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STOTT PILATES®

ANATOMY REVIEW

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Anatomy Review

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ObjectivesReview anatomical terminologyReview origins, insertions and actions of the major muscles of the bodyUnderstand how to analyze the functional anatomy of an exercise

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Anatomical TerminologyProvides a common language worldwide for people to describe the body clearly and to indicate the position of its parts and organs relative to each other

Anatomical Position:› Used as a reference position › All descriptions are expressed in relation to this position› All movement is categorized and defined from anatomical neutral› Refers to a body position of:

• head, gaze and toes directed forward (anteriorly)• arms by the sides with palms facing forward• lower limbs with feet close together

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Anatomical PlanesMovement descriptions are based on three anatomical planes that pass through the body in anatomical positionAnatomical planes are used to describe movements

Sagittal / Median plane› Vertical plane that runs from front to back and divides the body into right and

left halves

Coronal / Frontal plane› Vertical plane that runs from side to side and divides the body into front and

back halves

Transverse / Horizontal plane› A horizontal plane that divides the body into upper and lower halves

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Planes of the body

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Terms of Relationship & ComparisonVarious adjectives describe the location of parts of the body by comparing their relative positions from anatomical neutral

› Superior (cranial) – closer to the head› Inferior (caudal) – closer to the feet› Anterior (ventral) – closer to the front› Posterior (dorsal) – closer to the back› Medial – closer to the midline› Lateral - farther from the midline › Proximal – closer to the trunk or point of origin› Distal – farther from the trunk or point of origin› Superficial – closer to or on the surface› Deep – farther from the surface

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Terms of LateralityBilateral – paired structures that have left and right parts, using both sides of the body, both limbs or both sides of the muscleUnilateral – structure only on one side, using only one side of the body, limb or muscleIpsilateral – occurs on the same side of the bodyContralateral – occurs on the opposite side of the body

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Terms of MovementVarious terms describe movement of the limbs and other parts of the bodyMovements take place at joints where two or more bones articulate with one another

› Flexion – bending of a part or decreasing the angle between body parts in the sagittal plane

› Extension – straightening a part or increasing the angle between body parts in the sagittal plane

› Abduction – movement away from the midline of the body› Adduction – movement toward the midline of the body› Lateral flexion – sideways bending of the trunk, neck or head› Dorsiflexion – movement of the dorsal surface of the foot toward the anterior

leg, decreasing the angle of the joint› Plantar flexing – movement of the plantar surface of the foot away from the

anterior leg, increasing the angle of the joint

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Terms of MovementRotation – moving a part of the body around its long axis

› Medial rotation – turns the anterior surface medially› Lateral rotation – turns the anterior surface laterally› Upward rotation – movement of the scapula where the inferior angle moves

laterally and the glenoid fossa moves superiorly› Downward rotation – movement of the scapula where the inferior angle moves

medially and the glenoid fossa moves inferiorly

Circumduction – circular movement of the limbs combining the sequence of flexion, extension, abduction and adductionPronation – medial rotation of the forearm and handSupination – lateral rotation of the forearm and hand

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Terms of MovementHorizontal abduction/extension – from a 90 degree flexed arm position, the arm is extended out away from the midline of the bodyHorizontal adduction/flexion – from a 90 degree abducted arm position, he humerus is flexed in toward the midline of the bodyInversion – the medial border of the foot lifts and the sole of the foot faces in toward the midline

› Note: inversion is often interchanged with supination. Supination is a dynamic movement and is a combination of plantar flexion, inversion of the tarsals and forefoot adduction.

Eversion – the lateral border of the foot lifts and the sole of the foot faces away from the midline

› Note: eversion is often interchanged with pronation. Pronation is a dynamic movement and is a combination of dorsiflexion, eversion and forefoot abduction.

