteopathy, chiropractic, naturopathy, physical therapy, etc., is that the latter are all relieving symptoms. They make no effort to put together elements into a more efficient energy system.”
Like Rolfers, M.A.T. is utilized to make your body a more efficient energy and healing system and does not focus on trying to relieve your symptoms. If your body is working according to its inherent design against the vertical forces of gravity and GRF, the force of gravity and GRF can flow through your body and allow your body to spontaneously heal itself relieving your symptoms.
Balance and being vertical describes this interplay, this dynamic dance between stability and mobility which is your response to gravity and GRF no matter the physical activity creating your posture and movement. As mentioned previously, balance is not a fixed state of alignment, but rather a never-ending series of fine, subtle adjustments occurring throughout your body in response to these vertical forces of gravity and GRF. When this dynamic polarity of stability, mobility, vertical perception, and vertical balance is managed successfully by your CNS, then you can successfully orient yourself to your constant environment of gravity and GRF in order to distinguish between threat and safety and choose appropriate responsive strategies when disrupted enhancing your survivability.
But just as vertical balance is brain driven, so too is your vertical perception and balance. However, your vertical perception can be further defined and characterized by your perceptions of vertical balance itself which include grounding, orienting, centering, spaciousness, connection, and myofascial tone.
•Grounding
“Grounding” is the integration and your perception of being vertical referring to your body’s relationship to the earth as your weight passes down through your COG and your base of support (BOS) involving your feet and ankles while standing and SITS bones while sitting. Whether standing or sitting, you want to be able to perceive equal weight down into both feet and both SITS bones so the sensory input on both sides of the body is one of equality and not inequality.
•Orienting
“Orienting,” on the other hand, refers to your external perception of your environment which includes the natural, constant, and vertical forces of gravity and GRF.
It is the ability of your nervous system no matter the activity to be simultaneously aware of and present to your external environment of gravity and GRF as well as your body’s internal perception and experience in how it responds to these vertical forces during posture and movement.
•Connection
“Connection” relates to the perception and integration of your body and the relationships. The linkages of your various parts of the body through your body’s global fascial web and nervous system no matter what you are doing to create a sense of the whole body. It is these relationships, these linkages that make your body a living, moving, whole, rather than a collection of disjointed, disassociated, or isolated parts. This perception, awareness, and coordination of your internal somatic or body’s relationships and linkages expands as your sensory information and motor output flows through your body no matter the activity.
•Centering
“Centering” is the vertical perception and visualization of the organization of your whole body around a vertical, center line referred to as your line of gravity. It implies functional symmetry and balance especially of your body’s pelvis, trunk, and head and involving the “ideal static alignment” of your structure.
It is a given that a well-centered body will manage vertical balance more efficiently and expend less energy no matter the activity than one that is poorly centered. Also when your head is centered over the spine, COG (S2), and BOS in standing or sitting, your range and ease of motion are improved which enhances your orienting capacity thereby improving your presence in and awareness of your environment of gravity and GRF. Centering facilitates connection, integration, and linkage because movement transmission improves with alignment. Again, demonstrating the integrative capacity of your nervous system and global fascia.
•Internal Spaciousness
“Internal spaciousness” is a vertical perception experienced as a subtle openness in your joints which allows you greater freedom of movement, greater mobility. A muscle imbalance of tone around a joint can inhibit this perception. It also influences your breath because the movement capacity of your skeletal structure allows or inhibits the ease of each breath allowing for optimal intake of oxygen.
When the joints of your feet, ankles, knees, hips, pelvis, shoulders, and spine are open and spacious, motion travels all the way up the body and through the head, promoting vertical integration and balance allowing for the ease of each breath.
Likewise when you are sitting and the pelvic girdle is equally balanced between the right and left sides allowing your rib cage, shoulders and spine to be open and spacious, motion too travels up through the head promoting vertical integration and balance and allows for efficient breathing.
