The train rolls down the track, heading for the next station on the line. It picks up passengers at each scheduled stop along the route, getting ever nearer its final destination. This is a visual we can all imagine, and it's also a unique and simple way of looking at the musculo-skeletal system and its myofascial interrelationships.

Tom Myers, known throughout the bodywork community for his work in the art and science of structural integration, developed the Anatomy Trains concept as a way of explaining continuity in the body and identifying the myofascial chains on which the human form is so reliant. The Anatomy Trains theory relies on the concept of synergy ("the whole is greater than the sum of the parts") which looks at the body as a series of interrelated myofascial chains, and not just a system of individual muscles. For the body worker seeking out the pattern which contributes to the origin of pain in a distressed client, this is an important basis from which to work.

The Anatomy Trains concept is a beneficial global pattern assessment tool and an indicator of how pain travels. It offers an integrative approach to looking at relationships in the body - and looking at the body as a whole.

Having studied with Dr. Moshe Feldenkrais and Dr. Ida Rolf, Myers has long been involved in myofascial continuity. He credits his teachers with laying the framework for his own Anatomy Trains. Even though it is rooted in the world of structural and functional integration, understanding the Anatomy Trains scheme will help you unravel your clients' patterns of compensation, no matter what technique you practice. So how exactly did this work evolve? "I developed the concept from teaching myofascial anatomy to body workers," says Myers. "Ida Rolf and others had already put forward the idea that the whole fabric is connected, but that leaves you in a vacuum. Are some places more connected than others? The Anatomy Trains is my answer to my students. From a teaching device, this concept has developed into an effective tool for seeing, strategizing, practicing and reassessing."

Myers said he received a lot of help from colleagues at the Rolf Institute, from yoga teachers and from his students in developing the Anatomy Trains. "But the mistakes are all mine." After Myers developed and published an extensive article on these myofascial continuities, he came across hints of the same ideas in some German Anatomis of the 1930s, and in the work of the French movement genius, Meziere. "I was both chagrined to realize my ideas weren't totally original and relieved to know I wasn't totally off track," says Myers. "But I have never seen the scheme that I am laying out anywhere else. It is simply systems-thinking applied to musculo-skeletal balance."

Those exposed to Anatomy Trains have been quick to praise. Myers admits his Anatomy Trains classes are always full and frequent comments solidify the work's importance to body workers. "Finally, a way to see the body that makes sense" - that's how students most often describe Myers' concept.

Let's see if we can convey that same framework here by looking first at the origins of fascia, the rules of this Anatomy Trains game, a synopsis of the Anatomy Trains myofascial lines and how to put all of this into practice.

The Origins of Fascia
Cotton candy. That's how Myers describes the all-important collagen which is fascia. It helps to define us in our earliest days of embryonic development and it's the fibrous net that keeps the early mass of rapidly growing cells together in proper spatial arrangement. Myers echoes Deane Juhan in saying that this pliable, collagenous net is to primates what cellulose is to plants. It has no definable beginning or end. This net, which is simply a large organ of the body, is unitary "from top to toe and from birth to death."

The fascial net can be cut with a scalpel, torn with injury, thickened by poor postural patterns and dried out by loss of movement, but it always remains unitary, “constantly communicating the mechanical strains of tension and compression throughout our structure and providing the alembic for every other organic system and process…”1

During our earliest development, Myers says this net will be stretched and folded again and again to provide the approximate "600 pockets for muscle tissue, dozens of bags for organs..., as well as the supporting tissue within the organs..."2 It is this folding and stretching process that eventually creates planes among the fascia, allowing for movement of the body's tissues. Outside of a very few areas - ventricles of the brain and lymphatic vessels, and the lumens of the alimentary canal - the fascial net can be found in every inch of the human body.

