Pelvic, Hip & Spinal Anatomy - Of-Course Online

Pelvic, Hip & Spinal Anatomy

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©Copyright January 2015, Of-Course-Online – Hip, pelvic & spinal anatomy (Tanya Thompson), South Africa

Contents INTRODUCTION AND COURSE BREAKDOWN .................................................................................................................... 3

Anatomy ............................................................................................................................................................................ 4

Anatomical Terminology .................................................................................................................................................... 5

Pelvic anatomy................................................................................................................................................................... 6

• Functional joint range ..................................................................................................................................................... 7

Muscles affecting the movement of the pelvis ................................................................................................................. 8

• Back extensors: Pulls the pelvis into an anterior and lateral tilt .................................................................................. 9

• Additional muscles that act on the spine (cervical) ...................................................................................................... 11

• Hip flexors: They will pull your pelvis into an anterior tilt ............................................................................................ 13

• Hip extensors: These will pull your pelvis into a posterior tilt .................................................................................... 15

• Hip adductors: This will pull the pelvis into a lateral tilt .............................................................................................. 16

• Hip abductors: These will pull the pelvis into a lateral tilt - Refer back to page 12 ..................................................... 17

References ....................................................................................................................................................................... 19

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INTRODUCTION AND COURSE BREAKDOWN

Outline of course: HIP, PELVIC AND SPINAL ANATOMY

In order for Movement Professionals to stay at the top of their careers, they need to maintain a strong anatomical background in relation to

movement. During a client’s assessment, it is vital that the professional has the knowledge of how the muscles of the body affect the joints and how

this would affect a client’s movement patterns. A look into anatomy and the bases for all movement and client assessments is covered in this course.

What are the muscles involved in the hip, spine and pelvis and what are all the joints that are affected? Why are the reasons for the chain reactions?

These are just a few of the puzzle pieces that will fit together. This video course covers the anatomy of the entire pelvic, hip and spinal area with high

quality images.

Objectives: This course is to recap and develop insight into the muscles of the pelvis, hip and spine in order to add to the process of pelvis, hip

and spinal training and stability. The Movement Professional will have a clearer understanding of how we can relate anatomy to movement as

well as assess which muscles are working in various exercises.

Course description:

➢ Quick recap on anatomical terminology relating to movement

➢ Images and information of the skeletal system on the above-mentioned areas

➢ The muscles that affect the pelvis, hip and spine in all their joint movement abilities as well as antagonists

➢ Conclusion of how these muscles will affect a pelvic tilt

Course requirements:

➢ Computer, Internet, Manual (to be printed off of website), stationery

Course agenda:

1. This course is done online at a time convenient for the candidate

2. The course is presented via a video so the candidate is able to watch the course and follow the presenter from the manual

3. The course is divided into sessions and therefore they can do one session at a time

4. The course duration is approximately 2.5 hours

5. At the end of the final session, they are to complete a test at their convenience

6. They will also receive the 1-page course summary

7. A certificate will be available once they have achieved 70% on the test

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The pelvis, hip and spine are so strongly interlinked through their attachments of the spine to pelvis at the sacroiliac joint and

the pelvis to hip at the acetabulum socket that if either of these joints were to change, they would affect the other two. This

leaves the body in a vulnerable position as it is susceptible to injury in all three of the joints even if the initial problem originated

in only one of them.

As movement professionals, it is vital that we have a comprehensive understanding of the anatomy of the

body. However, knowing the names of muscles and where they are is not sufficient in the movement

industry. We need a deeper understanding of how these muscles relate to one another and how they

react on an individual. Each client can be viewed as a unique puzzle, and through a comprehensive understanding of

the anatomy, all the parts of their puzzle will fit together perfectly. In order to get to the point of anatomical

‘AWESOMENESS’, we need to jump right back to the basics and start unfolding the amazing world of the human body.

So sit back, relax and absorb all that there is to learn about this amazing structure.

