To be honest, when I talk about the myofascial chains located on the front of the body, I seem to mostly refer to the Deep Front Line and the Front Functional Line. That's because I often find "weak links" along these chains upon testing them, especially in the hip adductors or inner thigh muscles.
The Superficial Front Line is more of an afterthought, if everything else tests normal. When I do believe the Superficial Front Line is contributing to someone's pain, I immediately look to their quadriceps. These front thigh muscles are to me the major players in this fascial connection. But let’s first discuss the entire line from bottom to top.
The Superficial Front Line connects the anterior surface of the body in two sections: 1) from toes to pelvis, and 2) from pelvis to head. When the body is erect in standing or walking, these two sections function as one continuous myofascial line. When the body is bent in sitting, these two sections function as two separate lines. And when going through a sit to stand movement (squat, lunge, etc.), these two sections must work together in tandem to help control the bending and straightening motions of the knees and hips.
For the first section (toes to pelvis), the Superficial Front Line starts with the muscles on top of your feet, travels up the shin bones, connects to the subpatellar tendon and into the quadriceps, and then attaches to the pelvic bones at the anterior inferior iliac spine (AIIS). For the second section (pelvis to head), the Superficial Front Line starts at the pubic tubercle and goes up into the rectus abdominis ("six pack" muscle), and then travels up the ribs and sternum, and finally into the sternocleidomastoid (SCM) on each side of the neck and into the scalp fascia.
The SCMs are the most prominent muscles of the neck that you can see and feel when you rotate your head to the left or the right. I find that they are chronically weak and tight on most people for several reasons. They are a compensatory muscle group for those who have difficulty with breathing, like smokers or people with COPD. They are also dysfunctional when the deep stabilizers of the neck turn off ("deactivate") due to the presence of pain. The SCM’s will overcompensate when these smaller, deeper muscles are not firing properly thus leading to pain and dysfunction.
So can chronic neck pain stem from an old ankle, knee or quad injury that has affected the integrity of the fascial connection thus not allowing forces to transfer properly up the chain? Absolutely! These forces flowing through the body are called either ground reaction forces, transfer of forces, or summation of forces. They all have to do with how forces come up from the ground and through the kinetic chain to complete a given task.
Now let’s take a look at a common scenario that can create a poor transfer of forces thus leading to injury somewhere along the chain. Imagine a soccer player who hurts his knee and quad during a game. The injury is severe enough for the athletic trainer to have to help the player off the field and seek immediate treatment. The following day he wakes up and the injured area is swollen and he can hardly walk on his right leg. The only thing this player can think of is getting ready for the next game.
So he gets well enough to play, but he never fully heals. This is a typical scenario for athletes since there isn't much time for proper healing during the season. So the player’s body learns to "muscle through" the next few games. Months later this compensation can start causing problems further up the chain, such as pelvic pain, neck tightness or even recurring headaches.
Proper functional stability is also required to play sports at an elite level. According to Dr. Manohar Panjabi, a professor of orthopedics and rehabilitation at Yale University, functional stability is dependent on three subsystems of the body working properly. The first system is the muscular subsystem which consists of all the muscles and tendons in the body. The osteoligamentous subsystem is a fancy term for all the passive structures in the body like bones, joints and ligaments. The third subsystem is the neural system which consists of the brain, spinal cord and all the nerves in the body. Panjabi believes that an injury to one of these subsystems leads to immediate compensation in order for the body to continue to function, or play in the next game for this soccer player. It can also lead to long term adaptations of the body. This means that the body gets used to functioning in an inefficient way and, the longer it functions this way according to Panjabi, it can ultimately lead to an injury.
The take home message here is that if you have a nagging injury for weeks, months or even years, you may be susceptible to other injuries if you don’t take care of it right away. My advice is to take advantage of physical therapy and find someone who takes a holistic approach to rehabilitation and performance.
To learn more about how I find and fix muscle imbalances along each myofascial chain, check out the Redcord suspension system.
Panjabi MM. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 1992;5(4):383-9.
Disclaimer: The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.