Introduction

CHAPTER CONTENTS
Movement 2
Archetypal postures 3
Meridians 4
A patient presented to my clinic in Wellington, New Zealand complaining of
low back pain, left buttock pain, chronic tension with episodic pain across both
shoulders/neck, and almost as an afterthought, discomfort with noises from
both knees. This pleasant woman was in her middle 40s, worked at a desk, was
about 15 kg overweight, and found the 1 km walk to my practice hard work.
Where does one start when attempting to address her various complaints?
This type of presentation is all too common. Diffuse musculoskeletal distress (also known as regional pain syndromes) appears to be endemic within
our society. People of all hues seem to be afflicted. It is hard to discern underlying patterns when both male and female, young and old, fit and unfit, stiff
and flexible, thin and fat are affected dichotomies of many shades but similarly afflicted by chronic musculoskeletal dis-ease that periodically flares up.
The personal cost and the cost to society is simply staggering.
A whole gamut of professions and research avenues are called upon to
address these disorders of movement, but with little consensus yet to emerge
as to a common conceptual understanding (Kent etal 2009). It appears we
need to revise aspects of our understanding of the neuromusculoskeletal
system that moves us and is the source of so much of this type of everyday
dis-ease. Below I will introduce a new model of human movement (the contractile field model) that is then developed in later chapters. Crucial to treatment is assessment a new model of movement engenders a different
approach to assessment; a methodology called the archetypal postures is
proposed. Simple assessment procedures will be introduced that look for the
tune of the musculoskeletal system. The word tune implies proper for
purpose, harmony, accord, with music often a reference context. Tune as used
here is the harmonious interaction of thousands of named anatomical structures. Watching a person walking effortlessly compared with a person
walking with osteoarthritis of a hip joint gives us a sense of tune that is like
a summative insight into the ease or otherwise of that movement pattern. As
in music, tune can be reduced to reference notes that I suggest in this context
are the archetypal postures. In the authors experience, patients quickly grasp
the implications of being in or out of tune, and find the treatment and advice
offered easy to comprehend and comply with. These ideas are then used to
consider the meridians of Traditional Chinese Medicine (TCM), the final
chapters of the book. Thus the three primary themes that form the warp and
weft of this book are movement, archetypal postures, and meridians.

Muscles and meridians

MOVEMENT

The first theme concerns the awe-inspiring complexity of human movement.

From 1979 to 1983 I studied osteopathy at the British College of Osteopathic
Medicine in London. As an undergraduate I was interested in how multiple
muscles might functionally link together to move the body, an idea that was
then called muscle chains. Traditional musculoskeletal anatomy is taught
bone-by-bone, joint-by-joint, and muscle-by-muscle. Each structure is carefully revealed by the painstaking dissection of a cadaver. Obviously, cadavers
do not move, nor do they complain quite unlike the patients I treated at the
college clinic! My fourth-year thesis revolved around the topic of dance injury.
I collated what little there was then in the academic literature, and supplemented this with interviews of dancers at the Laban School of Dance (London),
Alan Herdman (Pilates), and teachers from the yoga/martial arts world. I
soon realized my cadaver-based anatomical studies gave me little insight into
how power and poise were derived from the underlying muscle matrix.
My enquiry into the nature of whole person movement patterns took on a
new momentum when I read Bright Air, Brilliant Fire by Gerald Edelman
(1992), a book that looks at how Darwinian concepts can be applied to neurology. Of interest to me was the context Edelman suggested was needed to
approach something as complex as brain and mind. Only a synthesis derived
from a knowledge of the evolution of animal nervous systems, the embryological/childhood development of the nervous system, allied with anatomy/
physiology would get close to understanding something as complex as brain
and mind. Edelmans approach appealed to me so I then decided to employ
a similar broad scope in my enquiry of human movement.
I have developed an understanding of human movement that I call the
contractile field (CF) model. The word contractile was selected as I did not
want to define the concept by a named anatomical tissue. Individual cells
have contractile elements, and tissue not usually associated with movement,
such as fascia, has demonstrated contractility (Schleip etal 2005). As we shall
see, the CF model suggests that both blood pressure and kidney function
profoundly affect our movement patterns. Fields are defined as an area of
operation, a region in which some common condition prevails. The CF model
explores the innate patterning found in the human neuromuscular system.
Based on an analysis of vertebrate movement, I have identified the minimum
number of interactive CFs needed for primary human movement patterns.
Each of the proposed CFs will be described in terms of its evolutionary and
embryological derivation. The fields will have their borders delineated, and
field interpenetration will be considered.
Dissective anatomy teaches us that a nerve from the brain or spinal cord
innervates every voluntary muscle, an association that is so close, the two
systems are commonly linked together as a neuromuscular system. When a
CF is described a field of contractility that spans head to tail its innervation would span from the cranial region to the coccygeal region. Each CF
would be similarly innervated, and thus a meaningless association in this
whole person context.
What is needed for a whole field of contractility is a supra-segmental form
of innervation. In the neurological hierarchy, the primary sense organs are

profoundly important to any animal as they inform and direct movement.