Anatomy

Spine

This is affected through

movements of the hip &

pelvis

Hip

This is affected through

movements of the legs,

pelvis or spine

Pelvis

Forms the bridge between the spine at

the sacroiliac joint & the legs at the

acetabulum joint (hip)

SIJ: sacroiliac joint

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It is important for a movement professional to understand anatomical terminology. This enables them to communicate easily with other

professionals within the health industry.

It will also assist you in designing client specific programs as you are able to think on a scientific anatomical level.

LET’S DO THIS!

Positional terminology ✓ Anatomical position Standing, feet and palms facing towards the front ✓ Supine Lying on the back ✓ Prone Lying on your abdomen

TERM JOINT MOVEMENTS

Flexion Movement in an anterior direction for upper extremities and back and a posterior direction for the knee/

bending or folding of a joint

Extension Movement in a posterior direction for the upper extremities and back and an anterior direction for the knee/

straightening of a joint.

Hyperextension Excessive movement in the direction of extension. Note that the agonist is working / shortened and that the antagonist is lengthened / weakened e.g. hyper-extended knees or lordotic posture of the lumbar vertebrae

Abduction A movement that occurs by moving the legs, arms or shoulder blades away from the midline of the body.

Adduction A movement that occurs by moving the legs, arms or shoulder blades towards the midline of the body

Circumduction Combination of flexion, extension, abduction and adduction

Spinal Rotation Rotation of the head, neck or trunk towards the left or right

Lateral Rotation Rotation of the shoulder or hip away from the body

Medial Rotation Rotation of the shoulder or hip towards the anterior part of the body

Anatomical Terminology

That was easy right?

It is always good to recap on anatomical terms!

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IMPORTANT TERMINOLOGY

Range of Motion The amount of mobility that occurs within a joint. This is affected by the muscular, structural and ligament

composition.

Core

Comprising of a deeper group of muscles within the trunk and pelvis.

Planes of motion Transverse plane—a horizontal plane dividing the standing body into superior (top) and inferior (bottom) halves

(dividing the body into upper and lower allowing rotation)

Sagittal plane—a vertical plane dividing the standing body into left and right halves (allowing for flexion and

extension)

Coronal plane—a vertical plane dividing the standing body into anterior (front) and posterior (back) halves

(allowing for abduction and adduction)

Joint mobility The ability for a joint to move through its full range of motion

Joint stability The muscle, tendon and ligament action needed to hold a joint in position.

Protraction and retraction Protraction is moving the shoulder blades apart and retraction is moving the shoulder blades together

Lateral Towards the outside

Medial Towards the centre

Inferior Below / towards the feet

Superior Above / towards the head

Proximal Closer to the centre

Distal Further from the centre

Pelvis This is formed by the fusion of the ilium, ischium and pubis. The sacrum and coccyx forms part of the pelvis and the pelvis attaches to the spine at the Sacro-Iliac Joint (SIJ)

ASIS Anterior superior iliac spine. This refers to our hipbones on the anterior side of the body. This is very important when referring to neutral pelvis

PS Pubic symphysis. This refers to the pubic bone, a cartilaginous joint and important when referring to neutral pelvis

Acetabulum This refers to the hip socket, where the head of the femur fits deeply into the cup shaped acetabulum forming the ball and socket hip joint

Femur

This is the thigh bone and is the heaviest and longest bone in the body. The head of the femur forms part of the hip joint and it is important to note the greater trochanter (lateral) and the lesser trochanter (medial)

Pelvic anatomy

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Functional joint range As we are focusing on anatomy in movement, it is vital that we understand the natural range of movements for our joints. This

will give us the ability to assess a client’s movement with the knowledge of what the natural range should be, therefore

allowing us to distinguish between an adaptation and compensation.

