Elements of a Structural Theory of Breathing

Author
Translator
Pages: 28-39
Year: 1988
Notes on S.I

Notes on Structural Integration – December 1988 – 88/1

Volume: 88/1

A very general way to answer the question of what constitutes the subject matter of Structural Integration is to state that it is the “body in gravity”. Not the parts of the body and the way they are assembled is regarded primarily, and it is not even the “whole body” which is under consideration, but the larger system “body in gravity” forms the object of theory and practice. From this follows that gravity becomes the referee when we make quality statements about different structures or decide on the intention for integrating structure. This separates Rolfing in two distinctive ways from most methods and points of view which may seem similar or are actually related in some manner. First, the frame of reference is derived from the reality outside the human person and not from inside. This is in contrast to such fields as chiropractice, osteopathy, or acupuncture which construct their concepts of normalcy from the body itself or parts and properties of it. Secondly, gravity is an absolute reference in that its two properties, direction and quantity of energy, are exactly defined and can be measured with great accuracy. This is again in contrast to most other methods because the nature of the body is such that it provides no objective absolutes. Their concepts of normalcy if defined absolutely are always arbitrary to a greater or lesser degree.

For rendering the concept of gravity as the referee useful the term “body in gravity” must be qualified. From the distinctive view point of Rolfing the body is made up of two elements: structure plus a functional component provided by active muscle tension, the tonus pattern of the whole musculature of the body. All three elements can be thought to be related in the following way. Gravity acts on structure causing it to collapse. This is prevented functionally by muscle tension. The notion permits to make value statements about structure, such as: the less muscle activity is needed to uphold the body in gravity the higher its degree of structural integrity; if after a session less muscle tension is necessary for standing than before the structure has been integrated (more). Stated more formally, the quality of structural integrity of a body relates reciprocally to the energy needed to maintain its erectness in the gravity field.

Some difficulties arise aside from the problems of measuring total muscle activity. They stem mostly from the possibility that a body with its given structure can stand in innumerable different ways at very different levels of muscle tension. The fact is that nobody stands as easy as possible, with minimal muscle tension just necessary to uphold stance, if asked to stand as easy as possible. Usually various areas of the body can be relaxed considerably without the body breaking down. The body stands actually better then as expressed by better balance and the subjective sense of better support from the ground. This suggests to answer the question of how a body with its given structure stands best with: the easiest way is the best. The answer may be a little surprising because it is not in terms of geometry, the vertical and the horizontals, but in such of economy in the physical sense. It finds its theoretical counterpart in the basic premise of Rolfing which is economical. In the form of a question it asks: what kind of structure permits the body to function most economically? The evolved theory of normal structure in geometrical terms then only specifies that structure which meets the criterion stipulated by the economical premise.

A consequence of this view is that both the basic premise and the final criterion for evaluation minimal muscle tension as imposed by gravity the referee – are in the functional realm, on a level above the structural one. This theoretical framework as well as the practical necessity to understand stance, which is function, suggest and perhaps make it mandatory to examine function more closely. The functional question is in analogy to the structural one: what kind of function is most economical? From the specific structural point of view we expect the answer to be in geometrical terms, too. We want to know what economical function looks like. Furthermore, Rolfing provides a natural method for approaching the problem. We ask the specific question: how does an ideally integrated body stand and move most economically? The question is extrapolated directly from the structural intention of providing a structure that can function most economically. The question appears natural and interesting how such a normal structure makes use of its potential.

An entirely different aspect of what could be called the “structural method” of inquiry needs to be mentioned. Probably the large majority of methods which examine aspects of reality are analytical in nature. They tend to isolate and define the smallest parts as sharply as possible and attempt to find the rules by which these parts combine. Putting them together along those rules they kind of rebuild the whole of reality under examination as a model. Valid as it is, the procedure inevitably encounters the difficulty that on more complex levels of synthesis new principles enter which are not contained in the parts. The problem is expressed in the saying that the whole is greater than the sum of its parts.

There are very many attempts but actually not so many successful methods which start at the whole and try to explain reality from there. They often suffer from the drawback that very often when they proceed to the more concrete and detailed they also turn out to become so vague that they appear useless. Rolfing certainly belongs to this second class of methods. However, this procedure is very demanding, and because the “analytical mode” seems to be so deeply ingrained in the human mind one involuntarily drops into the latter all the time. This can lead e.g. to a theory of a “normal spine” or “normal walking” derived from examining the local aspect in isolation which not infrequently can be seen to be false right away when confronting them with the “body in gravity”. The following proposes a “ladder” to go from the general to the specific – and back up again!

1. The shape of the “body in gravity” at the structural point, or “structure proper”.

2. The alignment of all the segments.

3. The shape of the trunk.

4 The spinal system with its curves.

5. The shape of the thoracic segment.

6. The shape of the ribcage: ribs plus sternum plus thoracic spine.

7. The form of the thoracic spine.

8. The spatial relationship of two vertebrae

9. The geometry and tissue quality of local ligaments.

This ladder can also be read “functionally” because function is considered in this paper by extending structural principles to the functional. Then 1 becomes “the normal change of shape of normal structure”, 2 “the normal movement of normally aligned segments”, and 4 “the normal change of the curves of a normal spine”.

The example given is selected from a greater chart which would have the form of a branching tree. Except for 1 there would always be alternatives to fill in when descending the ladder to arrive at any part in the body. Instead of “segmental alignment” (2) ‘front-to-back contour” could be chosen, or “whole body rotation”, or perhaps even “collapse/tension considerations”.

I must also admit that the ladder is not consistent. The “spinal system” (4.) e.g. does not fit into the model of segments directly. The spine is neither inter- nor intrasegmental only.

An advantage of the system is that it is open, however. It is never finished as it permits new models or views to enter at any level if they are defined and described. Corrections of established notions are easily possible, and a little more consistency would be welcomed.

However, the main property of the chart lies in certain rules between levels. It is hierarchical in that the theory on a more general level precedes and determines the statements on lower levels. A certain contention on a lower level must not contradict a contention on a higher level. On the other hand, a lower level limits the number of possible contentions on higher levels. A statement about normal structure or movement of the whole leg e.g. must not demand something from the ankle joint it can’t do. Ideally and as a certain support for the truth and relevance it would be desirable that the contentions on the various levels harmonize with each other.