Using the Anatomy Trains
Myers says there are rules to follow when identifying an Anatomy Train. They are simple and concise:


Rules of the Tracks
1. Continuity of direction, either through myofascial or connective tissue, or through
a bone.
2. There is no crossing of conflicting planes of fascia.
3. Fascial lines can converge and diverge. There are Y junctions (much like switches on
the railroad) where choices can be made as to which track to take.
4. Lines have tracks and stations. Tracks are the muscle-connective tissue units, while
stations are typically where the lines are tacked down, also known as attachment sites.
5. Lines have expresses and locals. Expresses are more superficial and involve multi-joint
muscles; locals are deeper and involve single-joint muscles.

Myers contends that it's important to work with the line as an entire entity, and not a compilation of individual muscles and tissues. These singular parts we are used to looking at are simply human-made inventions, Myers says. "The Anatomy Trains concept provides a ready explanation for why events which are quite distant from each other (the site of your pain and my work, two different sources of pain, the problem and the source, etc.) can still be logically connected. If a stubborn pain does not yield to local ministrations, look farther a field - but look along the anatomy trains lines as likely routes of transmission from elsewhere."

When thinking of the line in its entirety, Myers says that "points or areas quite distant from the presenting symptom may hold the key to the entire pattern,"3 and he hastens body workers to be willing to look and work further from the pain site when administering touch.

Identifying Anatomy Trains
Myers has identified 11 myofascial lines in the body in common use across human movement. Following the rules of the game, you can identify other alternative routes or unique tracks that injury or attitude has forced on an individual client. Let's take an Anatomy Trains tour of the body. "Knowing the lines allows you to think creatively about the presenting ailment," he says.

The Superficial Back Line
The superficial back line moves from the bottom of the foot to the brow ridge and is used any time we forward bend. It starts with the plantar side of each toe, where fascia and tendon meet with the distal attachment of the plantar fascia at the metatarsophalangeal joint, says Myers. This line follows the plantar fascia as it joins with the periosteum of the calcaneus, eventually leading to the Achilles tendon origin. From where the line joins with the soleus and gastrocnemius muscles, where Myers puts his derailment - a kind of "fudge factor" - into play.

Following the rules of the tracks takes issue with the gastrocnemius connection to the hamstrings (they are contiguous, but clearly separate), but Myers makes his explanation. "The heads of the gastrocnemii reach around each other so that when the knee is bent, the hamstrings and gastrocs are disengaged, not part of our train. But when the knee is extended, the condyles of the femur push back exactly into the junction of the two sets of muscles, forcing them into a unified contact, much as if the two sets of muscle heads were trapeze artists grabbing each other by the wrist. In this way, our train continues up the back of the leg, tying the toes and the ball of the foot to the ischial tuberosity - but only when the knee is extended."4

Myers says this is why picking up an object from the floor is easier with a bent knee than a straight one. "The fully extended knee means the person engages and tenses the entire superficial back line from tuberosity to the toes - and as yoga students and dancers will tell you, tension can be felt at different times for different people anywhere along that line."5 Continuing on from the ischial tuberosity, the line moves to the sacrotuberous ligament which is attached to the sacrum, the dorsal sacroiliac ligaments and sacral fascia. As the latter is the origin of the erector spinae muscles, Myers says it's easy to take a "long ride" up the laminae of the erector fasciae, not getting off until the nuchal line of the occiput. After this track meets up with the buried galea aponeurotica - the scalp fascia - and travels over the cranium, the train makes its final stop at the brow ridge.

Putting it into practice
With the tracks identified, how is this superficial back line put into practice? Myers says both postural analysis and having the client bend forward slowly will indicate where the line is constricted. Myers offers this illustration of the distant point concept: "...affecting the plantar fascia may do more to release lumbar lordosis than wailing away for an hour on our client's lumbar erectors or poking at their psoas muscle. Staying aware of the entire pattern each time you assess helps avoid 'chasing the dragon' from one spot to another."6

Problems indicative of superficial back line origin include locked knees, lumbar compression, sub occipital hyperextension, and any restriction to a forward bend.

