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Chapter 7 Aligning the Upper Extremity 135
Adductor Pollicis
Origin:
Oblique head—bases of second and third meta carpals,
capitate, trapezoid.
Transverse—distal two-thirds of the palmar side of the
third metacarpal.
Insertion: Base of the thumb at the ulnar side of the proxi-
mal phalanx.
Action: Adduction of the thumb.
Trigger points may be located in this muscle by
squeezing the webbing between the thumb and
index finger. The referral zone is on the thumb,
particularly on the lower outside edge near the wrist.
Flexor Pollicis Brevis
Origin: Flexor retinaculum and trapezium, first metacar-
pal bone.
Insertion: Base of the proximal phalanx of the thumb.
Action: Flexion of the metacarpophalangeal joint of the
thumb.
Place the tip of your thumb against the head of
the metacarpal bone. As the client flexes the
thumb several times, feel for the tendon, and
press. The referral zone is local, around the trigger point.
Dorsal Surface of the Hand
Strokes
r Apply the fanning stroke with the thumbs over the entire
dorsal surface of the hand.
r
Perform short, up-and-down strokes with the tip of the index
finger on the interosseus muscles between the tendons of
the extensor digitorum muscle (Fig. 7-34).
Wrist (Tendons of Flexor and Extensor Muscles of
Fingers)
Strokes
r Apply the fanning stroke, with the thumbs on the palmar
and dorsal surfaces of the wrist (Fig. 7-35A).
r
With the sides of your thumbs touching, do short,
up-and-down and side-to-side strokes on the palmar and
dorsal surfaces of the wrist (Fig. 7-35B).
Opponens Pollicis
Origin: Flexor retinaculum, tubercle of the trapezium.
Insertion: Entire radial side of the first metacarpal bone.
Action: Draws the first metacarpal bone forward and medial,
bringing the thumb into opposition to the other fingers.
Using the thumb tip, roll across the muscle
fibers on the thenar eminence, feeling for taut
bands and tenderness. Pain is referred to the
inside portion of the thumb and to a spot on the radial
side of the wrist.
Fingers
Preparation
Begin the following sequence at the base of the proximal
phalanx of the thumb. Continue to the tip of the thumb,
and then repeat, sequentially, on each of the four fingers.
Strokes
r Grasp the digit with the tip of the thumb on one side and
the tip of the index finger on the other side. Alternately
move the thumb and index finger up and down along the
sides of the bone between the joints.
r
Repeat the stroke, grasping the front and back of the bone.
FIGURE 7-34 Direction of strokes on the dorsal interossei.
B
A
FIGURE 7-35 A. Fanning and B. Up-and-down strokes on the
tendons of the finger flexor muscles at the wrist.
136 Scheumann’s The Balanced Body: A Guide to the Integrated Deep Tissue Therapy System
Forearm
Hand and Finger Extensor Muscles
Trigger points will lodge in the distal portion of
the muscles, near the elbow. Pain is referred to
the lateral epicondyle and down the forearm to
the wrist and hand area.
Hand and Finger Flexor Muscles
Trigger points tend to be located in a line
across the muscles, about one-third of the way
down the forearm from the elbow. They are
best palpated with cross-fiber strokes, feeling for taut
bands in the fibers. They refer pain to the wrist and into
the fingers.
Strokes
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r
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UIFUIVNCBOEGJOHFSTPOUIFGPSFBSNCFMPXUIFMBUFSBM
FQJDPOEZMFPGUIFFMCPX3PMMUIFNVTDMFGJCFSTDIFDLJOH
GPSUFOEFSOFTTBOEUSJHHFSQPJOUBDUJWJUZ'JH
Elbow
Supinator
Origin:-BUFSBMFQJDPOEZMFPGUIFIVNFSVTSBEJBMDPMMBU
FSBMMJHBNFOUPGUIFFMCPXKPJOUBOOVMBSMJHBNFOUPG
UIFSBEJPVMOBSKPJOUTVQJOBUPSDSFTUPGUIFVMOBPOUIF
EPSTBMTVSGBDFPGUIFTIBGU
Insertion:%PSTBMBOENFEJBMTVSGBDFTPGUIFVQQFS
POFUIJSEPGUIFSBEJBMTIBGU
Action:4VQJOBUJPOPGUIFGPSFBSNBOEIBOE
A trigger point may be located near its attachment on the lateral epicondyle. The referral
zone is the lateral epicondyle. Pain may also
shoot to the webbing of the thumb.
Pronator Teres
Origin:
Humeral head—
DPOEZMFPGUIFIVNFSVT
Ulnar head—DPSPOPJEQSPDFTTPGUIFNFEJBMVMOB
Insertion:1SPOBUPSUVCFSPTJUZPOUIFMBUFSBMTVSGBDFPGUIF
SBEJVT
Action:1SPOBUJPOBOEGMFYJPOPGUIFGPSFBSN
The median nerve travels between the heads of the
pronator teres. Entrapment here can cause symptoms that mimic carpal tunnel syndrome.
EJTUBMTVQSBDPOEZMBSSJEHFNFEJBMFQJ
A.
B.
C.
David Rini
FIGURE 7-36 Location and direction of
strokes on the hand and finger flexor
muscles along the forearm.
A trigger point may be located near its attachment on the medial epicondyle. Pain is felt
deep in the radial side of the wrist and may
spill over into the forearm.
Strokes
r
8JUIUIFUIVNCBQQMZVQBOEEPXOTJEFUPTJEFBOE
TUBUJDDPNQSFTTJPOTUSPLFTBSPVOEUIFMBUFSBMFQJDPOEZMF
5SFBUUIFBUUBDINFOUTPGUIFFYUFOTPSDBSQJSBEJBMJTMPOHVT
BOECSFWJTFYUFOTPSEJHJUPSVNBOETVQJOBUPSNVTDMFT
'JH)BWJOHUIFDMJFOUFYUFOEUIFIBOENBLFTUIFTF
UFOEPOTFBTJFSUPQBMQBUF
Because of the close proximity of the radial nerve,
be careful when treating these attachments. If the
client experiences a sharp, radiating sensation that
is characteristic of nerve stimulation, release the pressure
immediately, and shift the location of your thumb.
r
8JUIUIFUIVNCBQQMZVQBOEEPXOTJEFUPTJEFBOE
TUBUJDDPNQSFTTJPOTUSPLFTBSPVOEUIFNFEJBMFQJDPOEZMF
5SFBUUIFBUUBDINFOUTPGUIFDPNNPOGMFYPSUFOEPO
CSBDIJBMJTBOEQSPOBUPSUFSFTNVTDMFT)BWJOHUIFDMJFOU
GMFYIJTPSIFSIBOENBLFTUIFTFUFOEPOTFBTJFSUPQBMQBUF
#FDBVTFPGUIFQPTJUJPOPGUIFNFEJBOOFSWFBUUIFNFEJBM
FQJDPOEZMFVTFUIFTBNFDBVUJPOBTBCPWF
Chapter 7 Aligning the Upper Extremity 137
Common
extensor origin
(lateral
epicondyle)
Common
flexor origin
(medial
epicondyle)
STRETCH
8JUICPUIIBOETGBDJOHFBDIPUIFSJOGSPOUPGIJNPS
IFSUIFDMJFOUDVQTUIFQBMNTBOETQSFBETBMMUIFGJOHFST
5PVDIJOHUIFUJQTPGUIFGJOHFSTPGCPUIIBOETUPHFUIFS
UIFDMJFOUCFHJOTUPQVTIUIFIBOETUPXBSEFBDIPUIFS
LFFQJOHUIFGJOHFSTBQBSUBOESFTJTUJOHTPNFXIBUXJUI
UIFDVQQFEQBMNT5IFDMJFOUDPOUJOVFTUPQSFTTUIF
IBOETUPXBSEFBDIPUIFSVOUJMBTUSFUDIJTGFMUJOUIF
GJOHFSTBOEQBMNT5IFTUSFUDIJTIFMEGPSBNJOJNVN
PGTFDPOET
1MBDFZPVSQBMNBDSPTTUIFQBMNBSTVSGBDFPGUIFDMJFOUT
GJOHFSTBOEFYUFOEUIFDMJFOUTIBOEVOUJMBTUSFUDIJTGFMU
JOUIFGMFYPSNVTDMFTPGUIFGJOHFSTBOEIBOE'JH
FIGURE 7-37 Rolling the fibers of the brachioradialis muscle.
FIGURE 7-38 Location of the forearm muscle attachments.
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DMJFOUTBSNJTLFQUGVMMZTUSBJHIU
1MBDFZPVSQBMNBDSPTTUIFEPSTBMTVSGBDFPGUIFDMJ
FOUTGJOHFSTBOEGMFYUIFDMJFOUTIBOEVOUJMBTUSFUDI
JTGFMUJOUIFFYUFOTPSNVTDMFTPGUIFGJOHFSTBOEIBOE
'JH
ACCESSORY WORK
i4OBQQJOHPGGuUIFGJOHFSTBTIJBUTVUFDIOJRVFXJMMIFMQ
UPESBXPGGBDDVNVMBUFEFOFSHZUIBUIBTCVJMUVQGSPN
SFMFBTFPGUIFIBOEBOEGPSFBSNNVTDMFT"OJOEJDBUJPO
PGUIJTCVJMEVQJTTXFBUZIBOET5PQFSGPSNUIFNPWF
IPMEUIFBOUFSJPSBOEQPTUFSJPSTJEFTPGUIFDMJFOUTGJO
HFSBUUIFCBTFCFUXFFOZPVSJOEFYBOENJEEMFGJOHFST
(FOUMZTMJEFEPXOUIFGJOHFSHMJEJOHTUSBJHIUPGGBUUIF
138 Scheumann’s The Balanced Body: A Guide to the Integrated Deep Tissue Therapy System
FIGURE 7-39 Stretch for the flexor muscles of
the fingers and hand.
tip (Fig. 7-41). Begin with the thumb, and continue with
each finger in succession to the pinkie.
2. A thorough foot massage is a good accompaniment to
hand and forearm work. It gives the client a sense of
integration between the upper and lower extremities.
CLOSING
Sitting at the foot of the table, lightly hold the heels of the
client’s feet in your hands for 30 to 60 seconds. Remove your
hands slowly to complete the session.
FIGURE 7-40 Stretch for the extensor muscles
of the fingers and hand.
FIGURE 7-41 The shiatsu technique, “snapping off.”
SESSION IMPRESSION
Chapter 7 Aligning the Upper Extremity 139
THE SHOULDERS AND ARMS
he client is a 43-year-old massage therapist named Doris.
T
She has been practicing massage therapy professionally
for 10 years. For the past several months, she has been
experiencing tightness and pain in her neck, shoulders,
and upper back. The tightness is exacerbated by giving a
massage. During the previous 2 weeks, she has begun to
experience sharp pains in her right forearm muscles. It is
becoming increasingly difficult for her to administer pressure with her right arm; the pain in her forearm becomes
intense when she pushes with her right hand.
Doris is a frail-looking woman. She is small-boned and
does not have well-developed musculature. She is somewhat
stooped over, with a slight kyphosis in her upper back. Her
scapulae are protracted, with her arms medially rotated
and her upper chest collapsed. She also exhibits a forward
position of the head. Based on observing her posture and
listening to her describe her situation, it is likely that she
may lack the body mechanics skills that she needs for her
job. She probably tries to push too much with her arm and
back muscles, rather than leaning forward and distributing
force throughout her entire body, when applying pressure
during massage strokes.
This and future deep tissue sessions will focus on releasing the muscles of the scapulae and relieving tension
in the neck, around the clavicles, in the serratus anterior
and pectoralis minor muscles, and throughout the muscles of the forearms and hands. She will require a series
of integrated deep tissue therapy sessions to address all
the problems arising from her posture and lack of proper
body mechanics.
Because of the protraction of the scapulae, collapse of
the chest, and medial rotation of the arms, her serratus
anterior, pectoralis major and minor, and anterior deltoid
muscles were emphasized during the first session. Numerous trigger points were encountered, particularly in the
lateral section of the pectoralis minor. Working on the right
forearm, the common extensor tendon was found to be
very tender and perhaps inflamed.
It was recommended that the client
apply ice to it regularly. The borders of
the forearm muscles were carefully traced
and separated. The client found that the degree
of mobility in both hands was greatly increased
following the session. The muscles of the thenar
eminence were tender on both hands, but on the right
side in particular.
After the session, the likelihood that she is favoring
her right arm and hand while performing massage was
discussed. Doris is also overusing her arm and hand
muscles to apply pressure instead of allowing the weight
of her body to flow through her. It was suggested that she
diminish her workload of massage clients until the strain
in her muscles from incorrect body mechanics is reduced.
In addition to receiving deep tissue therapy treatments
twice a week for the next month, she is going to engage
in daily stretching of the chest, shoulder, arm, and hand
muscles. She will also receive coaching in proper body
mechanics. Once the initial trauma to the upper body
muscles is reduced and better alignment of the shoulder
girdle achieved, she will begin a very mild weight-training
program to build strength and acquire more kinesthetic
awareness of her entire body. ¢
Topics for Discussion
1. Based on the client in the case above, describe some
specific exercises that would help to counteract muscular
weaknesses and postural distortions.
2.
What suggestions regarding body mechanics would you
offer to a muscular, male massage therapist who relies
exclusively on his strong shoulder and arm muscles to
perform massage strokes?
3.
Describe the position and movement capacities of
well-aligned shoulders and arms in relation to the rest
of the body.
4. How would you treat a client who describes difficulty
gripping the steering wheel while driving?
140 Scheumann’s The Balanced Body: A Guide to the Integrated Deep Tissue Therapy System
3.
REVIEW QUESTIONS
Level 1
Receive and Respond
1. The pectoral girdle includes the...
a. sternum, clavicles, and scapulae.
b. scapula and humerus.
c. clavicle, humerus, and scapula.
d. clavicle and scapula.
2.
Where does the shoulder articulate with the axial skeleton?
a. At the spinoscapular joints
b. At the glenohumeral joints
c. At the sternoclavicular joints
d. At the claviculohumeral joints
3. What is the best description of the glenohumeral joint
capsule?
a.
Loose, allowing wide range of motion at the shoulder
b.
Supported by internal cruciate ligaments to stabilize
the humerus
c. Tight, giving important support to the humerus
d.
Supported by external collateral ligaments to stabilize
the humerus
4. Which is the strongest flexor of the forearm?
a. Flexor carpi radialis
b. Brachialis
c. Biceps brachii
d. Flexor palmaris
5. The “funny bone” refers to what endangerment site?
a. The median nerve at the cubital fossa
b. The brachial plexus at the lateral neck
c. The radial nerve at the posterior aspect of the triceps
d.
The ulnar nerve at the medial epicondyle of the
humerus
What stroke is most effective for finding and treating
trigger points in the superior trapezius?
a. Shiatsu scapula release
b. Sifting the upper trapezius
c.
Elongation strokes from the occiput to the acromion
process
d.
Cross-fiber stroke at the superior angle of the scapula
4.
How would you recommend that a client strengthen
her triceps?
a.
Teach her how to do modified push-ups, using the wall
and varying her angle and speed to increase resistance
b.
Teach her how to do modified pull-ups, using surgical
tubing or an elastic exercise band looped around a
doorknob for resistance
c.
Encourage her to walk briskly while carrying light
weights to help tone her arms
d.
Encourage her to visit a gym where a qualified trainer
can assist with her strength-training goals
5. What is the recommended sequence for working with
the shoulder?
a.
From a prone position, work with the latissimus dorsi,
then deltoid, then trapezius, then supraspinatus
b.
From a side-lying position, work with the deltoid,
then supraspinatus, infrapinatus, then teres minor
and latissimus dorsi
c. From a side-lying position, work with the latissimus
dorsi, then the teres major, then teres minor, then
trapezius
d.
From a prone position, work with the trapezius, then
supraspinatus, then deltoid, then brachialis
Level 3
Problem Solving: Discussion Points
1.
Amelia is a 22-year-old childcare provider. She works long
days with lots of bending and lifting, and she frequently
Level 2
Apply Concepts
carries heavy bags in each hand. She complains of wrist
and shoulder pain. Bruce is a 55-year-old man who works
at a desk, using a computer and mouse for many hours
1.
If a client has rounded shoulders, what muscles are likely
to be shortened?
a. Pectoralis major, pectoralis minor, anterior deltoid
b. Rhomboids, trapezius, latissimus dorsi
c. Subscapularis, teres minor, infraspinatus
each day. He also complains of shoulder and wrist pain.
Use the routines described in this chapter to design a
treatment plan for each client. While each session will
have elements in common, what differences in approach
do you predict each client will need?
d. Posterior deltoid, rhomboids, pectoralis major
2.
2.