The function or movement of breathing has been chosen to apply such structural principles to because it seems to represent in an exemplary way the pretty saying that movement is the change of shape. It is also ever-present, it is an important tool in the practical work, and it is strictly a means to some other end: it doesn’t intend a movement of the body for its own sake and certainly not for an external purpose like locomotion.

General Aspects

On a very general level breathing presents as a fact that the body is changing its volume rhythmically by about 2%. It may be a little less or considerably more. For practical reasons it is easier to choose the conventional starting point of the body in exspiration. The question is then how the body distributes this additional volume that comes with inspiration throughout its space. Since we go from the assumption of a perfectly normal body in perfect balance – in exspiration -, inspiration at first can only seem to threaten to destroy that balance.

Of the simple geometrical bodies the cylinder offers itself as the most general model for the body. In a cylinder, mass is distributed symmetrically around the central axis and evenly all along it. Mass is closest to the central axis of all comparable bodies of the same length and volume. This minimizes its rotational inertia. A cylinder goes into rotation and is stopped in it easiest. Illustrated negatively, the cylinder is the form least apt to be chosen for a spinning top. Ease of movement is the most stringent condition for constructing a normal body, and the cylinder guarantees that at least for rotational movement.

A cylinder can add volume in two ways if its integrity is to be kept, if its main axis of symmetry and its midpoint which is also the gravity center should remain unchanged. It can increase its radius, become wider evenly in all four directions perpendicular to its long axis, and all along it. Or it can become longer evenly on both ends. The second solution meets the problem of the cylinder standing on firm ground which doesn’t permit lengthening into it. It would result in an up and down movement of the gravity center requiring additional energy. There is no question that the head should not hop up and down with breathing, but the notion will come up again in a different way. After all, the body should also lengthen in movement.

<img src=’https://novo.pedroprado.com.br/imgs/1988/1029-1.jpg’>
Fig.1 Two ways for a cylinder to add volume without disturbing its main axis of symmetry and its gravity center. The barrel becomes a cylinder when the material exceeding the limits of the cylinder is distributed at both ends, placing it closer to the central line.

Only the section of the cylinder representing the trunk is now considered. It is evident that the trunk of a normal body deviates in two ways from a cylinder in the general view. First, it resembles more a barrel than a cylinder because its two ends are narrower than the centre. The barrel increases in circumference from the upper thoracic aperture toward the center at about the costal arch and decreases again towards its lower end, the pelvic floor. Secondly, the cylinder is flattened in the front-to-back dimension. The horizontal crosssection shows an ellipsoid with a longer transverse than sagittal diameter.

An ideally integrated trunk is certainly not a cylinder. It is a flattened barrel, but just which one of the very large number of different flattened barrels is the normal one cannot be determined exactly. A partial solution comes from considering quantitatively imbalanced structures only. They are “too much barrel” – the ends are too narrow and the middle is too wide -, and they are too flat in the sagittal diameter. For such structures it seem safe to state that they should primarily add volume and widen towards their upper and lower end, and they should preferably increase their sagittal diameter in inspiration. In other words, when quantitatively imbalanced bodies change towards normal in inspiration, they change exactly in the direction toward the cylinder.

When considering the ideally shaped trunk again, which cannot be defined exactly, it turns out that when it adds volume it cannot keep exactly all its internal relationships. The observation reflects a special feature of the method of going from the perfect structure which should remain perfect in movement: it is not possible. The shape changes anyway. But then there is always a choice. The shape can change toward even higher perfection – which may appear as some kind of a paradox – or it can change away from it more. For the normal trunk and inspiration this means that it can change toward the cylinder or away from it. From the structural point of view the first choice is preferable. So the contention seems reasonable that a normally shaped trunk should change toward the cylinder in inspiration and back in exspiration (1). This should be even more evident when normal is thought to be in the middle between inspiration and exspiration. The system would oscillate around that bias in the way indicated.

Qualitatively imbalanced structures must be mentioned. An example would be a structure of some ectomorphs which is extremely restricted around the diaphragm and resembles an hourglass. Another is given by some structures with a narrow and deep thorax with a sagittal diameter greater than the transverse one. Such structures are not “flattened barrels” to begin with and therefore the statements made above don’t apply. The structural intention would in practice be to change these structures toward the flattened barrel first(2).

Another more practical aspect is indirectly related to these general considerations and not concerned by the several qualifications necessary. If the central axis of barrel and cylinder is to remain untouched, the movement of breathing must be symmetrical. This is self-evident for bilateral symmetry. But it is just as compelling for front-to-back balance. Most people breathe very much into their front side, be it more into chest or more into the abdomen. Parts of the back very often also move forward, especially the LDH and the cervico-thoracic junction. But even if the back stayed where it is such a pattern would necessarily bend and push forward the central axis, upsetting balance. Given the relative rigidity of the back, structural work and movement will primarily focus on the back, enabling it to balance the inevitable widening forward in front by a comparable excursion backwards. There are also functional obstacles to this, because of all the six directions in the body the back is by far the least prominent in consciousness. Now and then a client wants to know which type of breathing Rolfing theory favors, chest or belly or perhaps the sides. It is almost always a new idea for them when I state “back breathing” as normal. This does not mean of course that the front of the body should contract to blow out the back. It states that the breathing motion should be felt downward along the anterior side of the back. This results in what should be expected from the structural point of view: the motion travels down vertically along the central line.

The Thoracic Spine and the Dorsal Hinge

The logo shows two segments in the thoracic area. In contrast to this, the term “thoracic segment” is used here for the whole area as a unit, comprising roughly the two. This larger segment can be thought to be bordered by two planes going through the cervico-thoracic junction on top and the lumbodorsal junction at its lower end. These planes are perpendicular to the midline of the body. In an ideally normal body standing the midline would be vertical and so the planes would be horizontal.