Where it is appropriate, the CF is modelled as embedding a sense organ, a
novel association suggested to me via the Chinese meridial map.
Like models for weather or climate change, the CF model is not a definitive
mapping of the muscle matrix. Rather it is a starting point that will foster the
development of this modelling process. However, modelling human movement in terms of interacting fields of contractility is of real use to all those
professions that attend the moving body. It is an idea whose time has come.

A new way of looking at musculoskeletal anatomy and function will encourage and inform a new approach to an assessment methodology, the second
major theme of this book. CFs model movement. The opposite of animal
movement is animal rest movement and rest are flip sides of the same coin.
One without the other is nonsensical. When I examine a new patient I ask
them to assume a number of postures archetypal postures of repose. These
include lying on ones back, lying on the front, sitting cross-legged, kneeling
Japanese style, and squatting. Each of these postures has an evolutionary
history that goes back to our common ancestor with the other apes millions
of years ago. I suggest modern lifestyles have divorced us from a natural form
of biomechanical self-correction with a resultant back pain that has become
endemic in our societies.
Sitting on the floor in comfort is a developmental birthright. Every young
child on this planet masters floor sitting postures as a precursor to standing,
walking and running. From floor sitting to then erect from the floor is a profound movement pattern. It uses hundreds of named muscles to lift many
kilos from the floor upward. It is the anti-gravity exercise. A floor living
lifestyle, without further ado, means erecting from the floor many times a
day. I have developed a series of exercises called the Erectorcise as a way
of maintaining this crucial series of movements. The Erectorcise exercises are
all derived from the many ways we can erect from the floor.
Archetypal postures and erecting oneself from the floor are two legs of a
clinically applicable tripod of ideas. The third idea is the crucial role our feet
play in our biomechanical well-being. Standing up on hind limbs initiated a
cascade of evolutionary metamorphosis that has affected every aspect of our
being. But at a cost. Four living support platforms are reduced to just two.
We then cover the two feet with thick leather or man-made mush that reduce
the crucial raw data input a now precariously balanced upright body needs
in order to move with power and poise. I call shoes sensory deprivation
chambers that blind our low back in particular. Rehabilitating our feet is
essential if we are to help reduce the incidence and severity of musculoskeletal distress, and our tendency to fall over as we get older.
It is the authors opinion that one cannot understand clinical human biomechanics without an appreciation of these fundamental body postures and
the importance of the feet to musculoskeletal health. Archetypal postures,
and the effort to erect oneself from the floor to standing are a way of finetuning the many muscles we use in life. Biomechanical tune is an emergent
property that can be assessed. The concept of musculoskeletal tune is not the

Introduction

ARCHETYPAL POSTURES

icing on a biomechanical cake, rather it is as crucial, as non-negotiable, as

tune is to a musical instrument.

Muscles and meridians

MERIDIANS

The third broad theme of the book concerns the meridians of Chinese medicine. In the late 1980s I studied Traditional Chinese Medicine (TCM) as I
suspected a stretching of my conceptual frameworks would be helpful.
Osteopathy is grounded in a biomedical model of the body, with lip service
paid to a whole person approach to diagnosis and treatment. Was there
another perspective? Chinese medical theorists more than 2000 years ago,
after profound study, mapped what they perceived to be the flow of Blood
and Qi within conduits that we will call meridians. Use of this map via
manual therapy, needles, cauterization, and exercises still forms the basis
of the acu-moxa branch of TCM.
The meridial map is extremely detailed. A recent Western text on meridians/acupoints runs to more than 600 pages, describing in scrupulous
anatomical detail the meridians and acupoints (Deadman et al 1998). Fourteen named meridians run up and down the torso. The arm has six meridians in a regular pattern whereas the six leg meridians are crossed and
generally more complex. On meridians are acupoints that are said to predictably influence visceral function. For example, Lung-7 (Lieque) near the
ventral/lateral wrist is a main point on the body for many lung organ
dysfunctions.
However, the map has problems from a bioscientific perspective. Scanning
electron microscopy, microscopic dissection, thermal imaging, radioactive
tagging techniques, magnetic resonance imaging (MRI) and positron emission
tomography (PET) scans, etc. have all failed to find the meridians. Imagine
that I point to an alcove and describe a small man that I shall call a hobbit; the
600-page description of this man I give is detailed, richly textured and nuanced.
But you look, your friends look, photographs are taken, the alcove is carefully
examined using microscopes, thermal and radioactive scanners, etc. and
they all see nothing. In this respect, one of us is seemingly delusional. In the
case of the meridial map, a whole culture, thousands of human years, hundreds of texts, have been describing something. A lot of prestige and cultural
ego is on the line. But here we also have something remarkable. A wellpreserved pre-scientific-era medical map that now is in worldwide clinical
use. Acupuncture treatment is available to billions of people worldwide.
Firstly, what are meridians what was being mapped over 2000 years ago?
Chinese medical theory states that Qi and Blood flow in meridians was
mapped. The cardiovascular system has been extensively studied over the last
350 years meridians do not map blood vessels. Qi is an amorphous concept
and the meridians it is purported to flow in have not been identified.
Secondly, how does an acupoint such as Lung-7 (Lieque) affect lung function, and do so predictably? From a biomedical viewpoint, this is nonsense.
No lung tissue is in the arm for a starter. As a student of acupuncture one
learns by rote and places trust in the Chinese seers of long ago. The meridial
map certainly represents a profound and sustained cultural enquiry, but
again, what did they map?