The Superficial Front Line
The opposite and balancing component to the superficial back line is the superficial front line. Like its counterpart, the superficial front line starts at the toes, moving along the extensor digitorum and extensor hallucis tendons to the dorsum, under the retinacula and into the anterior lower leg. Here it weaves with the tibialis anterior and the tibia's periosteum before heading to the tibial tuberosity and the sub-patellar tendon of the rectus femoris.

The line follows the muscle up to the anterior inferior iliac spine, where once again we encounter a derailment. Myers explains that while jumping from the anterior inferior iliac spine to our next stop - the rectus abdominis - breaks the fascial continuity rule, a mechanical continuity exists between the rectus femoris and rectus abdominis via the hip bone, thereby allowing the leap when considering movements in the sagittal plane, like flexion and extension.

From the rectus abdominis, the line moves up to the outer aponeurosis to the fifth rib and sternocostal cartilages. Following the sternal fascia or sternalis muscle, the line travels to the origin of the sternocleidomastoid (SCM), arriving at the mastoid process before ending at the superficial fascia of the scalp.

While Myers admits some may be tempted to move the line along a different set of tracks up the front of the throat, the SCM "is clearly part of the superficial fascial cylinder of the neck and the proper track for continuing the superficial front line."7

Putting it into practice
Myers says the superficial front line is relative to the startle reflex (a predisposition to a protected posture) and to the body pattern identified as "red light" by Thomas Hanna. Make a loud noise behind someone's head and the "predictable reaction includes flexion all along the trunk, but (also) a hyperextension of the neck. This may now be seen as a contraction of the superficial front line, which would flex the trunk by drawing in anywhere between the sternal notch and the tibial tuberosity, but would hyperextend the neck by drawing the mastoid process closer to the sternal notch."8

This posture, if held over time, could affect practically all bodily function, especially breathing. "The shortened SCM pulls the head forward and requires compensatory action in both back and front that restricts rib movement. Excess tension in the belly restricts both rib movement and diaphragmatic response, while shortness in the front of the hips throws out the balance between the respiratory and pelvic diaphragms and results in only the front of the respiratory diaphragm being used in breathing."9

The Lateral Line
With front and back lines established, a lateral line on both right and left sides is the next track to follow. Starting again at the foot, the lateral line moves along the peroneus longus and the peroneus brevis to the crural fascia's lateral compartment and the fibular head. Jumping from the head of the fibula to the iliotibial band and up the iliac crest is the next path of the track. What's created here is the first of a series of diamonds, or Xs, of the lateral line - three along each side of the rib cage, crossing between the tensor fasciae latae and the superior fibers of the gluteus maximus, and the lateral portions of external and internal oblique muscles. From here the intercostals, which follow the same pattern as the abdominal obliques, create a series of these Xs up the ribs. Above the shoulder, we find another cross - the SCM and the splenius capitis helping to determine head position relative to the thorax. Derailment #3 - These Xs break the continuity of direction, but, says Myers, "they do still form a functioning unit along the side of the body," somewhat like those old Chinese finger puzzles.

Myers says some might rather put the levator scapulae as the muscle foundation for this final diamond form, but that can create problems. "Since the levator is clearly more involved with the shoulder than the ribs, trying to balance the trunk via the shoulder in this way leads to many a sore scapular apex."10 Before leaving this line, it's important to note that the underlying layer in balancing the lateral line are the quadratus lumborum at the waist and the scalene muscles at the neck. In terms of movement, Myers says a fish motivates by wagging its tail side to side with its lateral lines. For humans, who motivate much more through flexion and extension, Myers suggests thinking of this entire lateral line structure as a "moderator of movement" as opposed to a "creator of movement."