In real bodies where nothing is ever exactly vertical or horizontal, the perpendicular relationship of midline and planes can help to evaluate the shape of the thoracic segment. If the midline is known, the planes can be constructed. If the planes are known, information about the direction of the midline where it intersects the planes is gained. Unfortunately, both concepts are fairly abstract and can’t be determined exactly or even measured. The situation is circular with no part of the relationship known exactly. Still, for evaluating the shape of the thoracic segment in practice the relationship is useful. By mentally juggling back and forth between the midline and the bordering planes, correcting one by the impression of the other, perception of the actual shape of a thorax becomes fairly realistic.

The skeletal part of the thoracic segment consists of the thoracic spine, the ribs, and the sternum. The lower ribs dip deeply into the lumbar segment. The customary way of describing the change of shape of the thorax is by analyzing the complicated movement of the ribs. To this end, the thoracic spine is assumed to remain immobile. Not infrequently this legitimate procedure falls into the reductionist trap of never coming back to the original assumption and resolving it. The spine is left there immobile, so-to-speak. From the structural point of view it seems more promising to reverse the procedure and examine the movement of the spine in isolation first. This is very simple: the thoracic spine extends in inspiration and flexes in exspiration. The spine is given priority not as a system of itself but as part of the back. This implies a view of the body as a hollow cylinder or a tube. This tube is rather flaccid as it is formed by the soft tissue on all sides. Inserted into it are bony reinforcements, and since the posterior side of the tube is considered primarily the spine as part of this back side is viewed as a reinforcement of it. The spine is definitively not treated as a mast or as a structure holding up the body.

Description of the extending spine makes it necessary to go into the concept of “hinges” first. I propose to define for the time being a hinge as a joint whose rotational axis conforms to certain conditions. This leaves out the notion of “fascial hinges” which seems more a dark hunch so far. One can take exception rightfully to basing the “hinge” directly on the “joint”. The first is a much more abstract concept. It mainly regards the changing spatial relationship of the relatively large body parts which connect at the joint. For this aspect the rotational axis, which is itself a relatively abstract concept, is important, and emphasizing it in the definition should partly cover it, shifting the focus away from the more material content of the “joint” in the traditional sense. But the term “joint” has already expanded in the Rolfing context as expressed e.g. by its “definition” as “everything that crosses it”.

I find three criteria a rotational axis must meet for the joint to be a hinge, or have “hinge function”. They are first formulated in a structural way with the absolutely normal structure standing in perfect balance in mind. This is followed by a “minimal functional” description. It indicates the exact border between “hinge function” and function that cannot be considered so, between “normal function” and “random” or “average function”. The third formulation is “positive functional” and indicates the direction the rotational axis should take in hinge function. The meaning of this may become clearer when a circular movement is considered. When a person standing still lifts an arm and drops it again, the hinges of the arm behave in a certain way in a geometrical sense, they move in space, change direction, and then come back to their place of origin. This movement should be toward normal in the structural sense and back to “home”, not away from normal and back. In the arm movement mentioned, the axis of the shoulder joint should drop initially, not rise. The “positive functional” is concerned with the direction only in which a movement is initiated.

1) -structural: the rotational axis must be parallel to one of the three coordinates of space.
– minimal functional: the rotational axis must not deviate further from normal, its respective space coordinate
– positive functional: the axis of rotation must approach normal initially.

In the leg, the normal axis for most movements is transverse for knee and ankle hinge. The hip joint has three axes – which should be parallel to the three space coordinates – and hinge function exists when movement around each of the three axes conforms to the criterion. This multidimensional function presents no problem. In general, when movement around one of the axes improves because of structural work, the others profit from it, too.

One complication comes to mind, although others might turn up. It concerns the elbow. With the movement usually considered standard – elbows pointing out – the axis of rotation is in the sagittal axis with the arm hanging down. Perhaps a majority of movements call for this arrangement, as when one reaches to grab something, holds onto a handrail, cuts bread, or types. The axis changes away from horizontal a lot of course, but it always stays in the sagittal plane. Generally the forearm is pronated, the axis through the wrist of the hand is transverse, the palms look posterior or down. But there exist other movements as when carrying a large bundle, when being handed a baby, or when demonstrating the thickness of the biceps – which call for a different arrangement. Here the normal axis through the elbow is transverse, the forearm is usually in supination, the palms of the hands point forward or up. The axis through the wrist is also transverse but rotated 180°. Half of this difference, 90°, is contributed by rotation of the humerus which takes along the elbow, the other 90° by pronation/supination of the forearm.

It appears that there exist two different norms for the elbow. If the sagittal axis is considered the “primary norm”, the transverse one could be called a “supplemental norm”. It is remarkable that of course movements exist which call for the elbow axis to be somewhere between these two fixed points, but the majority of movements when analyzed as to what is normal reveal that the axis is in one of its two normal orientations. A conflict arises here because both orientations are normal for one and the same function: flexion/extension. This is not the case with the hip joint where different functions are assigned to each axis. The structural dilemma comes from the intention inherent in Rolfing that the whole body must be organized in such a way that the hinges are permitted to be without strain in their respective coordinate, and that movement around it doesn’t disturb the arrangement and requires no effort. Obviously, when the arm and the body are structured to fit the primary norm for the elbow perfectly, every time the elbow needs to go into the supplemental norm a major shuffle and rearrangement of the whole body ensues. It appears that it doesn’t make sense to organize the elbow firmly into one or the other norm. The structurally formulated criterion cannot be met by the elbow. Instead, the functional form of the criterion should take precedence. It would state that the elbow functions as a hinge when and if it can swing into either of the normal axes effortlessly as required.

2)- structural: the rotational axis must be far away from the center of the body.
– minimal functional: the rotational axis must not be drawn in towards center.
– positive functional: the rotational axis moves away from center initially.

The structural formulation does not appear very enlightening. It can perhaps be understood when considering the leg in easy stance. Then the axes of the ankle, knee, and hip joints should be on a vertical line in the sideview. The gravity center of the body should be on the same vertical. If any of these axes is away from this line structurally, the distance to the center of the body shrinks. The gravity center not only sinks but is pulled down.

The functional interpretation comes easier. It is in accordance with Ida Rolf?s contention that the body must lengthen in movement. What must lengthen is the midline through the body and the limbs.

3)- structural: the rotational axis must be in line with the other rotational axes.
– minimal functional: the rotational axis must not go out of line more. –
-positive functional: the rotational axis must go more in line iniatially.