Region Degrees of flexion Degrees of

extension

Degrees of

rotation

Degrees of lateral

flexion

Cervical +/- 50° +/- 60° +/- 80° +/- 45°

Thoracic +/- 50° Slight +/- 30° +/- 30°

Lumbar +/- 60° +/- 20° 3° - 18° 15° - 20°

Spine 24 mobile vertebrae:

• 7 cervical (Lordotic curve)

• 12 thoracic (mostly in slight flexion)

• 5 lumbar (extension) 8 Fixed vertebrae:

• 5 sacral (joins the pelvis to the spine at the Sacro-Iliac Joint)

• 4 fused (coccyx)

Ribs:

• 12 ribs that are attached to the thoracic spine

Note the:

Anterior

Posterior

longitudinal Ligament

Notes

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The pelvis is an extremely complex structure and forms the bridge between the upper and lower extremities. Due to its importance it has various muscle groups around it and within it to maintain its stability.

Abdominals: These pull the pelvis into a posterior or lateral tilt

Muscle Movement Antagonist Position Transverse Abdominus Expiration, trunk stabilization & rib closure. This muscle does not produce joint movement and

therefore will not be a mover when correcting posture.

Internal Oblique Lateral flexion of the trunk and contracts towards the direction of rotation Synergist in trunk flexion

Opposite internal oblique,

same sides external oblique,

same sides multifidus,

opposite sides rotatores

(rotation), opposite sides

quadratus lumborum and

obliques (lateral flexion)

Runs from the posterior

pelvis and attaches to the

ASIS to the ribs and a

sheath over the transverse

abdominus.

External Oblique Trunk rotation. Lateral flexion of

the trunk and contracts away

from the direction of rotation

Synergist in trunk flexion

Opposite external oblique,

same sides internal oblique,

opposite sides multifidus,

same sides rotatores

(rotation), opposite sides

quadratus lumborum and

obliques (lateral flexion)

Runs from the posterior

pelvis and attaches to the

ASIS to the ribs and a

sheath over the transverse

abdominus and internal

oblique.

Rectus abdominus Flexion of the trunk as well as

isolated lumbar flexion and

isolated thoracic flexion, assists in

lateral flexion

Erector spinae, multifidus

(flexion), opposite sides

obliques and Quadratus

lumborum (lateral flexion and

lumbar flexion)

Runs from the lower ribs to the pubic symphysis and over the abdominal cavity.

Muscles affecting the movement of the pelvis

Rectus abdominus

External Obliques

Internal oblique

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Back extensors: Pulls the pelvis into an anterior and lateral tilt

Erector Spinae

Spinalis (Concentrically)

Attachments: spinous to spinous process (interspinalis); Transverse (T5/6 ) to

Spinous process (C2-C5)

Movements: spinal stability & segmental spinal extension; bilateral spinal

extension; spinal rotation toward opposite side; localized spinal lateral flexion

to that side (cervical area & intertransversarii)

Longissimus:(Concentrically)

Attachment: originate and insert at various points along the transverse

processes of the entire spine

Movement/s: bilateral spinal extension; lateral spinal flexion to same

side

Iliocostalis: (Concentrically)

Attachments: along the sacrum, lumbar spinous proceses,

sacrospinalis aponeurosis and illium to the ribs above and transverse

process of cervical vertebrae

Movements: extension in thoracic & lower cervical regions;

stabilizes, extends and laterally flexes thoracic spine to same side as

it assists by depressing the ribs.

Quadratus Lumborum

Attachments: Illiac crest, transverse processes of lumbar vertebrae, last rib

(12th rib)

Movements: Aids in depressing the ribs during breathing Holds the 12th rib

down as we inhale and as we exhale and the ribs come down, it will move into

a slightly shorter position; unilaterally flexes the spine to the same side;

elevates the hip unilaterally; extends the LUMBAR spine; pulls the pelvis into

an anterior tilt; rotation of the spine to the same side.

What would the QL’s antagonists be?

Spinal flexors, opposite QL, antagonistic rotators

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Multifidus

Multifidus: (Concentrically)

Attachments: the feathered muscle in lumbar, thoracic and

cervical regions. Spanning 2 – 4 vertebrae runs from sacrum and

transverse processes to the 2nd or 4th superior spinous process

above it and continues to C2

Movements: the main function is spinal stabilization; however, some

literature has mentioned that the multifidus would assist with spinal

extension and rotation toward the opposite direction

What would the Multifidus’s antagonists be?

