What’s in a name?

You perhaps learned along that way that a tendon attaches muscle to bone. And that a ligament will attach one bone to another. And if you are anything like me, the next question you asked was: Well, what attaches the muscle to the tendon? Or the tendon to the bone. Or the ligament to the bone. Because, of course, if the first bit of information was deemed important or necessary to know, then all that other stuff should also be important, ya?

This is why I hardly have any friends.

Allow me to quickly explain it using a few hastily drawn pictures. (The anatomy, I mean. Not why I don’t have many friends.) Your understanding of anatomy might be based on this:

And while this is not incorrect, it is also not as accurate as the next picture I have drawn below. This way of attachment would make for a very injury-prone body (think parts falling off right at the interface) if tissues abruptly changed from one to another. Imagine how much stronger your towel rack would be if it wasn’t glued to the wall but actually wound some of its aluminum bits into the wood particles of the wall? Which I guess is what a screw does. Nice.

So, when is a thing a thing?

And you didn’t even know you were reading a philosophy blog, did you?

If we don’t go by the defining parameters of the tissue-names (muscle, tendon, bone) but instead go by the uniqueness of the tissue itself, the picture actually looks more like this:

Meaning that there are sevenish unique tissues to consider in the process of muscle blending into a tendon and then tendon blending into bone. And who’s to say that there aren’t more unique tissues in between each of these seven?

Of course there are. All we have to do is add the variables of unique fiber angles or count slightly different cell types and BAM, you’ll find new layers that differ. What you observe is entirely based on the established parameters and perspective from which you are observing it.

Why am I writing this today? I bring this topic up for a couple reasons.

First, I thought you might be interested in how muscle attaches to bone. The other reason seems to be that I like to make grand commentary on the state of things — in this case anatomical science and those who use it.

If your current level of understanding the body is here

and you make logical and educated progressions from this viewpoint, you can still come to erroneous conclusions when you apply your thoughts to this body here:

This seems to be the current trend in all things body-science — the application of big ideas based on over-simplified models that don’t account for biological mechanism. College-level textbooks are 30 years behind the most up-to-date information. Definitions are vague, even in current and published literature. Published literature? Who’s reading (and understanding) that?

Like many things, in trying to make information accessible to everyone (as it should be), we’ve effectively made the bulk of it incorrect through oversimplification instead of teaching the necessary mathematical skills necessary for evaluating function. From the big stuff (moving around the planet) to the little stuff (moving stuff in and out of the cells) both a full engineering and a full biological perspective are necessary to understand the mechanism of human function. Why? Because the picture gets a lot more narrow without these sets of information, which means conclusions made become quickly erroneous through lack of detail.

I posted this on our Facebook page this morning:

Update your idea of THE CORE: The linea alba is not “where the stomach muscles connect” but rather where the fibers of the abdominal muscles’ aponeurosis (think flat, bilayered tendons) cross over each other and then resume on the other side of the abdomen. Interestingly enough, the aponeurosis of the 3 waist muscles all come in obliquely (at angles) — even the transversalis, which means the rectus abdominals (the abdominal muscles running top to bottom) are really under the pull of three oblique angles at the linea alba.

(Who wants a picture??)

The linea alba is a huge topic since diastasis recti (unnatural distance between the rectus abdominus and the linea alba) has become a huge issue for women especially, but men and babies as well.

So, what is the linea alba, exactly?

Is it a line that runs down the center of the abdomen? Well, sure! I guess it could be, if you’re evaluating it on how it looks. Is that all it is? Nope. Is this “the place” where abdominals all come to connect? I guess that depends on if you think that a red square on this tablecloth…

is where two chunks of red thread “connect”; or where to chunks of red threads create the appearance of a red square based on how they interact. You’d likely evaluate the “red square” differently depending on if you were looking at the cloth or the threads and based on your internal definitions of connect and interact.

Damn. I’m getting all Aristotle with my bad self.

Moving on, the linea alba is an area of intersection between the aponeurosis of the obliques and the transversalis muscles. Or said in a different way, the linea alba is what we call an area made up of a bunch of other tissues that we already call something else. So, did you damage the linea alba or did you damage one (or all) of the aponeurosis? Note: Studying semantics is extremely helpful when it comes to the physical sciences. Who’d a thought?

Although necessary for study, keep in mind that process of cataloging and naming our parts shapes our understanding of the body — and not in a more accurate way. Every “definition” or “word” we use for a body part or a tissue type (known as a classification system) is based on the value system of that person, or group of people. This is why our health/movement science is busy getting a lot less science-y. Modern anatomical science is riddled with a cultural influence that is affecting our ability to see the body’s mechanism. But I’ll save that for a different post. Until then, I’ll leave you with this: There is no spoon.

The end.

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22 thoughts on “What’s in a name?

  1. Some say that even if you do heal the DR, that it very easily can split open again. But if the “fibers” are so intertwined and at angles, why would it be so fragile? I would think it would be strong. And I can’t help but wonder what is on the BACK of the paper you drew on. “look beyond what you see..” disney philosophy

    1. In many cases, in what I’d call extreme DR I don’t think that the fibers ever heal, actually. I believe that you can maintain a muscular wall, but the connective tissue doesn’t grow back together — so once you stop maintaining your muscular walls the issue is still there (which is why I’m more for the makeover the way you move in life — not just doing some exercises to force it shut every day, because that will become old, inevitably….)