For the joints of the leg this line is vertical and coincides with the Line as mentioned above. For the many eccentric joints of the spine the line through all the intervertebral joints should be smooth and curved “normally”, although normal cannot be stated exactly here. The functional formulation is in accordance with the extension mode of movement. When the spine extends by initial relaxation of the musculature in front of it, it becomes longer and the vertebrae generally align better. When the back contracts primarily (flexion mode), the spine shortens, rotations become more marked, and displaced vertebrae tend to be pushed out more.

The functional side of these criteria can be illustrated by an example. In sitting, one knee is held up with the hands, the lower leg and foot are left to hang away from the knee passively. This can also be done with folded legs. Then the ankle is slightly anterior of the knee because of passive tissue tension. The foot is in passive plantar flexion indicating that the gravity center of the foot is in front of the axis of the ankle. The foot is pronated, the ankle axis is tilted down on the fibular side and rotated internally a little. With dorsiflexion (extension) in the flexion mode – when the extensors contract – the situation becomes worse in all respects. Pronation of the foot becomes more marked because the extensors overpower the peroneals easily, the side-tilt of the foot is more pronounced. The foot is pulled up toward the lower leg, it moves forward more and up around the ankle joint.

In the extension mode, the heel lengthens first. It goes down, pulling the ankle with it in the distal direction. The heel also moves back, centering the gravity center of the foot better under the ankle joints. The medial malleolus goes distal with it a little. If the peroneals are favored over the extensors, the medial malleolus goes distal while the lateral one stays distal and comes back, normalizing the axis of the ankle hinge without jamming the joint.

In Ida Rolf?s proposed normal spine T7 appears as the most posterior of the thoracic vertebrae (Rolf, p. 209). It forms the apex of the posterior convex thoracic curve. In accordance with the general principles, T7 should not move when inspiration begins. The thoracic spine extends by the upper and lower vertebrae coming back over and under T7.

An odd feature of Ida Rolf?s spine appears on closer examination and when the question is asked how the spinal curves result from the geometry of the constituents, the vertebrae and the disks. In standard. descriptions the curves seem to result from slight differences in height in front and in back of vertebrae and disks. The thoracic curve appears to stem mostly from a slight wedge-shape of the vertebrae whose bodies are a little higher in back than in front. For the lumbar curve the wedge-shape of the disks seems to contribute more to the curve. Flexion and extension between two vertebrae is described primarily as a rotation around a transverse axis. In contrast to this, Ida Rolf s spine shows hardly any wedge-shape especially of the bodies of the thoracic vertebrae. They seem to have the same height in front and in back, and they appear to be oriented horizontal on top of each other. The curve seems to be due to a slight sagittal shift of the vertebrae. The impression is that of a stack of blocks where the single blocks are slightly displaced horizontally so that the line through their gravity centers is curved. This suggests that extension would be by a horizontal sliding back of upper and lower thoracic vertebrae, not by rotation. For this discussion the standard approach is chosen, but the problem deserves perhaps further attention (4).

Ill.2 depicts extension between two thoracic vertebrae. It can be imagined that T6 rotates back over T7, which is horizontal and immobile. One example is conventional (from Kapandji, p. 125), the other in the modified way structural theory would demand. The first shows that the intervertebral space widens in front but becomes narrower in back. This puts the axis of rotation which is transverse somewhere near the center of the intervertebral disk. The joint surface of the inferior articular process of T6 slides down on that of T7. It is limited and stopped when the bones of the articular and the dorsal processus touch. The disk in back and the whole joint area is compressed.

The extension mode stipulates that the joint surfaces don’t slide. The axis of rotation is much farther back and goes through the joint where the joint surfaces meet. If this is extended, it could even be speculated that in highly integrated bodies the axis of rotation is still farther back, posterior to the joint. This would mean that the inferior articular process of T6 slides up on that of T7 – initially. The joint would actually “open”. But in either way there is no compression of the disk – and the vertebral foramen but decompression.

The thoracic segment may be divided into “subsegments” consisting of one vertebra and a more or less horizontal slice through the thorax. The concept is perhaps a little artificial because the ribs certainly don’t fit into it. If they are disregarded, this permits to examine the movement of the subsegments with respect to each other. The axes of rotation between the subsegments of the conventional description are not hinges because they come closer to each other. Since it implies that contraction of the back musculature effects the movement, it also tends to push T7 forward, thus conflicting with the criterion which calls for a hinge to move away from center. The “extended” description with the axis in back of the joint and the joint surface of T6 sliding up a little on that of T7 would conform with the hinge criteria. The axes between the subsegments would all detach a little from each other vertically, and all would go back and away from center. The situation as shown in I11.3 for the extension mode would constitute something like a minimal demand: it would not fulfill all hinge criteria but neither would it actually violate them.

<img src=’https://novo.pedroprado.com.br/imgs/1988/1029-2.jpg’>
Fig.2 “Standard extension” of the spine (left) and proposed “extension mode extension” (right). Note the axes of rotation. (Adapted from Kapandji.)

For the thoracic spine as a whole it was stipulated that T7 should remain still in space initially because it is the place of the widest diameter of the barrel in back. The upper and lower thoracics coming back above and below it contribute as for the back contour to the barrel approaching a cylinder. When the slack of the extension possible has been taken up, the thoracic spine as a whole with T7 can move back more to allow for deeper inspiration. A “dorsal hinge” for the thoracic spine can now be defined with the following properties:

1. The dorsal hinge is the axis of rotation around which the upper and lower thoracic spine opens and closes.

2. This axis is at the level of T7 and not farther forward than the vertebral joints T6/T7 and T7/T8.

3. It doesn’t move forward in extension, and when T7 goes also back in deeper inhalation it goes back with it.

4. The hinges of the subsegments move back in proportion to their distance from T7, and the distance between the hinges of the subsegments does not become shorter.

These criteria are minimal in that they indicate the border where even slight failure to comply with them results in “flexion mode” and compression. The positive formulation would include that the dorsal hinge is farther back than the joints T6/T7 and T7/T8, that it would move back in extension, and that the distance between the “subhinges” increases. It should also have become evident that the “dorsal hinge” is a more abstract concept and of higher order than other hinges. It is something like the resultant of the action of its constituent “subhinges” and could be called a “compound hinge”. It cannot be compared to a doorhinge which as an image fulfills the minimal criteria for a hinge. It is more like the starting point where a wall-paper is being unrolled up and down the wall and being straightened and stretched in the process. However, this property exists also with individual joints with hinge function. For, a hinge does not only describe the relative movement of bones but of all the tissue. Perhaps it should be stated as a fourth quality of hinge function that the soft tissue changes too in a geometrical sense. For the knee joint when flexing this means that the slightly convex front contours of thigh and lower leg by elongating become less curved and more parallel to the limb axis.

The Ribcage

For the description of normal rib movement it is assumed first that they don’t move with respect to the vertebrae they are attached to. In other words, the angle between ribs and the x-axis of the vertebrae is held fixed. Then with extension of the thoracic spine it follows first that their posterior attachment goes back with their respective vertebra. The farther away from the 7th rib the more pronounced this receding will be. The uppermost and the lowest ribs extend backward most. Secondly, the slight rotation of the vertebrae which orients their sagittal axes more horizontal will lead to the ribs spreading. The upper ribs spread cranially away from the 7th rib and each other. The lower ribs spread away caudally. It could be said that the movement resembles that of a Japanese fan, but it must be remembered that the posterior rib attachments don’t come together but also detach a little from each other up and down.

The rib movement postulated in this way differs mainly in two ways from the standard description, or it can at least be said that it emphasizes these two aspects. First, the upper ribs don’t thrust forward but rise vertically in front because they recede in back with their vertebrae. Secondly, the initial movement of the lower ribs is caudal and back.

This spreading is limited by the fact that ribs 1-10 attach to the sternum directly or via costal arch. Evidently this restriction is less pronounced if the connective tissue is resilient. But there are also three anatomical mechanisms which specifically allow the spreading of the ribs to go farther.

1. The angle between manubrium and corpus sterni opens. The first two ribs following the movement of their vertebrae become more horizontal. Their attachments to the vertebrae rises a little bit beside going back, their frontal attachment to the manubrium rises more. The sagittal diameter increases first back and then also forward. The opening of the sternal synchondrosis – with the angle between corpus and manubrium closer to 180° – takes up some of the forward gain. It also verticalizes the manubrium more and so delays the moment when tension would come into the sternum (cf. Kapandji p. 135).

2. The sternum as a whole which is slanted back cranially becomes more vertical. This seems to be in the form of a tilt around a transverse axis through about the middle of the sternum or a little behind it. Especially if the initial slackening of muscle tone at the end of the exspiratory pause is pronounced it can be observed how the distal sternum with the xiphoid sinks back a little. Gravity and slight tension from the receding lower thoracic spine transmitted via costal arch would explain this movement. The upper sternum tilts forward a little. The sum of 1. and 2. is a somewhat larger vertical distance between the sternal attachments of the. first rib and the costal arch.

3. The costal arch opens. The ribs are cartilaginous here where they turn medial and cranial to reach the sternum. Right behind is the junction with the bony ribs. These end as cones in their cartilaginous continuation and permit mainly vertical movement in the sagittal plane at the junctions. The situation for the costal arch would look as follows: The lower thoracic spine takes the posterior rib attachments back and down a little. This opens the angle at the costal arch. The opening may be a little less or delayed if the distal sternum is allowed to sink back. It certainly is not increased at first by the distal sternum because this doesn’t go forward and up initially. Later in inspiration the costal arch may come forward and up a little when the sternum begins to rise vertically. But by then the movement of the lower ribs is mainly out to the sides.

The question is justified and must be addressed why the ribs should follow the vertebrae first and not move relative to them by staying in place. A first answer is simple: because the stipulation fulfills the criterion of filling up the barrel to a cylinder. But the question goes of course deeper and really asks for the forces involved. For movement of the lower ribs and the costal arch the answer is gravity. The extension of the thoracic spine and gravity explain the behaviour of the lower ribcage. It can be viewed as a hanging bridge connecting lower thoracic spine and distal sternum. Later in the movement and with deeper inhalation muscle activity will set in and carry it farther.

This is different with the upper ribs. Gravity will cause them to lag behind and rotate caudally relative to the vertebrae going back and horizontalizing. This effect can be produced when experimenting. But when one wants to sense it very distinctly it becomes apparent that voluntary relaxation of the anterior muscles of the neck is necessary. It must be considered that the receding upper thoracic spine takes the cervico-thoracic junction back, too. As explained later, this takes back a little the cervical spine, too, and effects an extension in it. The head comes back with it and tilts down forward. These movements are subtle but noticeable. Then the cranial attachments of the fasciae accompanying the scalenes and sternocleidomastoideus go back and up a little. This induces a slight tension in this tissue which would tend to assist the upper ribs coming up in front. But such a mechanism would call for these muscles to keep their tonus with beginning inspiration or even raise it a little(5).

<img src=’https://novo.pedroprado.com.br/imgs/1988/1029-3.jpg’>
Fig.3 Proposed change of shape of the ribcage in which the trunk comes closer to the cylinder. The lower part of the barrel is omitted.

The theory ascribes a primary function to these muscles which are often subsumed under “accessory inspiratory muscles”. This is not a simple reversal of priorities however. In our case, this function is in the context of and actually depends on a subtle play of the tonus pattern which maintains opening of the body everywhere. When these muscles contract forcefully to effect strong inhalation the situation becomes completely different: the cervical spine is flexed, the head tilts back, the top part of the lungs is locked off instead of opened.

It should be added that the tonus in the upper ribcage seems somewhat higher than lower down. It seems reasonable that the external intercostals by also keeping their tonus aid in raising the upper ribs to keep in tune with the spine.

The stage is then set for the upper ribs to rotate up additionally around the vertebrae. Actively the external intercostals and probably the anterior neck muscles are effective. Passively, the rotational axis needs to be considered. This is given by the line through the articulatio capitis costae and the costotransverse joint. It is oriented more along the frontal than the sagittal plane. Extension of the spine would augment this preference and take the axis a little back, away from center, horizontalizing it more in the frontal plane. This would fulfill at least partly the hinge criteria. With the lower ribs, this axis through the two rib joints is closer to the sagittal than the frontal plane. Pull along the ribs is then partly converted to a lateral movement.

The question of what effects the breathing movement needs more discussion. The conventional explanation names the diaphragm and the external intercostals as working muscles, which by contracting increase the volume of the thorax. One can accentuate that contraction to get a sense of these muscles working. However, the movement which results is different because the volume gained – largely in front of the body – is at the expense of compression somewhere else and so does not express the extension mode of movement. A variation is inspiration by the erector trunci muscles only, which seems to come closer to the pattern formulated here. However, this is the manner of a “true” Japanese fan. The thoracic spine is straightened but jammed in back, the dorsal hinge is driven forward and the opening of the chest in front is at the expense of severely upsetting balance.

An interesting phenomenon can be reproduced regularly experientially. When one goes from such flexion mode patterns to extension mode, the sensation of muscles disappears. No muscles which work can be identified subjectively anymore. The model of “working muscles” becomes useless and must be replaced by the “tonus pattern” model. This says for the thoracic spine that when it is considered as static in exspiration its curve is the result of a functional balance. To all the connective tissue in front of the spine with its passive tension plus gravity acting on this structural set-up, there adds a functional factor in the form of tonus of all the musculature in front. The sum of this is balanced by passive tension plus muscle tonus in back. If tonus of the prevertebral musculature is reduced voluntarily – which does not by necessity mean consciously -, balance is upset and movement results. This is extension of the spine as if extensors contracted. They don’t contract, however, and so the extension is qualitatively different from extension by extensors really contracting. It is not accompanied by contraction, shortening, and jamming of the back. It is granted that the effect of the extension mode in terms of visible movement may be small. But its importance and advantage cannot be overrated. Mechanically because energy is saved initially instead of spent, and especially because it is so more favorable energetically to accelerate a motion already initiated than beginning it from standstill. Physiologically because all the parts moving away from each other provides the prestretch essential for optimal muscular functioning.

An observation from the practice may be helpful. Sometimes when a client stands after a session and he is asked methodically to relax the sleeve muscles (neck, shoulder girdle, chest, back, belly, pelvic floor, knees, feet), his head comes up, he lengthens from the ground up through the middle. When a structure is unbalanced, the tonus of the sleeve muscles holds the body up. When a structure possesses a certain degree of integrity, these same sleeve muscles contract the body like a bedspring tied down with strings. After all, muscles can only pull the parts of the body together.

When a standing body – a client’s or one’s own – is observed, an exspiratory pause helps to demonstrate matters more clearly. The pause should not be longer than 2 or 3 seconds because very soon after this the body will prepare for a forced inspiration. Then, at the end of the pause just before inspiration begins, a slackening of the sleeve can be observed. It can be sensed subjectively or with hands on that chest and belly as well as the superficial layers of the back musculature relax. The sleeve seems to drop a little all around. At the same time and obviously connected with it the inside of the body begins to rise, the spine begins to lengthen(6). The phenomenon can perhaps be taken as a sign of core/sleeve differentiation, structural as well as functional. Slackening of the sleeve removes the “strings from the bedspring”, and well integrated bodies experience the rising of the inside at least initially as passive. This one-sided relaxation should shift the tonus balance between extrinsic and intrinsic musculature toward the latter. So the somewhat speculative conclusion is that initial sleeve relaxation causes the vertebrae to detach slightly from each other which at the same time optimizes conditions for the intrinsic muscles. These would actually not have to contract much to continue the lengthening of the spine because they would be “in charge” the way they are due to the diminishing contrary effect of the sleeve muscles. It can be imagined that they would be more “working” by modulating their own tonus pattern to align the vertebrae more exactly.

Movement of the Whole Body

The lumbodorsal junction is also sometimes called the lumbodorsal hinge (LDH). It is normally somewhere between T10 and L1. It is not easy to see why it should be a hinge. In the simplest example of a hinge the door and the door-frame rotate in opposite directions relative to each other around the hinge axis. With the LDH as the rotational axis the thoracic spine above and the lumbar spine below rotate in the same direction. The LDH resembles the central axis of a revolving door. A hinge needs a joint, the LDH doesn’t. Still, some properties of the hinge can be attributed to the LDH when it is compared with the dorsal hinge, which has been called a compound hinge. The feature common to both is that not only parts rotate around an axis but both parts of the spine above and below lengthen and become less curved as a result of the movement of the subhinges. From this point of view the only difference lies in the geometrical property of the curves which are to lengthen and straighten being in the same direction with the dorsal hinge, in opposite directions with the LDH. The LDH marks exactly the point of transition between convex and concave curves. Extension through the LDH would then mean that both curves lengthen and straighten at the same time, flexion that they both curve more at the same time. The movement is exemplified by what happens at the transition point of a sinus curve, at a, which is drawn apart and pushed together.

This geometrical specialty of the LDH is directly related to the mechanical integrity of the system. For, if on one side the spine lengthens but on the other it doesn’t or even curves more, shearing forces and compression result immediately. Of course we find exactly the same situation at the other ends of the curves. It shows that there exist four such special points of geometrical transition in the spine: the lumbosacral junction, the LDH, the cervico-thoracic and the atlanto-occipital junction. It is tempting to assume that these four points lie on one and the same vertical, which is posterior to the Line, around which the spine weaves back and forth. This line would indicate the normal vertical orientation of the back wall of the tube. It could be called the “back-line”. The four points on this line are intimately related if mechanical integrity is at stake. When the lumbar spine lengthens, the thoracic spine must also lengthen, and because of this the cervical spine must do the same. In other words, normal movement means for the spine that it extends (lengthens) and flexes as a whole through all the four points. There are of course movements which demand bending either way of the back which is also called flexion and extension and so confuses the issue. They involve bending of the midline of the body and must be analyzed from there. However, the large majority of such movements in which the back is bent with average bodies is not normal. Especially all the movements called “bending” forward and down are a variation of Folding and don’t bring about bending of the spine in the normal version. Midline and “back-line” actually lengthen.

<img src=’https://novo.pedroprado.com.br/imgs/1988/1029-4.jpg’>
Fig.4 Hypothetical “back-line”. The four points of geometrical transition are indicated. The line comes back in inspiration and lengthens, with the dorsal hinge staying in place initially.