Putting it into practice
Assessment from the front or back will give immediate indication of any differences between the two sides of the lateral line. "A more far-reaching clinical implication of the basket weave of Xs is immediately apparent when we look at our clients from the side," writes Myers. Draw an imaginary X on your client - one line from the spinous process of C7 to the pubic bone, the other line from the sternal notch to the sacro-lumbar junction. Are they the same? For many in the Western world, the sternum-sacrum line will be shorter (and more stuck) than the C7-pubis line. Myers gives this suggestion for working with this aspect of the lateral line:

"Start with the C7 - pubic bone leg of the X. Put your hand on the upper back and on the lower belly and instruct the client to move your two hands away from each other. Anterior tipping of the pelvis and lumbar hyperextension are common responses. Have the client try letting their head float up to the ceiling and note the different results. Then put your hands on the manubrium and the sacrum, and give the same instruction. Clients will often have trouble figuring out how they could do this. You can sometimes help them find this movement by taking a pinch of skin from the manubrium and the sacrum and pulling gently in opposite directions along the leg of the X. Get them to breathe in. Since this line goes through the mediastinum and the crura of the diaphragm, just achieving this movement is sometimes a deep experience for clients."11

The Spiral Line
Linking trunk rotations, scapular positioning and foot arches is the fascinating spiral line which wraps the trunk and legs. This track begins on the mastoid process with the splenius capitis muscle which wraps the erector spinae before connecting to the lower cervicals and upper thoracics. On the other side of these spinous processes, the rhomboids carry the line over to the vertebral border of the scapula.

Following the fascia deep into the scapula, the line tracks on the serratus anterior muscle, wrapping around the rib cage. Picking up the fibers of the external oblique, the line moves across the abdominal aponeuroses, through the linea alba and over to the opposite anterior superior iliac spine (ASIS). Of course, as with the lines previously discussed, there are two spiral lines - one on the right and one on the left. With the spiral line, though, these two lines cross each other - once at the upper thoracics, and at the navel. This "double spiral arrangement" was first identified in a paper by anthropologist Raymond Dart whom Myers credits for his first inspiration for the Anatomy Trains.

Continuing over the ASIS, the spiral line picks up at the tensor fasciae latae and the iliotibial tract. From the tract to the tibialist anterior muscle, the line moves around the shin and anterior ankle to the junction between first cuneiform and first metatarsal. Next on the route is the peroneus longus, the fibular head, and the biceps femoris. Crossing knee and hip, the line ravels the ischial tuberosity to the sacrotuberous ligament before joining with the superficial back line.

Putting it into practice
Much is at play in the spiral line, including structure and interaction with other superficial lines. In a scoliotic pattern - no matter what its source - a common occurrence is that one side of this line will be "locked" shorter than the other. It could be locked with the same rotation as the spinal scoliosis, or perhaps as a counter-rotatory compensation. Myers notes, "Although partial correction to a scoliosis can ensue when this line, or the held parts of this line, are freed, practitioners should note that any rotational pattern held for any length of time will necessarily involve many deeper structures in its maintenance."12 Notice that the lower part of the spiral line forms a loop from the front of the pelvis, under the foot arches, and back up to the posterior part of the pelvis. Myers notes that these connections have significant implications for clients with fallen arches, pronations or eversions.

The Arm Lines
Myers considers the myofascial continuities in the arm separately from the trunk and legs. "In a human being, the arms hang off the supporting trunk," notes Myers, "and therefore have a different relationship to the structure." In practice, of course, the arm lines are seamlessly connected to the rest, especially in the movements of sport or active work like shovelling. Myers identifies four arm lines which run from the axial skeleton to the four "corners" of the hand - the palm, the thumb, the back of the hand and the little finger.

Superficial Back Arm Lines
Beginning virtually where the superficial front line left off - the fascial plan posterior to the SCM - is where we first meet this line. Hitting the superficial trapezius, the line moves to the deltoid, the deltoid tuberosity, the lateral intermuscular septum and down to the lateral humeral epicondyle. Finally, the line moves along the common extensor tendon to the back of the hand and dorsum of the fingers.

Deep Back Arm Lines
When looking at the triceps, one has to go to a deeper line. Starting with the distal end of the rhomboid, at the medial border of the scapula, the line runs behind the humeral head and connects near the proximal attachments of the triceps. Running down the triceps to the olecranon process, the line ends along the periosteum of the ulna to the pinkie finger.