Introduction

Bioscience has no answers to these questions. Without a working explanatory model the entire practice is seen as a belief system that probably relies
on the placebo effect (and endogenous opiates) for much of its therapeutic
effect. This is harsh, but understandable, if one has not invested years cloaked
in the richness of image and metaphor that TCM can provide.
I have come to understand the meridians of TCM as emergent lines of
shape control. It is a deceptively simple phrase. The term acu-moxa is
shorthand for acupuncture and the burning of mugwort on or near the skin
both practices can elicit a basic survival reflex, i.e. recoil from a noxious
stimulus. When something hurts you, such as a skin prick or burn, you recoil
away. With the onset of predation via tooth, claw, and sting 500+ million
years ago, recoil from hurt has had a long time to deeply embed itself in the
way vertebrates wire their nervous and muscular systems together. There is
a pattern to this recoil and I suggest the Chinese discerned and mapped key
aspects of this pattern.
Here is the link between contractile fields and meridians. With the contractile field model of movement I could see how a pinprick would elicit a whole
body movement. Lines (i.e. meridians) then emerge on the living body that,
when pricked or pressed, will elicit the same basic movement pattern. As
meridians are emergent from the whole living form they will not be found
on a cadaver. In essence, I think the Chinese learnt to predictably influence
subtle body shape by using a three-dimensional pattern of pinpricks. Shape
and function dance closely together.
A thought experiment will be employed to flesh out the idea. Much of the
arcane detail found in the meridial map becomes understandable, rational,
and precocious, considering how many modern texts I have had to assimilate
to come to terms with what I now propose was mapped. I have developed a
new respect for the Traditional Chinese Medical map, and suggest it still has
value today.
This book is directed toward all those who deal with the moving human
body, its ease and its loss of ease. The first chapters step back to look at the
big picture via deep time the origin of moving animals, and back in personal
time our embryological development. Necessarily, this is a quick scan with
only a few key aspects dwelled upon, but context is created. Then a chapter
will draw together ideas that inform the modelling process, followed by
chapters that will introduce each CF. It is the seamless interaction of CFs that
shape human movement.
The concept of archetypal postures and biomechanical tune will be presented as an assessment methodology. If we are to make headway in reducing
Western societys endemic musculoskeletal pain, new perspectives are
needed. Surprisingly simple advice can have a profound effect on form and
function.
Good modelling is often able to cross genre and, in this case, the CF model
is employed to suggest a decoding of the Chinese meridial map. By decoding
I mean to explain why the Chinese settled on 14 primary meridians, why they
are classified and related as they are, what the Chinese were hinting at with
the deep meridians, and how they then mapped the acupoints. I do not
argue for the efficacy of acupuncture, as in the modern world of evidencebased medicine, the practice will need to prove itself. Insight into what the

Chinese mapped will aid the transfer of a traditional medical practice to a

new worldwide audience.
This book is not a technique manual, rather it offers context and explanation for all professions that have as a mandate the movement patterns
found in a whole living person. Re-establishing powerful self-corrective
mechanisms in our patients makes treating musculoskeletal distress more
comprehensible and effective, whatever the modality used.

REFERENCES

Muscles and meridians

Deadman P, Al-Khafaji M, Baker K 1998 A

manual of acupuncture. Journal of
Chinese Medicine Publications, Hove
Edelman G 1992 Bright air, brilliant fire.
Penguin, London
Kent P, Keating J, Buchbinder R 2009
Searching for a conceptual framework
for nonspecific low back pain. Manual
Therapy 14(4):387396

Schleip R, Klingler W, Lehmann-Horn F

2005 Active fascial contractility: fascia
may be able to contract in a smooth
muscle-like manner and thereby
influence musculoskeletal dynamics.
Medical Hypotheses 65:273277