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As Christmas approaches I usually try to find something festive and anatomical. In the past we have looked at the flight of reindeer and how you process your Christmas dinner, an advent of eponymous terms, reindeer and angels, cold paws in the snow, and party shoes. This year I want to bring you an anatomical phenomenon that you may be completely unaware of.

I present to you the anatomical Christmas tree.

You probably haven’t seen this before unless you hang around in body building gyms or someone points it out to you (I encountered it the second way).

What creates this tree?

The edges of this tree are formed by the medial side of the latissimus dorsi muscles. These run all the way up the sides of the back and are used to pull the arms down, or body up if you are doing pull ups – these are the infamous Lats.

They do not go all the way to the spine because the whole of the lower back is covered with a sheet of fascia called the thoracolumbar fascia. This is formed by several layers of fascia – a connective tissue that can not be developed in the same way as the muscle fibers of the lats. Hence, as you develop your lats the differentiation between the bulging muscle and the flat sheet of connective tissue becomes more pronounced.

The trunk of the tree is made up from a group of muscles that extend all the way up the sides of the spine. This group is known collectively as the erector spinae muscles – they literally keep the spine erect.

The final step to revealing a Christmas tree is drop your body fat down to around 5%. I am obliged to point out that this is not advised. The advice is that your body fat should be around 20% (varies with age). Dropping down to 5% will affect some of the metabolic pathways in your body so if you want a Christmas tree you are probably better off popping down the shops.

For the past 5 months people across the world (UK mainly) have been helping us by making felted vertebrae.

The instructions are in the Ive got yer Back section of the web page if you want to try it out.

At the beginning of October we brought all of those piece together for a special event during National Back week. The night had talks on spinal evolution and anatomy from Prof Tom Gillingwater and a talk on back pain by Gavin Routledge, clinical director at Active X clinics.

Whilst the final art piece was stunning in its position within the Anatomical department at Edinburgh University.

The final picture produced by the photographer Gordon from G5 Visuals is absolutely stunning

It just remains to thank everyone who took part and please consider joining us in our next project.

Did you watch the physical 100 in Netflix? It was a bizarre Korean show where people from all walks of life but supposedly at the peak of fitness were challenged, either individually or in teams, to perform tasks. A but like Squid Games only for real and not so terminal.

I don’t know how real the voice overs were that we got in the UK, there seemed to be a lot of people with very similar voices saying the same things, but one of the over whelming comments was ‘Oh, look at those back muscles’.

There aren’t many sports where you do actually get to see back muscles. A trip a long time ago to a swimming competition sticks in my mind, but fully developed back muscles can be amazing. We tend to ignore the back and yet we lose a lot of working days to back problems and people tend to just accept back ache as part of life. People will tell you how many crunches they can do but when you ask if they ever do back elevations they look at you as if you have lost it.

We have an ongoing project looking at the spine and so back muscles have been on my mind lately and so I was amused when I was introduced to a new syndrome last week – ILS.

The L stands for Lats – short for latissimus dorsi. These muscles, one on each side, stretch from the lower thoracic vertebrae, the top of the back of the pelvis and some of the ribs across to the top of the humerus in the arm, catching the lower point of the shoulder blade on the way. It’s responsible for movement of the arm and has a role to play in respiration (because it’s attached to the ribs). It is the muscle that you work when you do a lat pull down in the gym.

The S could stand for Spread (although it stands for syndrome). The best example of this is Bruce Lee – The lat spread was one of his signature moves. It is a body building competition move although Bruce Lee does it the best (in my opinion).

Here is a picture of Bruce Lee – the famous martial artist. This is him just standing their normally, not much definition – looks fairly normal.

This is the same man spreading his lats. Now the six pack is obvious and look at the extra width that it has added to his body. (just remember this when you see another before and after picture – there could just be seconds between these two pictures). This is a common technique throughout many species. When threatened you make yourself appear as big as possible. Notice the arms are away from the body. The lats connect to the humerus and so any movement of the arms would affect the lats and so the arms are held still. To walk like this you would need to twist from your waist – a sort of swagger.