Superficial Front Arm Lines
This line begins with the latissimus dorsi, passing under the humerus to the medial intermuscular septum, where it's carried down to the medial humeral epicondyle to the flexor tendon and palmar side of the wrist and hand.

Deep Front Arm Lines
As with the triceps, biceps follow a deeper line. Starting at the outer scalene fascia, the line moves to the brachial neurovascular bundle, the costocoracoid ligament and the subclavius muscle to the pectoralis minor. The biceps myofascia then hooks up with the radius, flexors and thumb side of the hand.

Although the arms can be parsed quite neatly and usefully in this way, Myers notes that, "because our arms are modified for increased mobility (as contrasted with our relatively stable legs), there are many crossover switches in the arms which link these lines to each other. The short head of the biceps goes above the shoulder joint, linking it to the supraspinatus and rotator cuff, or, in Anatomy Trains terms, linking the deep front line to the deep back line." These crossover linkages are necessary to allow the arm's mobility to be employed in all the various possible movements.

Putting it into practice
According to Myers, misuse of these arm lines can lead to malposition of the shoulders on the rib cage, possibly contributing to kyphosis and imbalanced muscular development, or disturbance to breathing. Balanced arms hang in equipoise without disturbing breathing or neck function.

Functional Lines
Frequently, limb motion is powered or counterbalanced by the opposite side - think of a baseball pitcher as he powers a throw from the right hand with the left foot. The front functional line includes both pectoral muscles, thus joining the front arm lines to the abdomen - the outer edge of the rectus abdominis and inner edge of the external oblique - down to the public bone. Continue in a straight line through the pubic symphysis and emerge on the prominent tendon of the adductor longus, which goes deep into the thigh to attach to the back of the femur. Thus the shoulder is connected down into the opposite leg across the front.

In the back, the latissimus muscle connects the humerus to the sacral fascia. The line continues across the sacral fascia, the lower part of the gluteus maximus, and then sweeps over to the femur. The line can continue with the vastus lateralis, passing through the patella to connect to the top of the tibia.

Putting it into practice
Like the spiral lines, these cross at the midline and are thus easily assessed by drawing an X from shoulder to contra lateral hip to see which lines are longer. The fact we are right- or left-handed ensures that these lines are rarely exactly equivalent. "That's OK," says Myers. "Balance is less a matter of perfect symmetry than a good marriage between left and right." Spiral stretching is often a good way to get these lines back into the client's awareness.

The Deep Front Line
This line constitutes the body's myofascial core, which follows the interface between the ancient organic self and the newer locomotor body. Myers says the deep front line is a complex mixture of postural muscle and fasciae that "exposes the inner organization of the body and allows entry into a deeper system of resolution and healing."13 Described as a line in the front of the vertebral bodies, but behind the major blood vessels and alimentary canal of the trunk. Myers says the deep front line doesn't follow the body's surface geometry so much as it follows the "inner bio-logic of ontogeny and phylogeny."14

This core line begins at the distal end of the tibialis posterior, under the foot's tarsum. It moves behind the medial malleolus and under the soleus into the leg's deep posterior compartment, where three muscles merge into a fascial plane which follows the back side of the knee's articular capsule to the popliteus and then to the medial femoral condyle.

Passing through the adductor hiatus, the line meets up with the intermuscular septum, running under the sartorius muscle to the femoral triangle - the armpit of the leg. Travelling through the centre of the triangle, the line hooks on to the iliopsoas, which connects it from the leg to the trunk. Continuing behind the diaphragm, the line follows the anterior longitudinal ligament up the front of the spine to the occiput at the base of the skull. The upper portion of the deep front line offers three choices of tracks, including the one just mentioned.

Putting it into practice
The deep front line shows up earlier in embryonic development than any of the other lines, and with its core function, is considered a vital element in clinical and treatment applications, says Myers. In addition, attaining or maintaining length in this line is also important to overall health. "Length along the deep front line is what is ultimately sought in those methods that value length, such as yoga, Rolfing and the Alexander technique," writes Myers.15 He goes on to say that problems with organs "will find expression" in a shortening or distortion of this deep front line.