      Do you mean what is on the front of the back of the paper I wrote on? It’s a research article on the psoas. Disney-detailed.

      1. In the cadavers I’ve had the privilege of dissecting, many MANY have DR, and there is a nice pocket of superficial fascia (fatty layer) now connecting the hemispheres of myofascia/aponeurosis/deepfascia/tendonystuff that were split. It does “reconnect”….but essentially with a different “packing material” that does not have the same tough fiber organization as the original knit.

      1. You’re funny. I’m putting together a document/booklet of exercises. Good to start with until I figure out what DVD set to buy. It will happen. Fascinating stuff Katy – Hurray to a natural and healthy lifestyle!

  2. Yes in.. deed! The bigger the front the bigger the back.” We humans are problem solvers; we reached the door of wisdom when we learned to solve the right problem at the right time.” WD thank you for sharing the journey to some doors and how you go beyond the thresholds. 🙂

  3. Verrrrrry interesting. And nice drawings. I have always observed the gradual change in tissues when cutting up meat (we do a lot of our own butchering, so I get opportunity to observe). The bony-tendon part is most fascinating, I think.

    Also, I was very bummed when my third baby (now 9 months old) gave me a diastasis recti. Actually, I guess I gave it to myself, technically, but it’s more fun to blame it on my kid. I’m back into my old jeans, but they don’t button as comfortably as they used to. I wonder sadly if they ever will…

    1. Of course you can make all sorts of improvements! Don’t be dissuaded — there are a ton of people who have make huge progress on huge DR — it’s just about determining your best course of action that will last you a loooong time. No worries. There are some excellent teachers out there!

  4. I’m curious about Ashley’s comment, that once you have a DR, even if you can close it, you’re at constant risk of reopening it. I have read that as well, and it makes me nervous! I’m way too young to be worrying about that for the rest of my life. I know you’ve written a lot about DR (I’ve read the archives!) but can you address specifically what long-term approach to take when it is the result of pregnancy (even though I also know you wrote that its probably got less to do with the pregnancy than with what was going on before)?

  5. Thank you, thank you, the unanswered question of “what attaches tendon to bone” has bothered me for a long time. So what happens in knee and hip surgery when the tendony bones get cut? I think you said tendons can not regrow, I’ve heard it other places. How does the metal or plastic of the artificial knee/hip get reattached to the tendons?

  6. My husband had abdominal surgery a few years back, they cut him down the middle from ribs to pubic bone and sewed him up with non-dissolving plastic thread. Is that thread the only thing really holding him together?

  7. Katy, you are soooooooo smart! I never got philosphical while I had a toddler and a baby in belly. I look forward to the posts to come.

  8. I’ve read this a couple times now. Having just finished 8 weeks of BEACH summer school instructing on how to identify, isolate, relax and recruit the core and PF muscles (and psoaii) when you need them, this was timely…and I’ll be doing another 4 weeks of instruction on this topic this fall, whoo hoo! But a question came up in my head: does the rectus abdominus group attach to the interior surface of the aponeurosis in a lateral direction even tho the RA fibers run lengthwise? If the answer is “DUH, of course” please reply with a smiley face.

    1. No Duh 🙂 The best way to explain it is the sheath is the borders of the pocket the RA sits in. The muscles isn’t attached to it (as this would limit the movement of the muscle). It’s simply providing a little extra structural integrity (without impeding muscle function). So truly, the RA isn’t even connected to the LA, is it?

  9. Awesome blog as usual Katy. In doing cadaver labs, I have thoroughly enjoyed dismantling all of the collected anatomy book images in my brain, and layer-by-layer disconnecting the tissues of the body. Many may be shocked to know that the rectus abdominal muscles are quite irregular from body to body, and that the “6-pack” or “8-pack” or “10-pack” that you find on the cover of Men’s Fitness magazines or in anatomy books does not necessarily ring true. I have seen rectus abdominal muscles that only had 4 segments, 2 on the right side of the line alba and 2 on the left. Altogether, the cadaver had less “tendony muscle.” This means that “washboard abs” is truly out of reach for many bodies, regardless of the thickness of their outer belly fascias. I don’t believe in spoons either…only the little tiny ones used for gelato samples etc.

  10. I’ll be your friend…..and when we collaborate your biomechanics and my biometaphysics look out ‘modern medicine’ Katy and Sharron are here!!

    ps when are you coming to Vancouver Island? Soon if you don’t have triplets planned next?…..have been waiting months to hear back so maybe 14 more months to go?

    1. Who knows! My bookings come in randomly — you can keep an eye on the Where’s Katy going to be page to see which conferences I’ll be lecturing at!

  11. i like this quote we were given during my pilates training; blew my mind as a young pilates hatchling!:

    “the extensive fascia network and the bones provide the frame and the rigging for the support of the body and its parts. these two structural elements are woven into a single unit by the connective tissue, periosteum, ligaments, joint capsules, tendons and muscle sacs. in fact the strict distinction between all these elements are somewhat arbitrary, since all of them – including bone – are merely slight different forms of connective tissue which blend into one another with no sharp boundaries. Together they compose a complex and flexible tensegrity structure, made up of connective cables and bony spacers.” – Job’s Body, Deane Juhan

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