What is the best table position from which to stretch the
teres major and minor, latissimus dorsi, and subscapularis?
a. Supine, arm abducted
b. Prone, arm abducted
c. Side-lying, arm abducted
Read the Session Impressions piece for the client named
Doris. Choose one of the “Topics for Discussion” and
work through the question with a classmate. How can
you avoid some of Doris’s problems in your career as a
massage therapist?
d. Side-lying, arm adducted across the body
CHAPTER
O
S
a a a
Balanc
B B
y
y
t
.
tissue
thehe
ra
py
p
l features
es
g
g
p
op
e reco
co
k
ne
e
p
tissu
e
d
dual clients
dual clients
Establishing a Firm Foundation
EARNI
aving completed the reading, classroom instruction,
he learner is expected to be able to..
t
Apply key terms and concepts related to integrated deep
as related to the foot, leg, and knee
dentify anatomica
ncludin
ony landmarks
uscular and fascial structures
ndangerments or cautionary sites
Identify common postural or movement patterns associated
with pain or impaired function of the foot, leg, and knee
Use positioning and bolstering strategies that provide
afety and comfort for clients to receive integrated dee
tissue therapy to the foot, leg, and knee
TIVE
of the foot, leg, and knee,
ss
ned homework related to Chapter 8 of
Generate within-sc
elevant to the foot, leg, and
Safely and effectively perform the integrated dee
therapy routines as described
rganize a single session to address the foot, leg, an
nee, using the integrated deep tissue therapy approach,
mized to indivi
Plan a series of sessions to address whole-body incorpo
ation using the integrated deep tissue therapy approach,
mized to indivi
8
e
mmendations for client self-care
The Foot, Leg, and Knee
◗ GENERAL CONCEPTS
The legs and feet are responsible for efficiently transferring
weight from the upper body to the ground with minimal stress.
They are also the locomotive structures of the body, providing
the means for its movement through space. To perform the
multiple tasks of weight transfer and movement, the knees
and feet are necessarily complex in design. A balance of
muscle, tendon, bone, and ligament in the lower extremity is
essential to enable its effective operation without breakdown.
Integrated deep tissue therapy in this region seeks to re-establish
the precise integration of muscle action with correct bony
alignment. Lack of harmony among these body parts results
in tension and instability throughout the rest of the body.
The feet form a horizontal platform on which the entire
weight of the vertical body rests. The feet are small in proportion
to the load they carry, which can create problems for effective
weight distribution and support. This dilemma is solved by
a series of arches that are located throughout the feet. Architecturally, the arch is used to distribute weight evenly from a
smaller, concentrated area over a broad surface. In the case
of the feet, the body forms a vertical column whose weight is
focused at the ankle joints and then spread out through the
feet and transferred to the ground.
When the body’s weight is optimally balanced on the foot, it
radiates out from the talus through the bones of the foot. This
distribution of weight can be observed in the symmetrical shape
of a footprint in the sand. If the arches break down or don’t
function correctly, the body’s weight is more concentrated on
the outside or the inside of the foot. This causes a distortion in
the footprint and uneven wearing down of the soles of the shoes,
which compounds the problem by reinforcing poor weight
distribution through the foot. Whether the initial breakdown
occurs in the foot itself or further up in the body, it results
in a redistribution of weight throughout the body segments in
an effort to compensate for the lack of balance. This creates
stress and pain around joints, particularly the knee, and loss
of full function in the muscles.
The arches of the foot are supported and stabilized by
muscles of the lower leg, which attach in various places along
the bottom of the foot. These muscles pull up on the plantar
surface of the foot, acting as guy wires that suspend the arches
141
Scheumann’s The Balanced Body: A Guide to the Integrated Deep Tissue Therapy System
142
from above. Ineffective support of the foot through muscular
weakness is evident in legs that lack shape and proportion.
Abnormal thickening in the legs denotes lack of fluid flow.
This can be a sign of a systemic problem with fluid management like heart or kidney disorders, but it could also be
the result of the inefficient pumping action of muscles with
poor tone. As effective patterns of action are taught to the leg
muscles through integrated deep tissue therapy, diminished
arches may be strengthened and raised. This re-education of
the foot and leg muscles results in better-coordinated action
throughout the body.
The joints of the legs are meant to operate in a relay fashion. In other words, the hip, knee, and ankle should all flex
together and extend together during most leg movements.
Although these three joints are not all technically hinges, they
can be thought of in that way when working as a unit. They
work best when they are aligned directly over each other in
flexion movements, with the hinge at each joint forming a
horizontal platform in relation to the vertical standing body.
This alignment allows the muscles of the leg to store power
when the joints flex, as in a preparation to jump, and to release
that power effectively when the joints extend. Deep tissue
work can help to restore this balanced alignment.