Since the deep front line is entirely covered by the rest of the lines described, failure of some part of this core line is often unnoticed, but it sets up the conditions for further problems later.

The importance is even further clarified: "the connections of healthy communication along this line to breathing, circulation, digestion, elimination and sexual maturity are so vast and manifest so individually that we are reduced to pointing out the area, and urging practitioners to study and feel their way into a sensitive manner of freeing, easing and lengthening the myriad aspects of the deep front line."16

How to Apply Anatomy Trains
As body workers look more and more at whole body health as it is expressed in structure and movement, the Anatomy Trains concept will help lead the way. Looking at the body as a continuity of function, one can hone in on the Anatomy Trains lines for indication of what is occurring within.

No matter what method you use to treat, look for full range of movement along the lines, and an evenness of tone along the myofascial units comprising the line. An injury site on a line will eventually spread distress along the entire length of that line, like the rubber bands on one of Bucky Fuller's "Tensegrity" structures. The injury or dysfunction can also create problems for other lines, spilling stressors to other chains of fascia. "This dysfunction in turn can set up imbalances that create the conditions or predisposition for a new injury. As such, we view the fascial net as a whole and the lines in particular as the terrain in which the entire history of injuries, both somatic and psychological, play out into patterns of mechanical strain"17

For instance, a person who chronically shortens the superficial front line in a slump will necessarily create extra holding in the superficial back line. It could be anywhere along that line. Some people will come in pointing to their neck, others pointing to their mid-back and others rubbing their sacrum. Likewise, twists in the body could easily involve the deep front, spiral, functional and lateral lines. If what you have been doing is not working, ask yourself two questions. Given the line I'm working on, is there somewhere else along the line that is overly tight or fixed which could be helping to maintain the pain in the part that hurts? If the hamstrings simply won't release, check out the plantar fascia or the sub-occipital muscles. These muscles, which also lie within the same fascia as the hamstrings, may hold the key to releasing the stubborn tension. Secondly, ask: Is there another line that is pulling or forcing this line to overwork in compensation? To use the same example, are the hip flexors of the deep front line so tight that they are forcing the hamstrings of the superficial back line to stay contracted?

An easy, upright, poised balance is the goal here. To move closer to that goal, the body worker must first identify any restrictions to adaptability in the client's lines. Freedom of movement and communication amongst the lines are indicators of this adaptability. Although he teaches a structural integration protocol based around these lines, Myers says implementing any number of therapies - Trager, yoga, triggerpoint, myofascial release - can increase a line's freedom and the body's balance.

The Anatomy Trains serve as a potent tool for assessing client's posture and movement, especially in unravelling those patterns of compensation in the fixation of muscles which contract to steady our body every time we make a change in our position. Familiarity with the lines can make the body worker's job easier by providing an efficient and complete way to analyse the situation, and to create a treatment plan - either within a session or over a series of sessions, which will effectively and, most importantly, permanently deal with the situation.

Myers hopes the Anatomy Trains concept will provide a unifying theme across the various professions involved in human movement. "Anatomy Trains theory doesn't have all the answers by any means," he says. "But it does provide a valuable step away from mechanical thinking toward integrative, spatial medicine - and it could provide a common language, a means for us all to converse about how best to resolve the global patterns that manifest in our locomotor system."

Footnotes
1 Myers, T. W., "The 'anatomy trains'," Journal of Bodywork and Movement Therapies, 1,2 (Jan., 1997): 93.
2 Ibid.
3 Ibid., 97.
4 Ibid., 95.
5 Ibid.
6 Ibid., 97.
7 Ibid., 98.
8 Ibid., 99.
9 Ibid.
10 Ibid., 100.
11 Ibid.
12 Myers, T. W., "The 'anatomy trains': part 2," Journal of Bodywork and Movement Therapies 1,3 (Apr., 1997): 137.
13 Ibid., 140.
14 Ibid., 141.
15 Ibid., 143.
16 Ibid.
17 Ibid.

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james@active-health.org