Body Alignment & Balance. Midline Anatomy & the Median Plane.

An in­tro­duc­tion to my Base-Line Hy­poth­e­sis of Hu­man Health and Move­ment.

The anatom­i­cal in­for­ma­tion pre­sented here should be eas­ily ver­ifi­able.

What do bal­ance and al­ign­ment mean with re­spect to the hu­man body?

Two (of the many) defi­ni­tions for bal­anced:

1. Differ­ent parts of some­thing that ex­ist in equal or cor­rect amounts.
2. A state of equil­ibrium, be­ing in har­mo­nious ar­range­ment.

Align­ment has many defi­ni­tions, the two most rele­vant to ‘body al­ign­ment’ are:

1. Ar­range­ment in a straight line.
2. Ar­ranged in the cor­rect rel­a­tive po­si­tions.

Align­ment, Balance & The Me­dian Plane.

The me­dian plane (a.k.a. mid­sag­it­tal plane) is the plane that splits the body into left and right halves.

A straight line when viewed from the front or back. A 2-D shape from the side.

The body must be “cor­rectly ar­ranged” to cre­ate the me­dian plane, where:

  • The body is al­igned.

    • All midline anatomy is ar­ranged on the straight line of the me­dian plane.

  • The body is bal­anced.

    • Left and right sides in equil­ibrium ei­ther side of the me­dian plane.

The po­si­tion of the rest of the body should be con­sid­ered rel­a­tive to the midline anatomy and the me­dian plane.

Midline Anatomy.

Pal­pable Anatom­i­cal Struc­tures.

Some easy to find midline anatom­i­cal struc­tures in­clude the:

Feel for the rel­a­tive po­si­tion­ing of these midline mark­ers to in­crease your aware­ness of your body’s midline.

Midline Lin­ear Struc­tures.

The lin­ear anatom­i­cal struc­tures on our midline need to be at full ex­ten­sion to be truly al­igned - straight, smooth, no kinks or ten­sions so they can line up on the me­dian plane.

The main lin­ear struc­tures we should fo­cus on for body al­ign­ment are:

  • The linea alba. Midline at the an­te­rior (front) of the body.

    • Our pri­mary anatom­i­cal guide for body al­ign­ment.

  • The nuchal lig­a­ment & supraspinous lig­a­ment. Form­ing a con­tin­u­ous struc­ture midline at the pos­te­rior (back) of the body.

    • Our sec­ondary anatom­i­cal guides for body al­ign­ment.

Linea Alba.

The linea alba (Latin for ‘white line’) is a strip of strong con­nec­tive tis­sue midline at the front of the ab­domen.

One end of the linea alba at­taches to the pu­bic sym­ph­ysis of the pelvis and the other end to the xiphoid pro­cess of the ster­num with the navel situ­ated in the mid­dle.

The linea alba is formed from the aponeu­roses (tough, thin sheets of con­nec­tive tis­sue) of the three lat­eral ab­dom­i­nal mus­cles (the mus­cles that wrap around the sides of the ab­domen—the ex­ter­nal ab­dom­i­nal oblique, in­ter­nal ab­dom­i­nal oblique and transver­sus ab­do­mi­nis) as left and right sides fuse at the front of the ab­domen.

Cross sec­tion of an­te­rior ab­domen.

Be­fore the aponeu­roses of the lat­eral ab­dom­i­nal mus­cles merge at the linea alba they form the left and right rec­tus sheaths (tun­nels of con­nec­tive tis­sue) in which the cor­re­spond­ing left and right rec­tus ab­do­mi­nis mus­cles lie (like a rib­bon in a sheath ei­ther side of midline).

The rec­tus ab­do­mi­nis mus­cles are the clos­est mus­cu­lar tis­sue to the linea alba, ly­ing ei­ther side from pelvis to chest and are the key mus­cles to fo­cus on to be­come aware of the rel­a­tive al­ign­ment of the linea alba.

The linea alba and rec­tus ab­do­mi­nis mus­cles all origi­nate from the pu­bic sym­ph­ysis.

Nuchal and Supraspinous Liga­ments.

The nuchal lig­a­ment (lig­a­men­tum nuchae) and supraspinous lig­a­ment are one con­tin­u­ous struc­ture at the pos­te­rior of the spine, a long strip of tough con­nec­tive tis­sue from head to tail.

The nuchal lig­a­ment is a sep­tum (di­vid­ing wall) midline in the back of the neck. It con­sists of fibro-elas­tic con­nec­tive tis­sue i.e. it is strong with elas­tic prop­er­ties.