This then leads us to ILS, Invisible Lat Syndrome. Someone, usually in a gym, that walks as though they have spread their lats and so doesn’t move their arms and has a swagger. It’s only three letters but you can see exactly what it looks like.

This week saw Mark Cavendish, the all time best ever sprinter in the Tour de France crash out of the race. This denies him the opportunity of setting the record for most ever stage wins in the race, upping his current total of 34 to 35 and topping the great Eddy Merckx.

What Cav damaged was his collar bone or clavicle.

This is a small slightly s shaped bone that acts as a brace between the top of the sternum and the shoulder blade, holding the arm out from the body and allowing it to function as a useful appendage. It may be visible depending on the percentage of body fat

The name clavicle derives from the Latin for a small key and may be suggestive the bones ability to rotate around its axis in the same way as a key turn in a lock.

The clavicle is the most often broken bone in the body. As people fall they reach out a hand out to safe themselves and the shock transmits up the arm with the resulting stress shattering the bone.

The clavicle is an unusual bone. It is the first to start to form in a foetus but it is also the last bone to completely ossify – where the cartilage that forms the developing structure is replaced with bone.

The end closest to the sternum has a plug of cartilage which begins to ossify around age 14. As this plug continues to ossify it eventually fuses with the main shaft of the bone, a process that starts around 16 but continues into the late twenties.

This makes the clavicle a very useful bone for forensics. Due to its location the bone is often protected from the elements by the rib cage and upper limb. Its state of ossification can age some one to under 14, between 15 and mid twenties or older.

Lets hope the tour continues uneventfully and does not fuel anymore anatomically based posts.

I recently had an article published on one of my favourite subjects – why winged four legged creatures don’t really work.

You can read the whole article here

As part of the peer review process other people read your article and send back comments as to how it could be improved. One such comment was a link to a document that reviewed ten flying creatures. The issue being that I had not mentioned any of these creatures in my article.

The issue was – they didn’t fly. In the words of Buzz Lightyear – they fell with style.

When it comes to the anatomy of flight, I was concentrating on the limb structure and the mechanics of moving those limbs up and down to create lift and how those muscles and bones affected the others limbs and also, rather importantly, breathing. This, to me, was flight. Large skin flaps between your limbs that allowed you to glide, or fins that allowed you to soar above the water, or limbs that allowed you to glide down from tall structures did not count and I ended up being quite dogmatic about what I meant as flight.

It appears that when you get into flight with a moveable wing, we are not so sure about how it works. In the article there is a link to a you tube video where a flight researcher openly admits he isn’t sure about the mechanics.

A fixed wing that allows a differential in air pressure to be created and creates lift is not, for the purpose of this article, flight. I’ll ponder that tomorrow as I prepare to fall with style at the airport.

Last month a class member asked me about the pelvic joints. A friend of theirs had injured themselves skiing in Sweden and had been told by the physio there to rest to give the joint time to recover. Upon returning to the UK they were told that the joint was not moveable and so to be active. The question was simple – was the joint at the back of the pelvis moveable. The answer is not so simple.

The pelvis is such a crucial bony girdle for our upright posture that it is maybe not surprising that people have lots of different ideas about it. It starts its life as a number of separate bones. The ilium, the ishium and the pubis – this set of three on each side and then the sacrum and coccyx at the rear (there is a philosophical debate as to whether the sacrum and coccyx are part of the pelvic girdle or part of the spine but for now lets consider the pelvic girdle to be the complete ring and include these bones).

We will know the ilium from the ridges at the top of our hips or the anterior superior iliac spine (ASIS) that we are told to point in certain directions in exercise classes. We will know the ishium from the ishial tuberosities or sit bones on which we are told to sit. All 3 bones come together to make the acetabulum or socket for the ball and socket hip joint. It is not until the early 20’s that all of these bones are fully fused together and it is hormonal levels that affect the shape, with oestrogen giving the wider pelvic openings required for childbirth.