The increase in volume of the trunk would be by two mechanisms as far as the posterior wall of the tube is concerned. The dents in the back, the lordotic curves, fill out; and the vertical of the transition points moves back as a whole, keeping its vertical orientation (Fig.4).

The normal change of shape of the back in breathing can now be described as follows. The spine is assumed to be shaped perfectly normal – which cannot be defined exactly – and forms a median. The system swings around this bias by lengthening homogenously as a whole in inspiration, and in exspiration it becomes shorter: the curves become a little more marked than normal. As for the whole of the trunk, the posterior excursion of the back as indicated by the “back-line” is matched by a forward widening of the front of the body. This leaves the gravity centers of the segments in the same place in space; the midline of the body remains intact. A complication turns up already when looking at real bodies. The description is only valid for the perfectly normal body and for internal spines. When posterior lumbars, “deep thoracics”, or a kyphotic cervical spine come into play, the model has reached its limits. It does not explain how such structures should function normally. But it permits to formulate a hierarchy of goals for the structural work:

1. Normal direction of the spinal curves must be established.

2. Transition points must be established at their normal place.

3. Normal degree of curvatures must be established.

Maybe the cause for a certain fixation on 3. lies with a tendency to identify the “random body” with the internal body only. There the direction of the curves is normal and the transition points are generally not too far from normal. Only 3. needs to be considered. But it is self-evident that in more complicated cases, which seem to turn up more and more often, the hierarchy stated must be observed. It makes no sense to talk or think about the degree of a curvature when its direction is the wrong way.

The situation is radically different at the upper and lower pole. For head and pelvis, horizontal is normal. If they are to oscillate around normal too, the head is tilted back in exspiration, the pelvis anterior. With inspiration, both switch their tilt to the other side. But while the spine and the back change shape rhythmically on a purely quantitative range, the stipulated switch of direction of tilt for head and pelvis means that they alternate constantly between two entirely different mechanical regimes.

The movement of the head presents itself in the following way. Its gravity center as indicated by the ear is a little more forward and higher than the atlanto-occipital junction. With the dorsal hinge remaining stationary, the lengthening of the spine brings the junction a little up and posterior. Since the gravity center must remain on the Line to conform with normal balance, the head tilts anteriorly in inspiration around a transverse axis through its gravity center. Similarly, the spinal movement brings back and down a little L5/S1, taking the pelvis into a posterior tilt around its gravity center which stays on the Line. Since the gravity center is a little higher than the rotational axis through the hip joints, these go forward a little. The net result is a slight extension of the hip joint.

For reasons discussed elsewhere (p. 7) it is unfavourable for head and pelvis to alternate between anterior and posterior tilt. They choose one of the two kinds of tilt with the mechanical regime which belongs to it and oscillate within that regime quantitatively. Only the internal structure is now considered. It comes closer to normal in inspiration. The spine with its too deep curves lengthens and straightens. The head which is tilted back becomes more horizontal. The anteriorly tilted pelvis horizontalizes also. The flexed knees extend a little. This comes from the postulate of the gravity center of the thighs having to stay on the Line. Since its upper end at the hip joints goes slightly forward, the knees must go back in compensation. Then the ankle joints want to go forward to keep the gravity center of the lower legs on the Line. This seems to express itself a little differently in reality, though. The ankles can’t go forward much for anatomical reasons. Instead, the heels recede a little. The medial arches of the feet so become a little longer; the soles of the feet relax and approach the floor more(7).

The whole movement appears like the extension of a spring in inspiration and a sinking back in exspiration. But it is not “up and away” from the ground. With the initial relaxation of the sleeve and of the soles of the feet, the body is first set down on the ground and by extension against or into it the inside rises aligning the segments more vertically and horizontally from the ground up. The subjective impression is that of the body going onto a higher energetic level in inspiration and back with exspiration to rest. The term is very vague, of course, but it corresponds to the viewpoint of potential energy. It is also in accord with considerations about the slight oscillation of the autonomous nervous system.

A further aspect is provided by the cross-planes of the body which all horizontalize more. The soles of the feet, the pelvic floor, the respiratory diaphragm, the upper thoracic aperture, and perhaps also the cranial base become more horizontal and widen. Maybe they “resonate” with each other in inspiration.

This leads to considering the role of the diaphragm which is less prominent than in most other theories of breathing. The model initiates breathing by a lengthening of the spine which is effected primarily by an additional relaxation of the sleeve musculature. The resulting tonus imbalance leads to the predominance of primarily the intrinsics which keep their tonus. The volume of the whole cavity of the trunk increases, especially towards its ends; the pelvis becomes more horizontal and this allows the pelvic floor to relax and widen. Negative pressure develops in the whole trunk. It not only draws in air but also sucks in the soft abdominal wall. Initially the abdominal wall falls back. The diaphragm descends like the piston of an engine, but its function is not to increase the volume of the thorax. The movement of the diaphragm serves to transfer the volume gained in the lower half of the trunk upwards where it can be put to use. From the point of view of integrity of form it preserves that of the lower trunk. The lower back widens, the LDH goes back, and the pelvis provides additional volume. Without the action of the diaphragm this would lead to the belly being sucked in, in this way upsetting balance of the lower trunk. The task is optimized for the diaphragm by the kind of movement described. It is horizontalized from its posterior downward slant by the xiphoid dropping, the LDH going back, and the angles of the costal arches opening and turning outside. The ring of attachment of the diaphragm to the tube widens and provides prestretch. So the relatively rigid horizontal plate of the tendinous diaphragm is lowered easily by its muscular part all around its rim from an optimal vertical direction.

The subjective experience of this kind of breathing looks about like this. Just before inspiration the sleeve relaxes some, especially chest and upper back. The breath is imagined as a passive flow vertically down along the anterior side of the back. It is more a trickle than a stream. At the height of the “wave-front” moving down, the “tube” relaxes more. Especially the pelvic floor is felt clearly to relax and widen. After 2-4 seconds the flow reaches the floor. There it presses the relaxing soles of the feet lightly down to the ground, spreading them like soft sucking caps. The heels slide back. Then the rebound from the floor can be felt coming up the body. It juggles the inside of the body up and closer to the vertical. The sensing of the soft feet on the floor is increased and must not be lost. At the same time when the wave comes back up along the central line, verticalizing it, the “tube” widens all around. The horizontal planes horizontalize more and widen, too. It is not so easy to sense both aspects of the rebounding wave at the same time. Focus should alternate between the inside verticalizing better from below and the circular “wave-front” widening the “tube” from the ground up. The upper thoracic aperture rises last, horizontalizing more, and it should not be forgotten that the cervico-thoracic junction goes back and also rises slightly.