◗ MUSCULOSKELETAL ANATOMY
AND FUNCTION
See Essential Anatomy Box 8-1 for a summary of musculoskeletal anatomy and function.
The Foot
The ankle and foot should be thought of as a unit, because their
functions are interdependent. Structurally, they are similar to
the wrist and hand, and they are potentially capable of many
of the same movements. The foot is organized as a series of
arches that are meant to distribute weight. The foot also acts
as a springboard to push the body away from the ground and
propel it through space. To accomplish these functions, the foot
must be both strong and mobile. It is composed of 26 bones,
31 joints, and 20 intrinsic muscles (Fig. 8-1). The bones of
the foot are connected by a series of more than 100 ligaments.
These ligaments reinforce the arches and limit movement at
the joints so that the foot can maintain its integrity.
The foot has three major arches. The medial longitudinal
arch is largely responsible for pushing the foot forward in
walking and running. It is made up of the inner portion of the
calcaneus, the talus, the navicular, the three cuneiforms, and
the first three metatarsals and phalanges. The lateral longitudinal arch is more weight-bearing and weight-distributing. It
supports the inner arch by supplying lift and balance, and it
is formed by the calcaneus, the cuboid, and the fourth and
fifth metatarsals and phalanges. When the outer longitudinal
arch is collapsed, the weight of the body is thrown too much
onto the outer portion of the foot, the balance of the lower
limb is lost, and the risk of lateral ankle injuries increases.
The third arch comprises a series of transverse arches across
the foot. They are formed by the relationship of the tarsal and
metatarsal bones with the surrounding muscles and ligaments.
All the arches of the foot depend on ligamentous support
and strong muscular stability. The majority of these muscles
have long attachments on the tibia or fibula, providing powerful
points of leverage. The long and short plantar ligaments are
crucial in maintaining the shape of the arches. They connect
the bones that form the ends of the longitudinal arches, like
the string of a bow, and prevent them from sliding too far
apart when weight is placed on the foot.
The superficial intrinsic muscles on the plantar surface
of the foot are the extensor hallucis brevis, abductor hal-
lucis
, flexor digitorum brevis, and abductor digiti minimi
BOX 8-1 ESSENTIAL ANATOMY | The Foot, Leg, and Knee Routines
MUSCLES
Toe tendons
Insertion points of flexor hallucis longus, flexor
hallucis brevis, and abductor hallucis
Muscles of the plantar surface of the foot
Muscles of the dorsal surface of the foot
Ankle retinaculum
Flexor digitorum longus
Lateral leg muscles—tibialis anterior, extensor
hallucis longus, extensor digitorum longus, and
peroneals
Gastrocnemius
Soleus
Knee—ligaments and tendons
BONES AND LANDMARKS
Bones of the foot—phalanges, metatarsals,
cuneiforms, cuboid, navicular, talus
Tibia
Lateral malleolus
Medial malleolus
Tibial tuberosity
Fibula
Head of fibula
Patella
Chapter 8 Establishing a Firm Foundation 143
Iliotibial tract
Biceps femoris
Peroneus longus
Extensor digitorum
longus
Peroneus brevis
Quadriceps
femoris
Sartorius
Gracilis
Semitendinosus
Tibialis anterior
Peroneus
longus
Tibialis
anterior
Peroneus
brevis
Extensor
digitorum
longus
Extensor
hallucis
longus
A
Gastrocnemius
muscle
Soleus muscle
Superior
extensor
retinaculum
Peroneus tertius
Extensor digitorum
brevis
Peroneus brevis
Peroneus tertius
Extensor digitorum longus
(via extensor expansion)
B
Extensor hallucis
longus
DAR
Extensor hallucis
brevis
Extensor hallucis
longus
FIGURE 8-1 A. Muscles that move the foot and toes, superficial layer—anterior view. B. Attachment sites of muscles of the leg and foot—
anterior view. C. Muscles that move the foot and toes, superficial layer—posterior view. D. Attachment sites of muscles of the leg and foot—
144 Scheumann’s The Balanced Body: A Guide to the Integrated Deep Tissue Therapy System
Gastrocnemius
(medial head)
Semimembranosus
Gastrocnemius
(lateral head)
Gastrocnemius
Popliteus
Flexor digitorum
longus
Soleus
Tibialis posterior
Flexor hallucis
longus
Peroneus brevis
C
FIGURE 8-1 (continued)
Soleus
Achilles
tendon
Achilles tendon
DAR
D