The nuchal lig­a­ment at­taches to the base of the skull at the ex­ter­nal oc­cip­i­tal pro­tu­ber­ance (feel for the midline bump at the back of the skull) and the me­dial nuchal line (a.k.a. the ex­ter­nal oc­cip­i­tal crest).

The nuchal lig­a­ment then at­taches to the spinous pro­cesses of all the cer­vi­cal ver­te­brae. At the 7th (last) cer­vi­cal ver­te­bra, the nuchal lig­a­ment con­tinues as the supraspinous lig­a­ment, a strong, fibrous cord at­tach­ing to the spinous pro­cesses of the sev­enth cer­vi­cal ver­te­bra, all twelve tho­racic ver­te­brae and the up­per lum­bar ver­te­brae, usu­ally ter­mi­nat­ing at the 4th lum­bar ver­te­bra (but pos­si­bly L3 or L5).

The left and right trapez­ius mus­cles at­tach to the nuchal and supraspinous lig­a­ments from the base of the skull to the last tho­racic ver­te­bra. The trapez­ius mus­cles are key to feel­ing and con­trol­ling the po­si­tion­ing of the nuchal and supraspinous lig­a­ments.

Un­im­por­tant to my hy­poth­e­sis, I men­tion it now to be com­plete: The an­te­rior lon­gi­tu­di­nal lig­a­ment is the longest anatom­i­cal struc­ture on the midline. Run­ning the en­tire length of the spine and at­tach­ing to the an­te­rior (front) of each ver­te­brae, it can­not be ‘felt’, ei­ther by pal­pa­tion or by fo­cus­ing on ad­ja­cent mus­cles.

In­creas­ing Con­scious Aware­ness of Midline.

To in­crease con­scious aware­ness of our midline we can tap into the pro­pri­o­cep­tive feed­back (sen­sory in­for­ma­tion re­gard­ing po­si­tion­ing, mo­tion and bal­ance) gen­er­ated by var­i­ous struc­tures by ac­tively fo­cus­ing on them.

Mus­cles and other struc­tures that are on, or ei­ther side of, midline in­clude:

  • The pelvic floor mus­cles. A group of mus­cles at the base of the linea alba, left and right sides meet­ing as a cres­cent shape on midline.

  • Per­ineal mus­cles. Anal sphinc­ter.

  • The cli­toris/​sus­pen­sory lig­a­ment of the pe­nis lo­cated at the pu­bic sym­ph­ysis.

  • The rec­tus ab­do­mi­nis mus­cles ei­ther side of the linea alba.

  • The trapez­ius mus­cles at­tach­ing to the nuchal and supraspinous lig­a­ments.

Much in­for­ma­tion about the rel­a­tive po­si­tion­ing the head can be gained from:

  • Nostrils. Feel the air flow in each nos­tril, aiming for bal­ance.

  • Move­ment of the mouth, lips and jaw.

  • The tongue. Po­si­tion­ing the tongue be­hind the cen­tral in­ci­sors and on the hard palate pro­vides sen­sory feed­back about midline.

Dy­namic Align­ment and Balance.

(still work­ing on the word­ing:)

The body is al­igned when the midline anatom­i­cal struc­tures can be felt to be al­igned, po­si­tioned in the cor­rect rel­a­tive po­si­tions on the me­dian plane, with the body bal­anced ei­ther side.

The body is not static. We are con­stantly on the move and thus bal­ance and al­ign­ment are dy­namic states. A full range of nat­u­ral move­ment per­mits true dy­nam­i­cal al­ign­ment and bal­ance, our midline anatomy can be at max­i­mal ex­ten­sion. For this to be pos­si­ble the body must be free of phys­i­cal re­stric­tions that would oth­er­wise ap­ply ten­sions to our midline anatomy.

The linea alba, nuchal and supraspinous lig­a­ments are like a rib­bon or a rope that can bend and twist at ev­ery level, sup­port­ing the rest of the body when we have a full range of nat­u­ral move­ment.

The body sta­ble in all po­si­tions and move­ment is fluid when we are dy­nam­i­cally bal­anced and al­igned.

Dy­namic al­ign­ment and bal­ance:
Midline anatomy can al­ign on the me­dian plane.
A full range of nat­u­ral move­ment.

Think about where your midline anatomy is in re­la­tion to the me­dian plane.

Feel for your al­ign­ment.