The model of inspiration presented resembles to a large part the craniosacral motion in the flexion phase. There is a difference however because towards the end of inspiration arms and legs clearly want to rotate internally. This does not imply that their front aspects come closer together. The axes of the limbs detach laterally with the “tube” wave coming from below. So internal rotation is a result of the musculature in back of the girdles relaxing more or having a greater effect than those in front. If arms and legs remain passive however, a tendency can be felt for them to rotate externally. If this is allowed to happen the front of the body widens more than the back eventually and the midline of the body bends forward convexly. This upsets balance. So the internal rotation of the girdles should better be called external rotation of the posterior side of the body. It counteracts the unbalancing tendency and in effect assures balance as expressed by the midline remaining vertical and free from drag.

For anatomical reasons the front of the trunk can widen more and permits a greater anterior excursion than the back. The attention paid to the back can be understood to optimize primarily the situation on this more restricted side which has less potential for opening. But even then towards the end of inspiration and especially if the inhale is deeper the front can be felt to overtake the back. External rotation of the limbs would aggravate this imbalance and result in a rhythmical alternation of the midline of the body bending forward convexly and back. This is not desirable. So in inspiration we have eventually a relationship of external rotation of the trunk compensated by internal rotation of the limbs. In exspiration this relationship is reversed. This does not mean that there is a conflict between craniosacral motion and the breathing movement as seen from the structural point of view. The first is probably driven by a rhythmical change of pressure in the liquor system. It affects the body passively. For the second the medium is the tonus pattern of the body which is or should be designed to safeguard functional balance. Gravity dictates which pattern is best.

When one looks at reality it becomes apparent that truly congruent internals and externals are about as hard to find as structures which are so close to perfect that they can be called normal. The normal breathing movement described could lead to regard conflict in structures not only as pathology. Such conflict could also function as compensation because neither the congruent internal nor external structure is favorable from the structural point of view.

An entirely different problem is presented by external structures. If the movements of the parts of the body were imposed on them in the same manner and direction as those for the normal and internal structure, they would change shape away from normal with inspiration instead of toward it. This would be contrary to the idea of functional integrity. It appears that in these cases the direction of movement is in many ways reversed. The problem is however related to the fact that externals present many more and more intricate problems when working structurally. A different theory of breathing is needed for externals. When using breathing as a functional auxiliary means in Rolfing externals, the principle that with inspiration the body changes toward normal takes precedence.

Summary

The “structural method” is described as going from the system “body in gravity” which dictates what is normal for local concerns. It can be extended to the realm of function by formulating its basic economical premise as: “what would most economical function of a perfectly normal body look like?” The main criterion assuring economy is balance in the gravity field. To this structural concept corresponds a functional one stating the same. Most economic and therefore normal function is also dictated by the gravity field, and the answer must also be in geometrical terms.

Breathing is understood as a change of shape of the body. Normal breathing is defined by balance being kept intact in movement. This leads to more special considerations of a geometrical nature. To this end, several definitions must be made, especially concerning the concept of hinges. Normal breathing is described from the movement of the spine as a part of the back because it is the most restricted part of the body. This permits to conclude on the geometrical change of the ribcage. The forces involved are discussed. Finally, the description is extended to the whole body.

Complications turn up at every step of theorizing from the approach chosen. They not only limit the validity of this approach but also open up the view to new problems which can be presented as more sharply defined questions. The enquiry into a functional problem is intended to demonstrate that this approach presents structural questions in a new light permitting a more concrete and concise formulation of such structural problems. So just as the structural approach gives new insights on function, these functional consequences enrich structural theory. The paper is open-ended intentionally – but also by necessity – and invites the reader to continue the enquiry by creating a more solid ground for further evolution of the theory.

Additional sources:

Kapandji, I.A.: “Funktionelle Anatomie der Gelenke”, Bd. 3: “Rumpf und Wirbelsaule”, “Bucherei des Orthopaden”, Bd. 48, 1985, Enke, Stuttgart.

Schmitt, Johannes L.: “Atemheilkunst”, 1966, Humata, Bern.

Notes

1. An objection is justified here. We could start with the normal body in inspiration and contend by the same kind of reasoning that in exspiration it change toward the cylinder. However, the situation is not symmetrical. This alternative contention would ask for the thoracic spine to extend in exspiration and flex in inspiration e.g.

2. This leaves a group whose structure is a flattened barrel but not enough so. This seems more a theoretical problem, though. In Rolfing practice change will also be toward normal as with qualitatively imbalanced structures, preferably for exspiration.
3. The gravity center of the foot does not appear among the criteria Perhaps it can be said that if the gravity center is aligned better, the hinges of the foot are also aligned better.

4. The geometrical “modeling” must not be confused with the structural description of segments as in the Notes on S.I 87/1, p.26/27. There, the coordinates of space are used. The “shift” defines the position of the segment, the rotation around axes through the gravity center its orientation. Here the rotational axis is eccentric, not through the gravity center of the vertebrae, and hence describes a shift of the gravity center of the vertebra (up and back) plus a rotation around an axis through that gravity center.

5. It must be kept in mind that not the conventional movement up and forward of the upper ribs is described. This is a rotation of the ribs relative to the vertebrae. The much more subtle movement is being discussed which allows the ribs to match the movement of the vertebrae so that in effect no rotation of the ribs, which would be downward, happens.

6. Perhaps the term “extension” should be substituted by “lengthening” for structural purposes because it is so strongly associated with extensors contracting.

7. It is not so clear what constitutes internal and external in the foot. My working hypothesis is that in the internal foot the lateral contour is longer than the medial one and vice versa in the external foot. This leads to a lateral convex midline of the foot with internals, a medial convex one with externals. The tendency for internals would be towards a high

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