Spinal flexors, antagonistic rotators when

it assists with rotation

Rotatores

Rotatores: (Concentrically)

Attachments: transverse process of vertebra and base of spinous

process of vertebra above, spanning 1 to 2 segments

Movements: spinal extension, rotation and lateral flexion on a

smaller scale. Due to their size, the rotators are less likely to work

intensely in these movements and will therefore be synergists to

the movements mentioned. They also assist in stabilizing the

pelvis but have a strong sensory component where they play a

role in proprioreception of the vertebrae as they move.

What would the Rotatores antagonists be?

Antagonistic rotators, spinal flexors and opposite lateral

spinal flexors

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Additional muscles that act on the spine (cervical)

Muscle Movement Antagonist Position

Scalenus anterior, medius and posterior

Lateral flexion and rotation of neck Scalenus on opposite side of the neck & SCM on same side

Cervical vertebrae to ribs

Longus Capitis Neck flexion Upper trapezius, multifidus, splenius capitis, splenius cervicis

Anteriorly of the transverse process to the occipital bone

Longus Colli Neck flexion Upper trapezius, multifidus, splenius capitis, splenius cervicus

3 different areas: transverse process to atlas, bodies of vertebra to transverse processes, bodies to bodies

Sternocleidomastoid Lateral flexion and rotation of neck Sternocleidomastoid on the opposite side of the neck & scalenes on same side

Skull to clavicle

Splenius capitis Extends the neck bilaterally, lateral neck flexion and rotation on the same side.

Deep neck flexors, same sides sternocleidomastoid

Spinous process of thoracic vertebrae to transverse process of first 3 cervical vertebrae

Splenius cervicis Extends the neck bilaterally, lateral neck flexion

Sternocleidomastoid, deep neck flexors, opposite side sternocleidomastoid, opposite sides scalenes.

Spinous process of T3 – 6 to transverse process of C1-3

Scalenes Longus capitis Longus colli

Sternocleidomastoid

Splenius capitis

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Serratus posterior inferior It assists in rotation and extension of the trunk as well as expiration

Serratus posterior superior, diaphragm

From the 9th to 12th rib slightly diagonally to the lower thoracic and beginning lumbar region

Serratus posterior superior Elevates second to fifth ribs and therefore is involved in inspiration

Abdominals (as they do expiration) & serratus posterior inferior

The lower cervical region, spanning horizontally and slight diagonally to the ribs

Serratus posterior inferior & serratus posterior superior

Notes

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Hip flexors: They will pull your pelvis into an anterior tilt

Psoas Minor and Major Iliacus Rectus Femoris


Psoas Hip Flexion (Research has show that it has ‘core’ properties)

Gluteus maximus, biceps femoris, semitendinosis, semimembranosus

Runs from the lumbar region of the back (bodies and bases of transverse processes), anterior to the hip joint and onto the lesser trochanter of the femur

Iliacus Hip Flexion Gluteus maximus, biceps femoris, semitendinosis, semimembranosus

Runs from anterior part of the iliac crest, joins the Psoas, anterior to the hip joint and attaches onto the lessor trochanter of the femur

Rectus femoris Knee extension and hip flexion biceps femoris, semitendinosis, semimembranosis (extension) gluteus maximus, semi-tendinosis, semimembranosis, sartorius

Runs from the Anterior Inferior Iliac spine into a tendon which runs over the kneecap and attaches onto the tibia.

Are you ready to see the rest of the hip flexors?

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Adductor Longus Adductor Magus Adductor Brevis Pectineus

uscle Movement Antagonist Position

Adductor longus Hip adduction and hip flexion Gluteus minimus & medius, gluteus maximus, TFL, sartorius (adduction) gluteus maximus, semimembranosis, semitendinosis (flexion)

From pubic symphysis to the mid femur medially

Adductor magnus Hip adduction, flexion and extension

Gluteus minimus & medius, gluteus maximus, TFL, sartorius (abduction) gluteus maximus, semimembranosis, semitendinosis (flexion) iliacus, psoas, pectinius, TFL, sartorius (extension)