•Muscle Tone
Finally in the integration and perception of vertical balance, “optimal muscle tone,” could be described as the readiness of your soft tissue’s to respond appropriately to your environment of gravity and GRF no matter the activity as well as your behavioral needs.
Simply, the quality of your muscle engagement through the myofascia affecting the engagement of the global fascial web affects M.A.T.’s four neuromyfacial patterns permitting or inhibiting your posture and movement. It represents a balance between sufficient tone for an adequate response to create vertical integration, balance, stability, mobility and the ability to relax and rest when appropriate.
Healthy tone means your soft tissues are not too strong, nor too weak, neither too stiff, nor too slack. Instead, there is a sense of “springy”responsiveness to it in relationship to the demands of gravity and GRF during movement. Just watch a great athlete in any sport. That is why they make it look so easy. Therefore, your vertical integration and perception is a critical and vital part of being human and your muscle tone is an essential feature because of its relationship to your sense of security and the sense of who you are in this world.
This ability to orient yourself vertically to your environment of gravity and GRF enables you to see the full 360º of your surroundings in order to identify and distinguish between threat and safety. Successful orienting from your vertical integration and balance combines your internal proprioceptive system involving your neuromuscular, fascial, and skeletal systems with their perception of information from the environment involving your visual, vestibular, and proprioceptive systems.
Vertical integration and balance, or lack of it, as already mentioned can also affect your autonomic nervous system, your emotional well-being, your experiences of living within your body, and more importantly your survivability.
We as humans live the majority of our lives in a vertical posture or vertical skeletal balance and equilibrium assuming the advantages of the evolutionary development of a vertical spine. When discussing vertical balance and equilibrium, once again I have to use another quote from Ida Rolf, “We are not truly upright, we are only on our way to being upright. This is a metaphysical consideration. One of the jobs of a Rolfer is to speed that process along. We want to get a man out of the place where gravity is his enemy. We want to get him into a place where gravity reinforces him and is a friend, a nourishing force.” With M.A.T., that is also our ultimate goal.
The human experience of vertical balance is best described as an experience of motion, confirming again that “motion is life.” Your entire body is set in motion to create vertical integration and balance, stability, and mobility of your structure and the alignment of your bones and joints in reaction to gravity and GRF.
A motion of your body is felt throughout your entire body even affecting your internal organs and their inherent motility or motion. A motion also impacts your sympathetic and parasympathetic divisions of your autonomic nervous system (ANS) as mentioned. When your structure lacks stability against gravity and GRF, tone of the sympathetic nervous system increases whereas with the improvement of stability, the tone of the parasympathetic system is enhanced. Remember the vagus nerve is involved with the tone of the parasympathetic system. Once again your posture and movement affecting your ANS confirms everything is integrated and connected within the body by the global web of the fascia and the nervous system.
When standing, the motion of vertical balance is facilitated by your weight in gravity and GRF, stimulating sensory nerves traveling from your feet, ankles, knees, hips, shoulders, and upper cervical spine to your spinal cord and to the brain for integration and processing. Therefore, it is an accurate statement to say your feet are in your brain and your brain is in your feet.
In sitting, this motion of balance is facilitated from the vestibular system and the sacrotubersous ligaments attached to the SITS bones on either side of the pelvic girdle sending information up and down the spinal cord as well as sending information to the brain for integration and processing. So too, it could be said that the SITS bones of your pelvic girdle are in your brain and your brain is in your SITS bones. Clearly demonstrating your posture and movement is a brain driven system. Regardless whether you are standing or sitting, sensory input runs up and down the spinal cord and to and from the vestibular apparatus, cerebellum, brain stem, eyes, and cortical regions of your brain creating your vertical integration and balance, stability, mobility, posture, and movement.
Over my forty years of clinical practice treating musculoskeletal and fascial dysfunction, I realized you must begin to transform your myomemory first in the frontal plane. I have found it to be the foundational plane for the integration and perception of your vertical balance and the vertical position of the head and neck involving M.A.T.’s side linear pattern. I came to this realization observing many of my client’s possess a lack of perception that their head is tilted to one side when standing, sitting, and lying supine. When I passively positioned their head to what appeared to be a more vertical position, they would usually say, “that doesn’t feel vertical to me!”
Look at photographs of friends and family and observe how consistently most have their heads tilted to either the right or left side. With the definition of “ideal static alignment” there will be vertical and horizontal lines of the structure at 90º angles. With the head tilted to one side, that individual does not demonstrate “ideal static alignment” and is a sign of compensation. In addition to the head and neck tilt demonstrated, the postural compensation seen in the frontal plane with M.A.T.’S side linear pattern includes elevation of the pelvic and shoulder girdles on the same side and a tilt on the opposite side. In addition, a tilt of the temporal bone on the side of the elevated pelvic and shoulder girdles and elevation of the temporal bone on the side of the tilted pelvic and shoulder girdles.
Because of the brain’s inherent “organizational hierarchy” the three systems of sensory input affecting your muscle tone, posture, and movement do not contribute equally. Vision is by far the most dominant sense in creating your muscle tone and posture and its importance is emphasized by the fact that 60% of total, human brain neuronal activity is somehow involved with your sense of vision.
The otoliths and semicircular canals of the vestibular system and proprioceptive sensory input of the muscles, tendons, and ligaments activate a group of reflexes involving the muscles of the eyes referred to as the “vestibular-ocular reflexes” (VOR). These reflexes involve the six extraocular muscles of the eyes and neurologically connect the muscles of your legs, trunk, and arms for postural stability and support.
However, the main function of the VOR’S is to stabilize an image on the retina of the eye during motion of the head. This means the eye must counter-rotate to compensate for the head, and keep the eye stable in space. We live in a world where we can both rotate and translate along a line and along 3 axes. Therefore, the VOR has two foundational components, angular and linear.
VOR’S provide a neuronal connection between the visual, vestibular, and proprioceptive systems. But, it is both the visual and vestibular systems that are foundational to your vertical integration and perception, balance, stability, mobility, posture, and movement against the vertical forces of gravity and GRF. A linear VOR is mediated by the otoliths and is primarily responsible for gaze stabilization and compensation for translation and acceleration in a linear direction in the frontal plane.
Optimally when your head is in a vertical position, the L and R vestibular nerves and their neurons in the vestibular nucleus to which they project have equal resting discharge rates referred to as vestibular tone. With compensation in the frontal plane, the head will tilt toward the side of the elevated pelvic and shoulder girdles exciting the vestibular labyrinth and the otoliths. The side to which the head is tilted facilitates the labyrinth on that side and inhibits the labyrinth on the opposite side creating an imbalance of vestibular tone. In response, the otoliths and utricular pathways facilitate an ocular tilt response (OTR) consisting of a lateral head tilt to the opposite side and vertical misalignment of the eyes.
The main function of M.A.T.’S side linear pattern is to provide lateral stability for the body against the vertical forces of gravity and GRF that runs from the cranium and C1 (atlas) of cervical spine to the lumbosacral spine on either side involving the body’s craniosacral system. In addition, from the pelvic girdle and hips down through the lower extremities to the ankles and feet. It involves visual, vestibular, and proprioceptive sensory input including the otoliths of the vestibular system and vestibular-ocular reflexes setting the tone of the muscles in the side linear pattern.
The muscles of M.A.T.’S side linear pattern on the tilted side of pelvic girdle include the temporalis, middle scalene, lower/mid trapezius, QL iliotransverse portion, adductor minimis, posterior gluteus medius, anterior tibialis, flexor hallucis brevis, and flexor hallucis longus while the muscles on the elevated side of pelvic girdle include the masseter, rectus capitis lateralis, upper trapezius, QL iliocostal portion, adductor magnus, triceps surae, extensor hallucis brevis, and extensor hallucis longus.
With the side linear pattern providing lateral stability, it all starts with sitting starting at about 7 months of neurodevelopment. It involves the SITS bones on either side of the pelvic girdle and proprioceptive input coming from the sacrotuberous, sacrospinous, and iliolumbar ligaments. An uneven sitting posture down through the SITS bones over time creates a functional muscle imbalance causing increased tone of the iliocostal portion of the quadratus lumborum (QL) on the elevated side of the pelvic girdle and the adductor minimis on the tilted side involving vestibular reflexes and the otoliths.
It has been my observation over the years that most R hand dominant people will put more weight down into their L SITS bone while sitting. This compensatory postural pattern while sitting will cause a functional muscle imbalance mentioned above in addition to “pelvic obliquity” and an iliosacral “upslip” because the position between the ilium and sacrum is no longer symmetrical.
With a sacral upslip, basically, the tissues of this joint between the sacrum and ilium of the pelvic girdle experience upward shear forces on the tilted side resulting in distortion of the SI joint. Since these ilium-on-sacrum shear forces are more affected by gravity than other iliosacral dysfunctions, they have very little chance of self-correction and in most cases must be addressed not only with exercise, but with manual therapy. With constant and repetitive unbalanced loading caused by this muscle imbalance and resultant asymmetry of the pelvic girdle in the frontal plane, it can gradually deform the SI joint ligaments causing an upslip of the sacrum opposite to the elevated side of the pelvic girdle.
In addition, it can cause a “functional leg length” difference creating a dysfunctional unleveling of the pelvic girdle and sacral base when in standing which is one of the most important contributing factors of chronic musculoskeletal pain. Although leg-length discrepancies are quite common and have various causes, any measurement of over 1/2” or more is significant. “Anatomical short legs,” on the other hand, can only be accurately documented with a measurement using a x-ray image and are usually attributed to fractures, polio, limb overgrowth, and of course someones genetic make up causing a defect.
The functional muscle imbalance of a hypertonic iliocostal QL on one side and the adductor minimis on the other side in sitting not only causes asymmetry of the pelvic girdle, but binds down the lumbar vertebrae and tends to flatten the lumbar curve on the elevated side. In addition, there is more compression forces on the L hip from the tilting of the pelvic girdle. It is the QL and other lower back muscles that comprise what is referred to as the “multifidus angle” and should be considered when treating a functional muscle imbalance of the iliocostal and iliotransverse QL.
The multifidus angle includes the facet joints, erector spinae muscles, and lumbar fascia. The functional mobility of the lumbar spine affects the coupled motion of the spine, pelvic girdle, and lower extremities in all three planes and is significantly affected by this tilt and elevation of the pelvis in the frontal plane.
During the dynamics of the vertical, upright human gait, an important kinetic chain link identified is the side bending/lateral flexion and rotation of the cervical, thoracic, and lumbosacral spine encouraging the cross-patterned gait, the pinnacle of human movement. The central element permitting the development of a vertical upright human gait is this coupled motion of the spine that is significantly affected by the compensation in M.A.T.’s side linear pattern. As you trace the path of energy from heel strike in reaction to GRF during walking, you can see how the spine conserves this energy it has been given from the ground. It seems reasonable to suggest that this pulse of energy from GRF and the lower extremity chain entering the body at the L5/SI interface is distributed to all levels of the spine until none remains at the atlas/axis junction of the neck.
The coupled motion of the spine just described is a fundamental feature of human movement and is used in training programs by various sports disciplines. Therefore, it can be argued that coaching any athletic skill should essentially be teaching the proper use of the spinal coupled motion to maximize the power required for performance of an athletic skill. From my life experiences in training and competing for twenty-three years in the sport of nordic ski jumping, I would agree with that statement.
Another muscle imbalance of the side linear pattern in the frontal plane involving vestibular reflexes and the otoliths is the trapezius which is part of Vladimir Janda’s upper crossed syndrome (UCS) who was a physician and physical therapist from Czechoslovakia. The UCS is a neuromuscular muscle pattern and imbalance used to describe postural compensation and asymmetries.
The trapezius is a broad, flat, superficial muscle extending from the cervical to thoracic region (T12) of the spine on the posterior aspect of the neck and trunk. It is divided into three parts including the descending superior, ascending inferior, and middle. The muscle contributes to the “setting” of the shoulder girdle and the scapulohumeral rhythm through attachments on the clavicle and scapula, and to head balance through muscular control of the cervical spine.
With the side linear pattern, the upper trapezius has increased tone on the elevated side of the pelvic girdle causing an elevated shoulder girdle on the same side and the lower and middle trapezius has increased tone on the opposite tilted pelvic girdle causing depression and retraction of the shoulder girdle on that same side. Again, this functional muscle imbalance affects the “setting” of the shoulder girdles that then causes compensation of the glenohumeral joints.
Due to the muscle imbalance of these muscles just mentioned, the head is no longer in an optimal vertical position causing an inequality of vestibular tone. The side to which the head is tilted by vestibular reflexes, facilitates the labyrinth on that side and inhibits the opposite side causing a vestibular-ocular reflex involving the OTR consisting of a lateral tilt to the opposite side and the vertical misalignment of the eyes.
Because of the OTR, a muscle imbalance is created involving the rectus capitis lateralis (RCL) on the side of the elevated pelvic girdleand middle scalene on the tilted side. This muscle imbalance causes a lateral shift of the atlas or C1 due to the increased tone of the rectus capitis lateralis (RCL) and lateral flexion/side bending of the neck on the opposite side. The RCL when having increased tone will cause a shift of the atlas toward the side of the elevated pelvic and shoulder girdles. It is described as a weak lateral flexor of the head and neck.
On the opposite or tilted side of the pelvic girdle, there will be increased tone of the middle scalene. The middle scalene is the largest and longest of the scalene muscles on either side of the neck and is often penetrated by the dorsal scapular and long thoracic nerves. The dorsal scapular nerve supplies the levator and rhomboid muscles while the long thoracic nerve innervates the serratus anterior. The middle scalene not only laterally flexes/side bends the head and neck, it is also an accessory breathing muscle lifting the rib cage with inhalation.
It runs from C2 to C7 of the cervical spine and its origin deviations can include the transverse process of the atlas while its inserts on the first rib. The middle scalene forms what is referred to as the “interscalene triangle” (scalene triangle) formed between the anterior scalene anteriorly and the middle scalene posteriorly and the first rib inferiorly. Abnormal anatomy, injury to this region, or postural compensation can cause compression of the neurovascular structures leading to thoracic outlet syndrome (TOS). TOS typically leads to paraesthesia, pain, and weakness of the upper limb on the same side of the tight middle scalene. TOS affects 8% of the population and is 3-4 times more prevalent in woman than men.
As already mentioned, M.A.T.’s side linear pattern has an effect on the coupled motion of the spine during walking. With the compensation described in sitting, a lateral shift of the pelvic girdle on the side of the hypertonic iliocostal QL occurs along with a lateral shift for the shoulder girdle toward the opposite side when walking.
When stepping during gait, you normally shift your body weight over the supporting leg balancing on just one femur. In order to do this, you must transfer your COG by shifting the pelvis over the standing leg. Try walking without the shifting of your pelvic girdle laterally and you will soon learn the importance of this side-to-side shift or translation of the pelvic girdle during gait. When the shoulder girdle shifts, your upper body instead laterally shifts over the standing leg allowing the swinging leg to be lifted. In this way, the pelvic girdle does not have to lateral shift as much during gait. The compensatory gait pattern often demonstrated in the frontal plane is asymmetry for the shoulder and pelvic girdles with a greater shift of the pelvic girdle on one side and a greater shift of the shoulder girdle on the opposite side.
Again, this asymmetrical shifting of the pelvic and shoulder girdles walking is a direct result from compensation in sitting. Pay closer attention to the gait of people today especially after this pandemic where people have a tendency to sit way too much causing this compensatory shift during their gait. You will notice more of this asymmetrical shifting between the pelvic and shoulder girdles and the loss of the inherent cross-patterned walking between the torso and hips while limiting the lift coming from the lower extremity kinetic chain in reaction to GRF.
But when talking about the human gait and the nervous system’s reaction to GRF, there are several muscles that also have to be mentioned in regards to lateral stability. First is the posterior gluteus medius and adductor magnus. The gluteus medius along with the tensor fascia latae (TFL) and quadratus lumborum on the opposite side is extremely important in maintaining frontal plane stability of the pelvis created by what is referred to as a “lateral fascial sling.”
The gluteus medius vital in efficient walking, running, and single-leg weight bearing like when walking up and down stairs because it prevents the opposite side of the pelvis from dropping during these functional activities. When a lower limb is not in contact with the ground, the pelvis on that side will tend to drop without the support from the ground. The gluteus medius for the limb that is in contact with the ground works to keep the pelvic girdle level to allow the other limb to swing forward for the next step.
Whereas the posterior gluteus medius is a primary hip abductor, its anterior portion will produce hip internal rotation. That is where the differentiation between the anterior and posterior gluteus comes into play. The anterior gluteus medius is a hip internal rotator which will be described in M.A.T.’s diagonal neuromyofascial pattern and is the antagonist to the piriformis.
When there is weakness of the posterior gluteus medius during gait, compensation will be noticed in the trunk involving the QL iliotransverse portion resulting in lateral flexion/side bending of the trunk away from the side the pelvic girdle is dropping. When the compensation is at its extreme, it is referred to as a “trendelenburg gait.”
The adductor magnus, on the other hand, is a dynamic stabilizer of the pelvis and a primary hip adductor. It plays a similar function to the deltoid muscle in the shoulder where one portion of it flexes the thigh and works as a medial rotator while the other portion extends the thigh and is a lateral hip rotator with both portions adducting the thigh. The curvilinear attachment of the adductor magnus on the pelvis is like the attachment of the deltoid on the spine of the scapula, acromion, and clavicle.
When talking about human gait, there is a significant amount of proprioception that comes from the ankle and heel involving the M.A.T.’s side linear pattern. It involves the “triceps surae” and anterior tibialis. The triceps surae is a term used to group muscles of the calf which include the soleus, the two-headed gastrocnemius, and plantaris. Research indicates that tightness of the triceps surae is correlated with various conditions that affect the forefoot and mid foot during weight bearing activities.
With M.A.T., the main function of the triceps surae is to manage the pronation and supination of the ankle that affects the timing of gait. Pronation and supination are normal movements of the lower extremity kinetic chain that occurs during the human gait cycle.
The talocalcaneal or “subtalar joint” is affected by the tone of the triceps surae which according to Dr. Phillip Greenman is the “body’s steering wheel and is the most important joint you didn’t know you had.”Located just below the ankle, where the calcaneus (heel bone) and the talus (ankle bone) meet, it primarily does only two things, rolling in and rolling out in reaction to GRF. Keep in mind that the talus is the only bone of the human, skeletal structure that does not have a muscle attached to it. It reacts to the inversion and eversion of the heel that reacts to GRF.
It is the energy from heel strike impacting this motion of the subtalar joint that helps initiate the coupled motion of the spine as just mentioned. Upon heel strike, 80% of your body weight should be directly over your calcaneus producing a vertical force that is transmitted up through the lower extremity chain into the body at the L5/S1 interface.
The lower leg, foot, and ankle pronate (roll in) during the stance phase of your gait allows for the absorption of your body weight in reaction to GRF. The weight is distributed between the calcaneus and metatarsals causing the subtalar joint to dorsiflex and adduct causing eversion of the heel. In response to the internal and medial shearing forces, the lower leg internally rotates to complete the articulation with the calanceus. This rotation of the talus and calcaneus is known as the “torque converter” of the lower leg.
In supination (roll out), the extrinsic muscles in the lower leg function from toe-strike to push-off allowing for external rotation as the contralateral limb swings forward. This external rotation of the lower leg causes lateral shearing forces within the foot and ankle causing the midtarsal joint to lock while the subtalar joint goes through plantar flexion, abduction, and inversion of the heel. It should also be noted that dorsiflexion of the first metatarsalphalangeal joint (MTP) occurs increasing the tension of the plantar aponeurosis assisting the subtalar joint in supination, a mechanism referred to as the “windlass effect.”
Part of a normal human gait is this “windlass effect” of the big toe involving the flexor and extensor hallucis longus and brevis muscles. The first MTP should be able to extend as much as 65º, but many people lack full range of motion causing compensation during their gait. It alters the foot’s natural movement patterns leading to mysterious knee or hip pain and an unstable gait.
During the stance phase of your gait, your toes dorsiflex to help raise the arch and provide greater shock absorption. As the arch flattens, the toes, plantar fascia, and associated muscles lengthen via this windlass mechanism involving the flexor and extensor hallucis brevis and longus.
This action helps spring you forward with greater propulsion during push off. However, it only works when there’s decent big-mobility and a balance of tension between these big toe muscles. With the feet acting as springs, absorbing and transferring the forces of gravity, it should be a remarkably efficient system, but as you well know it is not always the case.
The antagonistic muscle to the triceps surae is the anterior tibialis, a primary dorsiflexor of the ankle that works with the extensor hallucis brevis and longus, extensor digitorum brevis and longus, and peroneal tertius. It primarily contributes to maintaining the medial arch of the foot. When the anterior tibialis is inhibited by the increased tone of the triceps surae on the elevated side of the pelvic girdle, other muscles will try to compensate.
Finally, I would be remiss if I didn’t mention the muscle imbalance of the middle deltoid and supraspinatus created by the imbalance of the trapezius and levator scapulae in “setting” the shoulder girdle. The trapezius is part of M.A.T.’s side linear pattern and the levator scapulae is part of M.A.T.’s diagonal pattern which will be described later.
The deltoid is a large triangular-shaped muscle that lies over the shoulder or glenohumeral joint giving the shoulder its rounded contour. It is comprised of three distinct portions consisting of the anterior or clavicular, middle or acromial, and posterior or spinal. Its main function is as a shoulder abductor and stabilizer of the humeral head as well as assisting with shoulder flexion.
It is a very powerful muscle and is used in many functional activities of daily living. While all its portions work together to produce abduction of the shoulder joint, it is active with carrying objects or reaching for objects to prevent subluxation or dislocation. The deltoid compensates for the loss of rotator cuff strength.
The supraspinatus is the smallest of the four muscles comprising the rotator cuff. It is also an abductor of the shoulder, but in a more limited manner. It is said to be the primary abductor during the first 15º of shoulder abduction and then assists the deltoid.
As part of the rotator cuff, it helps to resist gravitational forces which act on the shoulder joint to pull it downward from the weight of the upper limb. It also stabilizes the shoulder joint by keeping the head of the humerus firmly pressed medially against the glenoid fossa of the scapula.
In summary, M.A.T.’s side linear pattern provides lateral stability in creating the skeletal structure’s vertical balance, stability, and mobility in the frontal plane during sitting, standing, walking, running, and stairs as well as functional activities involving the shoulder girdles. It involves visual, vestibular, and proprioceptive sensory input setting the tone of the QL iliocostal, adductor minimis, trapezius, middle scalene, rectus capitis lateralis, masseter, temporalis, middle deltoid, suprspinatus, posterior gluteus medius, adductor magnus, anterior tibialis, triceps surae, and flexor/extensor hallucis brevis and longus.
With “ideal skeletal alignment,” there should be an equality of tone for these muscles creating balanced postural symmetry in sitting and standing so the pelvic and shoulder girdles, sacrum, occiput, and temporal bones are parallel to the ground in the frontal plane without any elevation, tilt, side bend/lateral flexion, and shift. By achieving your body’s inherent skeletal symmetry, it makes for optimal vertical movement.
Well, there you have it for M.A.T.’s side linear pattern. My next newsletter will be on the M.A.T.’s diagonal pattern involving the frontal and transverse planes. Until then, be well.
Terry