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JointsJoints are classified by the amount of movement they permit or their structural makeup

Immovable› Synarthrodial or fibrous joints – like the sutures in the skull

Slighly movable› Amphiarthrodial or cartilagenous joints › Symphyses – bones are connected by cartilage like intervertebral disks

Freely movable› Diarthrodial or synovial joints› Most common joints in the body› Characterized by

• Articulating bones whose ends are capped with articular cartilage• Surrounded by ligaments• Contains a synovial membrane

› Most Pilates exercises deal with freely movable joints, and movements are described as occurring at or ‘about’ a joint

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Bony ProminencesThere are many types of prominences or depressions that provide attachment sites for muscles and tendons

› Condyle› Epicondyle› Spine› Tubercle› Tuberosity› Process› Trochanter› Crest› Foramen› Fossa

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BonesBones provide the structure to the body and act as attachment sites of muscles, ligaments, etc.

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MusclesMuscles perform four important functions in the body

› produce movement› maintain posture› stabilize joints› generate heat

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Types of Muscle ActionsIsotonic

› A muscle action in which muscle length changes

Concentric› Active shortening of a muscle› The origin and insertion move closer together› Creates movement

Eccentric› Active lengthening of a muscle› The origin and insertion move apart› Controls movement

Isometric› A muscle action in which muscle length does not change› Occurs when the force created is matched by external force

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Muscle AttachmentsOrigin

› Attachment point of a muscle to a primarily fixed structure

Insertion› Attachment point of a muscle to a primarily moveable structure

Action› The movement a muscular contraction produces› Often when the insertion moves toward the origin

Reverse action› The reverse action of a muscular contraction› Often when the origin moves toward the insertion

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MusclesIn order to understand movement analysis, you must know where each muscle attaches and the movements it produces

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MusclesMuscle names reflect:

› Shape - rhomboid› Location – rectus femoris› Fiber direction – external oblique› Action – levator scapulae› Attachment site - sternocleidomastoid

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Anterior Trunk & NeckRectus Abdominis

› Origin: pubic crest and symphysis› Insertion: costal cartilages of rib 5 to 7 › Action: bilaterally – forward flexion of the trunk; unilaterally – › lateral flexion of the trunk to the same side

External Oblique› Origin: rib 5 to 12› Insertion: broad abdominal aponeurosis to the linea alba, anterior iliac crest› Action: bilaterally – forward flexion of the trunk; unilaterally – lateral flexion of

the trunk to the same side and rotation of the trunk to the opposite sideInternal Oblique

› Origin: medial iliac crest and thoracolumbar fascia› Insertion: rib 10 to 12› Action: bilaterally – forward flexion of the trunk; unilaterally – lateral flexion

and rotation of the trunk to the same side

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Anterior Trunk & NeckSternocleidomastoid

› Origin: sternal head – top of manubrium; clavicular head – medial third of the clavicle

› Insertion: mastoid process and occipital bone› Action: unilaterally – lateral flexion of the head to the same side, rotation of the

head to the opposite side; bilaterally – flexion of the head

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Muscles of RespirationTransversus Abdominis

› Origin: iliac crest; thoracolumbar fascia, rib 6 to 12 › Insertion: broad abdominal aponeurosis to the linea alba› Action: compression of abdominal viscera; stabilization of the lumbo-pelvic

regionDiaphragm

› Origin: inner surface of the body wall: sternal portion – back of the xiphoid process; costal portion – inner surfaces of lower six ribs; lumbar portion – anterior bodies of lumbar vertebrae

› Insertion: central tendon› Action: draws the central tendon downward increasing thoracic cavity volume

during inhalationPelvic Floor

› refers to a group of muscles of the inferior pelvis› made up of the puborectalis, pubococcygeus, iliococcygeus (collectively the levator

ani) and ischiococcygeus› extends from the body of the pubis to the coccyx and between the ischial

spines › functions to stabilize the joints of the pelvis including the sacroiliac joint

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HipPsoas Major

› Origin: transverse process and anterior surfaces of bodies of T12 to L5› Insertion: lesser trochanter› Action: flexion and slight lateral rotation of the hip, maintains lordosis

Iliacus› Origin: superior portion of iliac fossa› Insertion: lesser trochanter› Action: flexion and slight lateral rotation of the hip