From ischial tuberosity to insertions on the femur for the length of the femur

Adductor brevis Hip adduction and hip flexion Gluteus minimus & medius, gluteus maximus, TFL, sartorius (adduction) gluteus maximus, semimembranosis, semitendinosis (flexion)

From pubic symphysis to the upper femur medially

Pectinius Hip adduction and hip flexion Gluteus minimus, medius, gluteus maximus, TFL, sartorius (adduction), semi-membranosis, semitendinosis, biceps femoris, gluteus maximus (hip flexion)

Above the pubic symphysis to the upper femur medially

It is important to note that many muscles have more than one function

and therefore they might affect a joint in more than one way.

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Hip extensors: These will pull your pelvis into a posterior tilt


Gluteus Maximus Hip extension, lateral rotation, hip abduction

iliacus, psoas, pectinius, TFL, sartorius, adductor magnus (extension), gluteus minimus, gluteus medius, TFL (lateral rotation), adductor longus, magnus, brevis, pectineus, gracillis (abduction)

Runs from the Sacrum and medial part of iliac crest and attaches posteriorly to the femur (greater trochanter)

Gluteus medius Internal rotation, hip extension and abduction of the hip. Important hip stabilizer.

Piriformis, obturators, gemelli, gluteus maximus, quadratus femoris (medial rotation) adductor longus, magnus, brevis, pectineus, gracillis (abduction)

Runs from the Ilium to the greater trochanter of the femur above the gluteus maximus

Semimembranosis, semitendinosis

Knee flexion, medial rotation of the knee, hip extension

VMO, VLO, rectus femoris, itb (flexion), piriformis, gemelli, obturarors, gluteus maximus, biceps femoris (medial hip rotation) rectus femoris, iliacus, psoas, TFL, pectineus, sartorius (hip extension)

Medial hamstrings. Runs from the ischial tuberosity and attaches to the medial area of Tibia (laterally)

Biceps femoris Knee flexion, lateral rotation of the knee, hip extension

VMO, VLO, rectus femoris (flexion), gluteus medius, gluteus minimus, TFL, gracillis (lateral hip rotation) rectus femoris, iliacus, psoas, TFL, pectineus, sartorius (hip extension)

Lateral hamstring. Runs from the ischial tuberosity and attaches to laterally to the lower leg (fibula)

Gluteus Maximus Gluteus Medius

Gluteus Minimus

Semimembranosus Semitendanosus

Biceps Femoris

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Hip adductors: This will pull the pelvis into a lateral tilt

Adductor Longus Adductor Brevis Gracilis

Adductor Magus Pectineus


Adductor longus Hip adduction and hip flexion Gluteus minimus, medius, gluteus maximus, TFL, sartorius (adduction) gluteus maximus, semimembranosis, semitendinosis (flexion)

From pubic symphysis to the mid femur medially

Adductor magnus Hip adduction, flexion and extension

Gluteus minimus, medius, gluteus maximus, TFL, sartorius (abduction) gluteus maximus, semimembranosis, semitendinosis (flexion) iliacus, psoas, pectinius, TFL, sartorius (extension)

From ischial tuberosity, to 3 insertions on the femur for the length of the femur

Adductor brevis Hip adduction and hip flexion Gluteus minimus, medius, gluteus maximus, TFL, sartorius (adduction) gluteus maximus, semimembranosis, semitendinosis (flexion)

From pubic symphysis to the upper femur medially

Pectineus Hip adduction and hip flexion Gluteus minimus, medius, gluteus maximus, TFL, sartorius (adduction), semi-membranosis, semi-tendinosis, biceps femoris, gluteus maximus (hip flexion)

Above the pubic symphysis to the upper femur medially

Gracilis Hip adduction, medial rotation of the knee

Gluteus minimus, medius, gluteus maximus, TFL, sartorius (adduction). Popliteus, biceps femoris (medial knee rotation)

Runs from the pubic symphysis to the medial part of the femur onto the tibia.

