February 27, 2019

The Second Spine

By Suzanne Martin

Pilates instructors love working with asymmetry and I am no exception! We are all bound at the hip by our love of the curiously asymmetrical body. Starting out as a Pilates instructor from the dance medicine field and needing personal insight to my own issues led me into exploration of the spiraling world of torsional control. One especially useful dance training concept is of the inner thighs functioning like the Second Spine! Now a true convert, I use it as much as I can.

As a fascial enthusiast, it’s so astonishing to think that the Deep Frontal Line begins in the soft palate of the mouth, runs behind the heart and lungs, traverses down the psoas into the fascia of the Lower Pelvic Unit to form the gateway into the adductors, hamstrings, calves and finally ends in the soles of the feet. The Foot itself has nine Fascial compartments, which is a subject for another article entirely!
Assessing correctness of the width and orientation of the inner legs reveals asymmetries in musculature, an important aspect informing Pilates practitioners and clients alike in how to optimize their leg posture, something I call a Body Skill. Starting from top to bottom in the medial Fascial compartment of the thigh, is the pectineus, lying deep within the groin area, and connecting just below the femoral neck and attaching into the pubic Ramus region. These short muscles dictate a great deal about the side-to-side shift ability, which centers the torso squarely in between the legs. Going down the femur, next is the adductor Magnus. These muscles are often lost inside what most women fear most, the swish of the inner thighs against each other.
My best tool for educating about the use of the adductor Magnus is the wobble board, a sequence included in my recent asymmetry book. This important muscle mechanically links the Lower Pelvic Unit of the Deep Frontal Fascial Line, acting as an extensor of the femur. It assists tremendously in establishing that desirable connected vertical elongation from the trunk to the leg, what in dance we call being “on the leg”.
The next adductor is the Adductor Longus which ends just above the knee joint line on its tubercle on the medial part of the femur before it forms the condyle. The Longus truly forms the vertical strut system of the thigh. If it is not doing its job, the ilio-tibial band thinks it should be doing more, and then there is a problem. Usually we look toward releasing the IT Band before really looking at the internal /medial side of the thigh to investigate if the Longus is the forgotten relative. You absolutely cannot go wrong by working laterally in Russian splits or in Magic Circle inner leg work in both flexed hips and extended hips.
Finally at the bottom of the line is the sartorius, a long strappy, often undeveloped muscle that runs from the ASIS (the anterior superior iliac spine — yes, it does) to the inside (medial) aspect of the knee in union with its cousins, the Pes Anserinus. Literally translated as “goose’s foot”, this trio of tendons brace the medial knee. The sartorius is multi-talented is that it flexes the knee, participates in external rotation of the hip as well as being an adductor. The sartorius keeps the knees going in this sagittal progression, yet left unchallenged, it can turn into pigeon-toed gait. I’m currently working with a promising pre-professional ballet dancer who is overusing the Sartorius in lieu of her psoas. Advanced dancers are sneaky in that you have to look really hard to see where they are compensating. Although critical for pelvic arch connection, the Sartorius loses the battle in trying to solely elevate the leg into those above-the-pelvis développés. And that thought is also another whole article!
My favorite exercises to address and engage the Sartorius are half-kneeling knee extensions on the reformer and crossed standing work on the Split-Pedal Chair.
The inner thighs also really dictate what happens down into the feet, an important connection in anyone that wants to use their legs artistically or athletically. The feet appear to be their own islands, but indeed receive enormous influence from what happens above. Teaching about the feet is one of the most fun things I do all year, although it can take some persuading with the client. I cannot think of one client or one instructor, including myself, who does not need foot education. I was thrilled to become a Barefoot Rehab Specialist and now am a Barefoot devotee and incorporate those concepts into my teaching.
Although, in my dance medicine circles, training in front of a mirror is not always considered the best thing to do, it does serve a purpose. My mat classes accentuate standing with the use of the First Position Parallel, which I mean to be aligning the second toe (next to the Great Toe) with the mid-patella and mid-pant-line (where the femur head lies). Teaching this Body Skill to my clients and mentees is critical in the philosophy of lifetime management of performing arts skills, scoliosis/spinal asymmetry and leg issues.
Our clients are not as trained as we are. It takes a while to convert purposeful, conscious movement strategy changes into automatic mode. That’s why I use the “Imagine, Think and Feel” philosophy for movement acquisition instruction. I try to start with a good humorous or visceral image, and then show the client the anatomy and fascial links on themselves or a model, helping them to begin to finally feel the right position and movement quality. Then the magic happens … finding the second spine gave me immense control over my asymmetrical spine and now I get to help others find their true spine … what could be better?

Dr. Suzanne Martin has been practicing Pilates for over 30 years. She is a doctor of physical therapy, exercise physiologist and a gold-certified Pilates expert with a home studio in Alameda, California. An international presenter, she blends art and science, into her writing and instruction. She has been Lead Physical Therapist for over 20 years with Smuin Ballet. As founder of Pilates Therapeutics LLC she teaches worldwide on the subjects of spinal asymmetry, cancer restoration, foot management and performing arts enhancement. Look for her latest publication from Handspring Publishers, Spinal Asymmetry and Scoliosis; Movement and Function Solutions for the Spine, Ribcage, and Pelvis, available on the Pilates Therapeutics web site. For further information and to see her teaching schedule, go to www.pilatestherapeutics.com.
It is never too late to be what you might have been. – George Eliot
The only sin is mediocrity. – Martha Graham