Iliopsoas› the combination of psoas major and iliacus

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HipGluteus Maximus

› Origin: posterior ilium, sacrum, coccyx› Insertion: gluteal tuberosity and iliotibial tract (band)› Action: extension and lateral rotation of the hip

• Upper fibers – abduction of femur• Lower fibers – adduction of femur

Gluteus Medius› Origin: lateral iliac crest› Insertion: greater trochanter› Action: abduction of the femur

• Anterior portion – flexion of the hip and medial rotation of the femur• Posterior portion – extension of the hip and lateral rotation of the femur

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Hip

Gluteus Minimus› Origin: lateral ilium, inferior to gluteus medius› Insertion: greater trochanter (anterior surface)› Action: flexion of the hip, abduction and medial rotation of the femur

Tensor Fasciae Latae› Origin: anterior ilium, anterior superior iliac spine (ASIS)› Insertion: iliotibial band› Action: flexion of the hip, abduction and medial rotation of the femur

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Hip

Pectineus› Origin: superior surface of pubis› Insertion: pectineal line and proximal linea aspera› Action: adduction of the femur, aids in flexion and medial / lateral* rotation of

femurAdductor Brevis

› Origin: inferior ramus of pubis› Insertion: lesser trochanter, linea aspera, medial portion of femur› Action: adduction of the femur, aids in flexion and medial rotation of the femur

* References differ on actions depending on the position of the femur

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HipAdductor Longus

› Origin: anterior pubis› Insertion: medial portion of femur, linea aspera› Action: adduction of femur, aids in flexion and medial / lateral* rotation of

femurAdductor Magnus

› Origin: ischial tuberosity, inferior ramus of pubis› Insertion: medial portion of femur, adductor tubercle› Action: adduction and lateral rotation of the femur, extension of the hip

* References differ on actions depending on the position of the femur

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HipPiriformis

› Origin: sacrum (anterior surface)› Insertion: greater trochanter, superior aspect› Action: lateral rotation of the hip, aids in abduction of the hip

Obturator Externus› Origin: external / outer surface of obturator foramen, superior and inferior

ramus of pubis› Insertion: medial to greater trochanter› Action: lateral rotation of the hip

Obturator Internus› Origin: internal / inner surface of obturator foramen› Insertion: trochanteric fossa, medial surface of greater trochanter› Action: lateral rotation of the hip

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HipGemellus Superior

› Origin: lateral ischial spine› Insertion: medial surface of greater trochanter› Action: lateral rotation of the hip

Gemellus Inferior› Origin: superior portion ischial tuberosity› Insertion: medial surface greater trochanter› Action: lateral rotation of the hip

Quadratus Femoris› Origin: lateral border ischial tuberosity› Insertion: inferior, posterior greater trochanter› Action: lateral rotation of hip

• Note: the preceding six muscles are referred to as the deep six lateral rotators of the hip

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Hip & KneeRectus Femoris

› Origin: anterior superior iliac spine, acetabulum› Insertion: patella, tibial tuberosity via patellar ligament› Action: extension of the knee, flexion of the hip

Vastus Lateralis› Origin: lateral lip of linea aspera, lateral surface of gluteal tuberosity› Insertion: lateral border of patella, tibial tuberosity via patellar ligament › Action: extension of the knee, draws patella laterally

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Hip & KneeVastus Intermedius

› Origin: anterior, lateral, superior part of femur› Insertion: superior border of patella, tibial tuberosity via patellar ligament› Action: extension of the knee

Vastus Medialis› Origin: intertrochanteric line, medial lip of linea aspera › Insertion: medial border of patella, tibial tuberosity via patellar ligament › Action: extension of the knee, draws patella medially

Note: the preceding four muscles are referred to as the quadriceps

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Hip & KneeBiceps Femoris

› Origin: long head - ischial tuberosity, short head – lateral lip of linea aspera› Insertion: lateral head of fibula, lateral condyle of tibia› Action: both heads - flexion and lateral rotation of the knee; long head - extension,

adduction and lateral rotation of the hipSemitendinosus

› Origin: ischial tuberosity› Insertion: medial tibia, inferior to condyle› Action: flexion, medial rotation of the knee; extension, adduction and medial rotation

of the hipSemimembranosus

› Origin: ischial tuberosity› Insertion: posterior, medial tibia, inferior to condyle› Action: flexion and medial rotation of the knee; extension, adduction and medial

rotation of the hip

Note: the preceding three muscles are referred to as the hamstrings

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Hip & KneeSartorius

› Origin: anterior superior iliac spine› Insertion: anterior, medial tibia, inferior to condyle› Action: flexion, lateral rotation and abduction of the hip; flexion and medial

rotation of the kneeGracilis

› Origin: anterior symphysis pubis, inferior ramus of pubis› Insertion: anterior, medial tibia, inferior to condyle› Action: adduction and medial rotation of the hip; flexion and medial rotation of

the knee

Note: the sartorius, gracilis and semitendinosus all insert at the pes anserinas

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Knee & Ankle Soleus

› Origin: Origin – posterior surface of head and shaft of fibula; medial border of tibia

› Insertion: calcaneus via Achilles tendon (common calcaneal tendon)› Action: plantar flexion of the ankle

Gastrocnemius› Origin: lateral head - lateral condyle of femur; medial head - medial condyle of

femur› Insertion: calcaneus via Achilles tendon (common calcaneal tendon)› Action: plantar flexion of the ankle, flexion of the knee

Popliteus› Origin: lateral condyle of femur› Insertion: posterior, medial tibia› Action: medial rotation of the tibia on fixed femur; lateral rotation of femur on

fixed tibia

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Knee & AnkleTibialis anterior

› Origin: lateral condyle and lateral surface of tibia› Insertion: plantar surface of first metatarsal, medial plantar surface of first

cuneiform› Action: dorsiflexion of the ankle and inversion of the foot

Tibialis posterior› Origin: lateral posterior tibia, medial surface of fibula› Insertion: navicular, 3 cuneiforms and cuboid and 2nd, 3rd, and 4th

metatarsals› Action: plantar flexion of the ankle and inversion of the foot

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Knee & AnklePeroneus tertius

› Origin: distal half of anterior surface of fibula› Insertion: dorsal surface of the base of 5th metatarsal› Action: dorsiflexion of the ankle and eversion of the foot

Peroneus longus› Origin: head and lateral surface of fibula› Insertion: lateral margin of plantar surface of 1st cuneiform and base of 1st

metatarsal› Action: plantar flexion of ankle and eversion of the foot

Peroneus brevis› Origin: distal portion of lateral surface of fibula› Insertion: tuberosity of lateral side of base of 5th metatarsal› Action: plantar flexion of the ankle and eversion of the foot

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Knee & AnkleExtensor hallucis longus

› Origin: anterior surface of fibula› Insertion: dorsal base of distal end of the hallux› Action: extension of distal phalanx of 1st toe; aids in dorsiflexion of the ankle and inversion

of the footExtensor digitorum longus

› Origin: lateral condyle of tibia, head and anterior surface of fibula› Insertion: dorsal surfaces of bases of the middle and distal phalanges 2nd – 5th

toes› Action: extension of the lateral 4 toes, dorsiflexion of ankle and eversion of foot

Flexor hallucis longus› Origin: distal posterior fibula› Insertion: plantar surface of the base of distal phalanx of the hallux› Action: flexion of the great toe; aids in plantar flexion of the ankle and

inversion of the footFlexor digitorum longus

› Origin: posterior tibia› Insertion: plantar surfaces of bases of distal phalanges of the second to fifth

toes› Action: flexion of the toes; plantar flexion of the ankle and inversion of the foot

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ShoulderDeltoid – Anterior

› Origin: lateral portion of clavicle› Insertion: deltoid tuberosity› Action: abduction, flexion, horizontal adduction and medial rotation of the

shoulderDeltoid – Middle

› Origin: acromion process› Insertion: deltoid tuberosity › Action: abduction of the shoulder