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Hip abductors: These will pull the pelvis into a lateral tilt - Refer back to page 12 Piriformis Sartorius


Gluteus Maximus Hip extension, lateral rotation, hip abduction

iliacus, psoas, pectinius, TFL, sartorius, adductor magnus (extension), gluteus minimus, gluteus medius, TFL, gracillis (lateral rotation), adductor longus, magnus, brevis, pectinius, gracillis (abduction)

Runs from the Sacrum and medial part of iliac crest and attatches posteriorly to the femur (greater trochanter)

Gluteus medius Medial and lateral rotation of the hip, hip extension and flexions as well as abduction of the hip. Important hip stabilizer.

Piriformis, obturators, gemelli, gluteus maximus, quadratus femoris (medial rotation) adductor longus, magnus, brevis, pectinius, gracillis (abduction)

Runs from the Ilium to the greater trochanter of the femur above the gluteus maximus

Gluteus minimus Internal rotation and abduction of the hip. Important hip stabilizer.

Piriformis, obturators, gemelli, gluteus maximus, quadratus femoris (medial rotation) adductor longus, magnus, brevis, pectinius, gracillis (abduction)

Lies underneath Gluteus Maximus.Runs from the Ilium to the greater trochanter of the femur.

Piriformis External rotation of the hip, hip abduction

gluteus minimus, gluteus maximus, TFL, gracillis (lateral rotation), adductor longus, magnus, brevis, pectinius, gracillis (abduction)

Runs from the sacrum to the greater trochanter of the femur

Sartorius Knee flexion and lateral rotation of the hip (Ballet Attitude position), hip flexion, hip abduction

VMO, VLO, rectus femoris, itb (flexion), gluteus medius, gluteus minimus, TFL, gracillis (lateral rotation) semi-tendinosis, semi membranosis, gluteus maximus (flexion), adductor longus, magnus, brevis, pectinius, gracillis (abduction)

Runs from the ASIS and attatches medially to the knee onto the tibia

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Tensor Facia Latae Obturator Internis


Tensor facia latae Medial hip rotation, hip abduction, hip flexion

piriformis, gemelli, obturarors, gluteus maximus, biceps femoris (medial hip rotation) adductor longus, magnus, brevis, pectinius, gracillis (abduction) biceps femoris, semitendinosis, semi-membranosis, gluteus maximus (hip flexion)

Runs from the iliac crest to meet with the ITB that runs down the lateral side of the femur and there it attaches to fibula

Obturator internus and gemelli External rotation of extended hip and abduction of flexed hip

gluteus minimus, gluteus maximus, TFL, gracillis (lateral rotation), adductor longus, magnus, brevis, pectinius, gracillis (abduction)

Runs from the ischial tuberosity to the greater trochanter

Muscle Movement

Concentrically

Antagonists Moves Lumbar spine

into flexion/extension?

Abdominals Spinal flexion and rotation Back extensors, hip flexors Flexion

Hip Flexors Hip flexion Abdominals, hip extensors Extension

Gluteus Maximus Hip extension, abduction and

lateral rotation

Hip flexors, back extensors Flexion if you squeeze but

extension if you

hyperextend the hip

Hamstrings Hip extension, knee flexion

and slight knee rotation

Hip flexors, back extensors Flexion if you squeeze but

extension if you

hyperextend the hip

A quick overview

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References

C. (n.d.). CanStockPhoto. Retrieved November 12, 2017, from https://www.canstockphoto.com/

Clear anatomy images

V. (n.d.). Visible Body. Retrieved March 21, 2019, from https://www.visiblebody.com/anatomy-and-physiology-apps/muscle-anatomy Comprehensive Musculo-skeletal system application

C. (n.d.). Netter 3D anatomy. Retrieved March 21, 2015, from http://netter3danatomy.com/ Anatomy in 3D

Thompson, T. (2018). Pilates Unlimited - The Art of Movement Equipment Course(1st ed., Vol. 1, Updated 2018). .Pretoria, Non US: Pilates Unlimited.

This book covers hips, shoulders, knees and spines in relation to all 5 movement principles

Levangie, P. K. (2011). Joint structure and function(5th ed.). