technique

BODYREADING THE MERIDIANS | @WORK | ESSENTIAL SKILLS | MYOFASCIAL TECHNIQUES

The Arm Lines

By Thomas Myers
In our continuing series on visual assessment via
the Anatomy Trains lines, let us now explore BodyReading
the shoulders and arms. The shoulders involve not
one, but six myofascial meridians. Our highly mobile
shoulders move and shift position in a wide variety of
ways relative to the ribs and neck, contributing to strain
and pain patterns that include everything from headaches
to compensations in the low back and even the legs.
With such complexity before us, we simplify here
by 1) highlighting the uniqueness of the human arm
architecture, 2) briefly outlining the lines involved,
and 3) giving some indications of how the shoulder can
efficiently rest, move, and respond to the breath.
Our shoulders have a complicated history. In most four-legged
creatures, the foreleg bears more weight than the hind leg. The
ribs and spine rest into a myofascial sling made primarily out
of the serratus anterior muscle (Image 1A). In a well-trained

The shoulder is the main support for the body weight in compression for most quadrupeds (A) and
the main support in tension for arboreal apes (B). In a standing human (C) this is all reversed:
it is the turn of the heavy shoulder assembly to be supported by the ribs and spine.

98

massage & bodywork

march/april 2012

horse or a thin fellow doing a push

up, the saw-toothed slips of serratus
are readily visible. Since we reared
up on our hind legs some 4 million
years ago, we freed the shoulder from
its job of being the primary support
that holds the torso up off the earth.
If the anthropologists and
comparative anatomists have it right,
our line of ancestry went through a
time of swinging through the trees,
which developed the prehensile
capability of our hands, and involved
the shoulder moving and rotating
laterally to support the entire weight
of the bodybut this time in tension,
from hanging, not bracing (Image 1B).
When we came down out of the trees
and onto the seashore, the arms were
freed to swim, pick up sticks and stones,
curl around our beloved children,
steady the plow, and tap on computer
keys.
Our human shoulder is no longer
the major structural column (except for
those doing handstands or headstands).
For us, the shoulder is supported by the
structural columna yoke that half
hangs off the neck and half rests on
the top of the ribs. When you include
the weight of the attendant muscles,
the shoulder girdle is remarkably
heavy, and can easily load the neck and
spine significantly, and detrimentally
if it is out of balance (Image 1C).
While the arm and leg are similar
in constructiona ball and socket
joint, then one bone, then a hinge joint,
then two bones, then three, four, and
five bones in a similar arrangement
the shoulder and arm definitely lean
toward mobility, while the leg and
hip are designed more for stability
(Image 2). Put simply: to keep up

Superficial
Back Arm
Line

The Arm Lines are named for how they

present at the armpit leveltwo in
front of the axillary space, two behind.

with the arm and hands many talents,

the shoulder has to slide all over the
place, making it more vulnerable to
both injury and misalignment.

THE ARM LINES

The complexity of the myofascial
structures along the arm is mindboggling. The arms have to control
the finest instrument the world has
ever knownthe human handat
one end, and are anchored into the
head, neck, upper spine, ribs, low back,
hip, sacrum, and even arguably the

2
The arm and leg are similarly designed in a
1, 2, 3, 4, 5 arrangement of bones, and the
muscles are easily comparable as well. The
arm tilts this design toward extra mobility,
while the leg tends toward greater stability.

femurs at their other end. Let us make

some sense of this by organizing the
myofascialature (I made that up,
dont repeat it to anyone with a degree)
into a series of connected lines.
To qualify, these lines must 1)
start at the axial skeleton and go all
the way to the fingers, and 2) involve
conjoined fascial fibers running in a
fairly straight direction. Using those
rules, one can divide the arms soft
tissues into four of these lines.
We name the Arm Lines for
how they are arranged in the armpit
(Image 3). The pectoralis major is
part of the Superficial Front Arm Line
(SFAL) (Image 4A). The pectoralis
minor and subclavius, and the fascia
that surrounds them, are part of the
Deep Front Arm Line (DFAL). In the
back, the trapezius and deltoid form the
beginning of the Superficial Back Arm
Line (SBAL) (Image 4B). Beneath these
are the rhomboids and levator scapulae
leading to the rotator cuff of the Deep
Back Arm Line (DBAL). These lines
terminate in the four corners of the
handthe palm, thumb, back of the
hand, and little finger respectively.
Because the intricate anatomy is
beyond the scope of a short article, you
can follow the individual structures
in each line by following the charts
in Image 4. For simplicity, you can
best visualize the four Arm Lines
as the four aspects of a birds wing.
Lean forward and stick your arms
out like a kid playing airplane: the
SFAL is the bottom of your wing
from pectorals to palm; the SBAL is
the top of your wing from trapezius

Superficial
Front Arm
Line

Deep Front
Arm Line

Deep Back
Arm Line

The four Arm Lines go from the axial

skeleton to the four corners of the hand.

Celebrate ABMPs 25th anniversary and you may win a refund on your membership. ABMP.com. 99

5
to fingernails; and the DFAL is the leading edge from the
pectoralis minor out to your thumb. The final and most
problematic (from our point of view) line is the DBAL, the
trailing edge of the wing from your levator and rhomboids
through your rotator cuff on out through the triceps and
point of the elbow to your little finger (Image 4, page 97).
These lines are minutely detailed in Anatomy
Trains (Elsevier, 2009), but here and now, this will
have to suffice on the anatomy. In terms of function,
the SBAL holds the arm aloft and fixes it in position
and the SFAL directs the hand and fingers, while the
two deep lines provide stability and refinement in
aiming the hand at whatever we are working with.

SHOULDER POSITIONING
If you are working with a musician, jeweler, draftsman,
or ping-pong player, the details of the forearms and
hands are relevant, but here we will concentrate on the
positioning of the shoulder. Even with that limit, we
encounter sufficient complexity. The postural position
of the shoulder rests largely with the scapula. With some
exceptions, the clavicle and humerus have to follow the
scapulas lead. The scapula itself is a roundhouse of muscular
pulls all competing to dictate its position (Image 5).
Please do not talk to me of a scapulo-thoracic joint
there is none. The scapula floats in a sea of elastic guy-wires
that can be tense or relaxed, concentrically or eccentrically
loaded, competing and restricting or ready to accommodate.
Although I personally shrink from defining good versus
bad for a scapular resting place (it depends on the shape of
the back, the head, occupation, and a few other factors),
many would argue that good positioning involves:
the vertebral border of the scapula lying vertically
along a line above the angle of the ribs, and
the scapula hanging vertically when viewed from the side, with
the proviso that the rib cage must also be vertical. In the alltoo-common case of the rib cage being posteriorly tilted, then
the scapula that is vertical to the gravity line would actually
be anteriorly tilted relative to the rib cage (Images 6A and 6B).
Common displacements include a very common
(but often rib-cage centered) tilt of the shoulder
girdle as a whole, or the scapula can be:
too wide or too narrow (laterally or medially shifted);
held up or too far down (superiorly or inferiorly
shifted, though the latter is rare);

100

massage & bodywork

march/april 2012

wider apart at the bottom than the

top or (again, more rare) wider at
the top than the bottom (laterally
or medially tilted in our language,
but upward or downward rotation
in physiotherapy-speak);
held forward or pinned back
(anteriorly or posteriorly shifted); or
anteriorly or (very rare)
posteriorly tilted.
The commonly used protraction
and retraction are insufficiently exact
to lead to coherent strategies for
correcting shoulder position. The exact
nature of the terms outlined above
tilt, shift, and rotation applied to each
of the clavicle, scapula, and humerus
provides a shorter road to the most
efficient treatment plan. Protraction
may involve different levels of lateral
shift, medial rotation, and anterior tilt,
not to mention anterior, posterior, or
superior shift relative to the rib cage.

THE SCAPULAR X
The scapula is a roundhouse in
Anatomy Trains-speak, meaning that
many muscles compete in setting its
position. There are muscles going in
nearly every direction from the triangle
of the shoulder blade. Four of these,
however, are key to setting its position.

The scapula has many

muscles attaching
to itand thus its
position rests with
the balance of these
guy-wires: the rotator
cuff, deltoid, teres
major, triceps, biceps,
and coracobrachialis
attach it to the
humerus; the serratus
anterior and pectoralis
minor attach it to the
ribs; and trapezius,
rhomboids, and levator
scapulae attach it to
the spine and head.
We can safely ignore
the omohyoid in terms
of scapular position.

BODYREADING THE MERIDIANS

The scapula relates

primarily to the rib
cage in terms of
BodyReading. The
scapula can appear
vertical relative to
the gravity line (A),
but still be anteriorly
tilted relative to the
ribs. Straighten the
ribs, and then you will
see the anterior tilt
of the scapula (B).

Four muscles
compete to set
the primary
scapular
postural
position: the
rhomboids
and serratus
anterior form
one leg of
an X, while
the lower
trapezius and
the pectoralis
minor have an
antagonistic
relationship
along the other
leg of the X.

A
A

One leg of this X is the oppositional

forces between the rhomboid muscles
and the serratus anteriorthe
former pulling up and in (assisted
by levator) while the latter pulls
down and out (Image 7A). When the
serratus overcomes the rhomboids
is hypertrophic or concentrically
loadedthe scapula will rest too
laterally on the back (this happens
frequently in kyphotic patterns).
When the rhomboids dominateand
this happens frequently in flat-back
patternsthe scapulae rest too close
to the vertebral spinous processes, and
too medially for optimum function.
The other leg of the X is a little
less straightforward, but just as
powerful (Images 7B and 7C). The
only muscle that pulls down and in
on the scapula is the lower part of
the trapezius. To oppose this force, a
muscle would have to be pulling up and
out on the shoulder, which is clearly
impossiblethat would be a muscle
out beyond your ear. But wrap that
strap over the front of the body, and
you can see the reciprocal antagonistic

relationship between the lower trap and

the pectoralis minor, which can pull
the scapula up and over the rib cage
into anterior tilt or medial rotation.
You will have a difficult time
finding people where the lower trap has
overcome the pectoralis minor to pull
the scapula too far down and in, but
you will not have to go far to find those
where the scapula is crawling up over or
around the rib cage to the front. Medial
rotation or anterior tilt of the scapula
often lies with a short pectoralis minor
(or restriction in the clavipectoral
fascia in which it is imbedded). Various
stretching and manual therapy methods
can reach and lengthen these short
tissues, and are commonly needed
for proper shoulder girdle balance.
Whichever way we achieve an
even tonal balance among these four
and the other muscles that pull on the
scapula, the reward will be an easy
and mobile shoulder movement.

C
Celebrate ABMPs 25th anniversary and you may win a refund on your membership. ABMP.com. 101

BODYREADING THE MERIDIANS

Enjoy free ABMP

webinars with
Thomas Myers
as he details his
BodyReading the
Meridians series.
Visit ABMP.com
to access past
webinars in the
archives.

THE CLAVICLE
The clavicle holds our shoulder out away from the
midline, and is thus fairly well anchored to the top
of the sternum medially and must follow the scapula
laterally. There is a small disc in the sternoclavicular
joint, which tells us this joint must glide a little, which
is a necessary movement for good shoulder function.
When you ask a client to open his arms wide (as if
about to enfold a grandchild) and you see the scapulae rise
in back, the cause is often not a too-tight levator scapulae
or trapezius, but a sternoclavicular joint that cannot glide
laterally, causing this compensation in the back. When you
see this pattern, release the subclavius under the medial third
of the clavicle. When this heavily-fascial muscle relents,
the clavicle can glide, and proper arm carriage returns.
THE SHOULDER IN BREATHING
An easy but telling assessment for the shoulders is
to watch their response to the breath. Watch first
with the clients normal tidal breath, but if that is too
small to produce any shoulder movement, have him
increase the depth of the breath gradually until you see
some movement response in the shoulder girdle.
Generally, you will see one of three patterns:
The shoulder girdle moves straight up with the inbreath and back down on the exhale. In this case, look
to the muscles that hold the shoulder to the ribs
serratus anterior and pectoralis minor principally.
The shoulder girdle hardly moves, even with a deeper
breath. In this case, the shoulder is hanging off the
neck and head, and you should look to the trapezius and
levator scapulae that hold the shoulder girdle from above.
Interestingly, release of the scalenes, which are not normally
listed as shoulder muscles, but do attach fascially to the
arms, can often bring good results for this pattern.
The shoulder girdle moves up and out on the inhale; down
and in on the exhale. This, in my opinion, is the Goldilocks
movementjust right. The shoulder is loose enough to
ride and glide on the rib cage in response to the breath.

THE RELAXED ARM

From the hand up, one can read
more or less flexion in the fingers
(everybody flexes a little), ulnar or
(rarely) radial deviation at the wrist,
chronic pronation or supination of the
forearm, or excessive flexion at the
elbowcome to class for these details.
For space reasons, the last issue we
will deal with for the arms is where the
humerus lies in terms of medial and
lateral rotation. Various measures have
been proposed for where neutral lies
for the humerus. Ida Rolf urged us to
go for a balance where the olecranon of
the elbow pointed laterally, but I have
never been able to make sense of this,
either anatomically or functionally.
Some yoga teachers have suggested
that the elbow should point straight
back behind us, and I have never been
able to make sense of that measure
either. The conclusion I have come to
is that there is a broad range of neutral
in humeral rotation. It is, after all, the
most moveable joint in our body.
The humeral position that makes
the difference is not relative to the
torso, but relative to the scapula,
and that in turn depends on the
balance of tension in the rotator
cuffthe SITS muscles. The
subscapularis is a medial rotator;
the supraspinatus, infraspinatus,
and teres minor all contribute to
lateral rotationor more often,
stabilizing during medial rotation.
For an easy way to BodyRead
where the humerus lies, put the
index finger of one hand along the
top of the spine of the scapula with
your fingertip near the acromion,
and another finger to bisect the
olecranon. A 90-degree angle between

Celebrate ABMPs 25th anniversary and you may win a refund on your membership. ABMP.com. 103

BODYREADING THE MERIDIANS

The Functional Lines

extend the arms to
the opposite legs,
across the midline
of the body, forming
two large Xsone
on the front crossing
at the pubic bone,
and one on the
back crossing at the
sacrolumbar junction.

these two lines is about rightif the angle is too

acute, the humerus is laterally rotated; if too obtuse,
it is medially rotated in the glenohumeral joint.

THE FUNCTIONAL LINES

Finally, we should mention the other two lines that
extend the arms down to the contralateral legsthe
Front and Back Functional Lines (Image 8). When you
throw a rock or a spear, or bat a ball, the force generated
by the arm is multiplied by the additional lever arm of
the trunk pivoting on the opposite leg. The Functional
Lines transmit these forces across the midline of the
body in two large Xsone across the front, and one
across the back. These conjoined muscle linkagesthe
lower edge of the pectoralis major to the line between
the rectus abdominis and external oblique across the
pubic symphysis to the adductor longus in front, the
latissimus to the thoraco-lumbar fascia to the lower
gluteus maximus in backteam up to reciprocally
impart more momentum and speed to the hand.
Interestingly, despite the fact that we are all
handed and thus use one set of these lines more than
the other, my 30 years of observation tells me that
these lines rarely govern posture, perhaps because they
are used reciprocally with every step. Whatever the
reason, when you see one shoulder closer to the opposite
hip, it is usually the Spiral Line that is the culprit
( January/February 2012, BodyReading the Meridians,
page 94), not these innocent Functional Lines.
The arms are highly complicated bits of machinery,
very handy accoutrements to our bodys repertoire,
and amenable to the poetry of birds wings and
nonverbal haiku. We have covered only a few major
assessments, but we hope they are of use to you.
Next issue will be the last in this series as we take
on BodyReading of the last of the Anatomy Trains
lines, the core of the Deep Front Line.

Thomas Myers is the author of Anatomy Trains (Elsevier, 2009)

and Fascial Release for Structural Balance (North Atlantic, 2010).
Myers studied with Ida Rolf and has practiced integrative bodywork
for more than 35 years. He directs Kinesis, which offers more than
100 professional certifications and continuing education seminars per
year worldwide. For more information, visit www.anatomytrains.com.

Celebrate ABMPs 25th anniversary and you may win a refund on your membership. ABMP.com. 105