Last year I had the privilege to attend a four hour anatomy lesson with cadavers at the Bastyr University in Washington as part of Rebecca Leone’s Excel program. Spine safety is a big concern for me and at that point I was still experiencing lower back pain from my 2 disc bulges, so I went to Seattle to learn from Rebecca. She has devised a cadaver anatomy lesson relevant for the teaching of Pilates, with a strong focus on spine safety.
Our neurology is of utmost importance to our body’s health and function. Anyone who has experienced the impairment that results from nerve impingement worries about performing most of the exercises in the Pilates repertoire and being in pain again.
The cadavers in the lab have been donated to science by the individuals in life. The bodies are all previously dissected for a particular purpose and studied by future health practitioners while their integrity is preserved so they can be returned to their families. They are kept in hermetic bags on tables. We used special jackets and masks to avoid inhaling the fumes from the chemicals that preserve the bodies. The temperature in the lab was very low and we had to wear a few extra layers of clothing. This was a very different experience from university in Brazil where we would study body parts which were kept in baths of chemicals, a very confronting experience.
At Bastyr University, the atmosphere of respect and contribution towards the greatest good of humanity was so evident that we could let go of tension and allow our curiosity to overcome the fear of facing the absence of life in a body. It was interesting to see how the muscle tone of those individuals was affected by their health and lifestyle. What stood out to me was that in the absence of life, our bodies really only tell the story of how we treated them.
I was impressed by the thickness of the thoracolumbar fascia and the iliotibial band. It was quite interesting to see that the abdominal aponeurosis is quite wide and the abdominal muscles don’t cover a large area in the front of the body, which made me think that their role in spinal stabilisation is way more relevant than in spinal flexion. Some anatomy books refer to these muscles as the lateral abdominal muscles. The rectus abdominis can only be seen when the fascial sheath formed by the aponeuroses of the three lateral muscles is cut, moved and lifted.
The organs inside the abdominal cavity are all surrounded by their own supportive connective tissue called mesentery. The mesentery anchors the abdominal organs to the posterior abdominal wall, helping keep those organs in place but still allowing for some mobility.
Looking at the spine and the spinal nerves was the most amazing part of this experience. Dr Love had previously separated the lamina and spinous processes off the whole spinal column. The long stack of bones was held together only by the posterior longitudinal ligament. She discussed how the ligaments that bind and support the spine allow for little movement to happen between each vertebrae and the consequences of over stretching those ligaments.
When the spinous process was removed we could see the spinal cord and the sensory and motor nerve roots. The spinal cord at the L2 level divides into several cords looking like a bunch of soft wires heading towards the lower body. When Dr Love moved the spinal cord, right beneath it we could see the vertebral discs and the back of the bodies of the vertebrae. My general impression was that there are a lot of structures in the spinal canal and passing through the openings and not a whole lot of space for them in there. With the vast majority of our weight being in front of our spines and our movements mostly predisposing spinal flexion, it is not hard to imagine what a huge problem unsupported flexion can be for our spines.
My training in Seattle highlighted for me that there is not enough emphasis on the deep back muscles in our teaching. A lot of focus is placed on how we use our abdominals and we as teachers sometimes take axial elongation for granted. Our clients need a lot more information and enlightenment to make their practice as safe as it can be and to build the kind of strength we need them to build.
More to come in a future article about the role of the deep spinal muscles in proprioception, support and alignment.
Marcia Sharpira Teperman
PAA Ordinary Councillor
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