At the back of the pelvis, the iliums join the sacrum at the sacroiliac joint (SI joint – said as two separate letters not as my exasperation has spelt it above).

The joints are highlighted here in yellow.

They are synovial joints with cartilage on both side (different types of cartilage which is quite unusual). Strong ligaments abound in the pelvis as you would expect from something that is weight bearing. The pelvis is usually depicted as a bowl but in life the sacrum is almost parallel to the ground giving the bowl a forward tilt.

Can those joints move? If you ask an anatomist then the answer will probably be no. They are very strong joints, tightly bound and weight bearing. If they could move at birth (and these are all separate bones at birth so I am not sure that is a particularly good argument) then they fuse at some point. It is the weight bearing joint in the body – would you want it to move.

However – we have the motion of nutation and counter nutation. These are the names given to the movement of the sacral bone in relation to the pelvic bones. Why would someone name something that doesn’t exist? If you have found discussion about these movements then you are probably on a yoga or manual therapy website. The movement claimed is in the region of 2mm.

If you have severe lower back and pelvic pain there is an option of SI joint fusion surgery. Why fuse something that doesn’t move.

So – does the SI joint move? The answer, as with so many things in anatomy, is it depends. I think it probably does move to begin with. I think if you keep moving it it probably retains its movement for longer than if you don’t. I think different people have different ranges of movement and I suspect that most of the bodies donated to anatomists may well have a very limited range of motion if any due to their age.

If you want a clear yes or no answer then you won’t get it studying something as diverse as the human body.

I’m delighted to announce that a small group of us (depicted above as our favourite avengers) have been awarded a sum of money from the American Association for Anatomy to develop resources for public engagement.

We have an interesting time ahead as we try to canvas opinion as to what it is important to highlight to the public and we are joined by our anatomist colleagues across the globe to try and deliver entertaining events that increase everybody’s knowledge of their bodies.

Watch this space!

My combat class recently started back after the Christmas break. We finished the first class with a cool down called stick wrestling. It’s not what it sounds like and it certainly isn’t the activity you see if you google that term.

Two people grasp a stick and the aim of the practice is to make your opponent let go of the stick. This is not a test of brute strength, it’s not a case of throwing your opponent around. It looks like a dance, it’s a flow of allowing your opponent to move the stick around whilst being aware of what they are trying to do. Each of you are trying to move the stick into a position where the anatomy of your opponent’s body simply means they have to let go. I woke up the next morning and it felt like every muscle in my body had had a total workout – and that was because it had.

Often the trend when you go to a gym to workout is to isolate the one muscle group you are working on. People strap themselves into machines and think they are experiencing the pinnacle of exercising. Often you see the person doing the bicep curl but using momentum, the person doing the lat pull down but actually using their lower back, the person doing the stomach crunch but actually using their arm to move that weight, the list goes on.

What they are missing is that the body is not a series of independent muscles, it is one form that has to work together. This is the argument about using free weight over machines. If I am strapped in machine and doing the exercise correctly then I am working minimal muscles. If I do a bicep curl with free weights then I am using my legs, if I am working alternate sides then all of the muscles at the front back and side of my body are working to hold myself upright as I move that weight around. I don’t pick up the dumb bell and droop down to that side, my alternate side contracts so that I stay upright. Every muscles in your body can offer stability to the structure.

These sort of conversations lead us into the subject of core.

If you google core then often you get a picture like this. (notice the slight twist to make the muscles stand out more).

To most this is what they think of when they think of core muscles. Working your core is sit ups, crunches, hollow man exercises. It’s all about the abs with possibly the more enlightened also working the lower back.

What if we thought of core more like this

Everything that goes up and down your body, almost everything apart from your limbs. The movement of any part of your body affects every other part of your body and we need to stop thinking about it as a pile of parts. Nothing I could do in a gym would prepare me for stick wrestling. Stick wrestling prepares you for stick wrestling. Its time we thought more about functional fitness, the body working as a whole with stability coming from within rather than straps to hold you in the correct place.

I couldn’t resist a title like that with the New Year around the corner and a number of projects about to launch but what I really want to talk about is the TV series Limitless.