Deltoid – Posterior › Origin: spine of scapula› Insertion: deltoid tuberosity› Action: abduction, extension, horizontal abduction and lateral rotation of the

shoulder

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Scapula Trapezius (upper fibers)

› Origin: occipital protuberance, spinous process of C1 to C7, ligamentum nuchae

› Insertion: lateral clavicle, acromion process› Action: elevation and upward rotation of the scapula, aids in retraction of the

scapula› Reverse action: bilaterally – extension of cervical spine; unilaterally – lateral

flexion of the head and neck to the same side, rotation to the opposite side

Trapezius (middle fibers)› Origin: spinous process of T1 to T5› Insertion: superior border spine of scapula, acromion process› Action: retraction of the scapula; aids in elevation of the scapula

Trapezius (lower fibers)› Origin: spinous process of T6 to T12› Insertion: medial portion of spine of scapula› Action: depression, retraction and upward rotation of the scapula

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ScapulaLevator Scapulae

› Origin: transverse process of C1 to C4› Insertion: superior angle of scapula (medial and upper portion)› Action: elevation and downward rotation of the scapula, aids in retraction of

the scapula› Reverse Action: lateral flexion and slight rotation of the cervical spine to the

same sideRhomboid Major

› Origin: spinous process of T2 to T5› Insertion: medial border of scapula, inferior to spine of scapula› Action: retraction and elevation of the scapula, aids in downward rotation of

the scapulaRhomboid Minor

› Origin: spinous process of C7 and T1› Insertion: medial border of scapula, superior to spine of scapula› Action: retraction and elevation of the scapula, aids in downward rotation of

the scapula

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ScapulaSerratus Anterior

› Origin: superior, lateral surface of ribs 1 to 8, 9› Insertion: medial border, anterior (costal) surface of scapula› Action: protraction and upward rotation of scapula, stabilization of scapula on

rib cagePectoralis Minor

› Origin: anterior surface of ribs 3 to 5› Insertion: coracoid process› Action: depression and downward rotation of the scapula, anteriorly tips the

scapula

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Rotator CuffSupraspinatus

› Origin: supraspinous fossa› Insertion: superior portion of greater tuberosity› Action: abduction of the humerus, stabilization of the humeral head in the

glenoid fossaInfraspinatus

› Origin: infraspinous fossa› Insertion: posterior portion greater tubercle› Action: lateral rotation of the shoulder, stabilization of the humeral head in the

glenoid fossa

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Rotator CuffTeres Minor

› Origin: lateral border of scapula› Insertion: inferior aspect of greater tubercle› Action: lateral rotation of the shoulder, stabilization of the humeral head in the

glenoid fossaSubscapularis

› Origin: subscapular fossa› Insertion: lesser tuberosity› Action: medial rotation of the shoulder, stabilization of the humeral head in the

glenoid fossa

Note: the preceding four muscles are referred to as the rotator cuff

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ShoulderPectoralis Major – Sternal division

› Origin: sternum to rib 7› Insertion: anterior, medial aspect of humerus, crest of greater tuberosity› Action: flexion, adduction, medial rotation and horizontal adduction of the

shoulderPectoralis Major – Clavicular division

› Origin: medial half of clavicle› Insertion: anterior, medial aspect of humerus, crest of greater tuberosity› Action: flexion, adduction, medial rotation and horizontal adduction of the

shoulderCoracobrachialis

› Origin: coracoid process› Insertion: medial, surface of humerus, in line with deltoid tuberosity› Action: flexion of the shoulder, horizontal adduction, adduction and medial

rotation of the humerus

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Shoulder

Latissmus Dorsi› Origin: aponeurosis from spinous process T6 to L5, posterior iliac crest, posterior sacrum, rib 9 to 12, inferior angle of scapula

› Insertion: anterior humerus, crest of lesser tuberosity› Action: extension of the shoulder, adduction and medial rotation of the humerus