The series sees Chris Hemsworth push his body beyond what anyone could reasonably expect.

My attention was drawn to the series by some colleagues who helped out with the science side of things. Their contributions have been replaced with voice overs by the actor but I think they way the science is explained throughout the programs is good and easy to relate to.

The body is pushed with a number of things we probably all encounter in some ways

Stress – I am sure we all have a fair amount of stress although walking out on a beam projecting from a tall building is not the sort of stress most of us suffer from. It was interesting to see the techniques they used to try and help someone who doesn’t like heights step out above the city skyline. Particularly interesting when he got to the end of the beam and started to freak out – should have really seen that one coming in the risk assessment.

Shock – which was cold water swimming. I swim in the North Sea but luckily no one has put me through special forces drowning training.

Fasting – there is much debate on whether intermittent fasting is good for you or not. In this programme they undertook a 4 day fast. That would be challenging enough but they broke the fast by free diving down to a barrier reef and spear fishing for their tea. Missing breakfast will never seem so important again.

Strength – The. number of people I know who can successfully climb a rope is few, even smaller is the number of places where you could practice it so when the task is to climb 100 feet up a rope they had to come up with some innovative ways to practice. As if that wasn’t hard enough they then dangled the rope under a cable car.

Memory – this programme saw them navigating across the outback from memory. I very rarely drive anywhere without a SatNav now and I don’t even attempt to remember peoples phone numbers – I don’t need to they are all saved in my phone. Maybe if we didn’t rely on technology so much to do things for us we wouldn’t have to go trekking across the outback to try and preserve our memory. This episode was made more poignant by the fact revealed during the series that Chris has been found to be carrying two copies of the gene APOE4. This makes him 10 times more likely to develop Alzheimers disease. Something he had seen in his relatives.

Acceptance – the final episode was a tear jerker. They built a whole retirement village and placed the actor in a special suit which limited the use of his body in line with ageing. At first he struggled against it but eventually he had to accept that he could not do what he used to be able to do and adapt. With some fancy prosthetics they aged his wife and brought her on as a special guest before taking him through an immersive piece of work that played out his death.

There are many things you could take away from this series but what I take away is that the body is an amazing piece of kit which a lot of people do not fully understand. If we were to be able to explain to people what they had at their disposal then maybe we could enhance their understanding of their own anatomy in a way that could only improve their lives.

If that doesn’t set us up for a 2023 of some Anatomical Public Engagement then I don’t know what does.

I have recently started a new combat class.

I haven’t fully divulged my past TKD experience and I haven’t disclosed I am an anatomist (why would you, these things don’t come up)

This week though my questions almost gave me away. We were looking at solar plexus strikes and I asked the question ‘and where are you saying the solar plexus is?’ I sometimes struggle with the solar plexus because its not an anatomical feature and yet, as anyone who has ever been hit in it can tell you, it does exist.

Most anatomists have assumed that when people talk about the solar plexus they are talking about the Celiac plexus – a complex combination of nerves that is made up mainly from the greater and lesser splanchnic nerves with parasympathetic innervation from both branches of the vagal nerves. It is surrounded by 10 secondary plexus so you can understand the idea that this is a central nerve plexus with radiating nerves that affect multiple parts of the body – hence the name solar with nerves radiating out.

Kudos to any non anatomists who can see the circular structure with radiating nerves in this picture!

One of the troubles that I have with the solar plexus is the mixture of worlds. If you google solar plexus then you may get one link to an anatomical site but the majority of the sites are about chakras and blocking and unblocking energy paths. I guess that is my problem with being in two social worlds that view the world differently; are you striking an energy source or an anatomical structure?

The second problem I have is that the bundle of nerves is at the back of the body just in front of the spine. To have an effect on it then you must have compressed everything in front of it. We know that can happen because we all know people who have had the wind knocked out of them – that is a sign of a blow to the solar plexus and yet we struggle with massage therapists who claim they can release the psoas by massaging the front of the body.

The body continues to pose problems for us to ponder