Teres Major› Origin: inferior angle, lateral border of scapula› Insertion: anterior humerus, crest of lesser tuberosity› Action: extension of the shoulder, adduction and medial rotation of the humerus

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Shoulder & ElbowTriceps Brachii

› Origin: • Long head – infraglenoid tubercle of the scapula• Lateral head – posterior humerus• Medial Head – posterior humerus, inferior to lateral head

› Insertion: all heads – olecranon process of ulna› Action: All heads – extension of the elbow; long head – extension and

adduction of the shoulderBiceps Brachii

› Origin: Short head – coracoid process› Long head – supraglenoid tubercle› Insertion: both heads - radial tuberosity, bicipital aponeurosis› Action: both heads - flexion of the elbow, supination of the forearm when

flexed, flexion of the shoulder

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Elbow & ForearmBrachioradialis

› Origin: lateral supracondylar ridge of humerus› Insertion: styloid process of radius› Action: flexion of the elbow, aids in pronation and supination of the forearm

Brachialis› Origin: distal half of anterior humerus› Insertion: tuberosity and coronoid process of ulna› Action: flexion of the elbow

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Deep spineMultifidus

› Origin: sacrum, transverse process of L1 to T12 and the articular process of C4 to C7

› Insertion: spinous process of all vertebrae except C1 spanning 2 to 3 intervertebral spaces

› Action: stabilization of the spine; unilaterally – rotation of the spine to the opposite side. lateral flexion of the spine to the same side; bilaterally – extension of the spine

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Posterior SpineSemispinalis thoracis

› Origin: transverse process of T6 to T12› Insertion: spinous process of C6 to T4› Action: unilaterally – rotation of the spine to the opposite side;

bilaterally – extension of the spineSemispinalis cervicis

› Origin: transverse process of T1 to T6› Insertion: spinous process of C2 to C5› Action: unilaterally – lateral flexion of the spine to the same side, rotation of

the spine to the opposite side; bilaterally – extension of the spineSemispinalis capitis

› Origin: transverse process of C5 to T6› Insertion: occipital bone› Action: unilaterally – lateral flexion of the neck to the same side, rotation of the

head and neck to the opposite side; bilaterally – extension of the head and neck

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Posterior SpineIliocostalis lumborum

› Origin: thoracolumbar fascia from the sacrum to spinous process of T11 to L5› Insertion: rib 6 to 12› Action: unilaterally – lateral flexion of the spine to the same side;

bilaterally – extension of the spineIliocostalis thoracis

› Origin: rib 6 to 12› Insertion: rib 1 to 6› Action: unilaterally – lateral flexion of the spine to the same side;

bilaterally – extension of the spineIliocostalis cervicis

› Origin: rib 3 to 6› Insertion: transverse process of C4 to C6› Action: unilaterally – lateral flexion of the spine to the same side;

bilaterally – extension of the spine

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Posterior SpineLongissimus thoracis

› Origin: thoracolumbar fascia on the lumbar spine› Insertion: transverse process of T1 to T12 and rib 6 to 12› Action: unilaterally – lateral flexion of the spine to the same side; bilaterally –

extension of the spineLongissimus cervicis

› Origin: transverse process of T1 to T5› Insertion: transverse process of C2 to C6› Action: unilaterally – lateral flexion of the spine to the same side; bilaterally –

extension of the spineLongissimus capitis

› Origin: transverse process of C4 to T5 › Insertion: mastoid process› Action: unilaterally – lateral flexion and rotation of the head to the same side;

bilaterally – extension of the head and neck

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Posterior SpineQuadratus lumborum

› Origin: posterior iliac crest› Insertion: 12th rib and transverse process of L1 to L4› Action: unilaterally – lateral flexion of the spine; bilaterally – aids in extension

of the spine

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Exercise AnalysisAnalyze the following exercises and describe:

› Plane of motion› Movement at all joints affected› Muscles involved› Type of contractions involved

Ab PrepBreast Stroke (full)Roll UpSpine Stretch ForwardSibe BendSide KickSide Leg Lift #1Saw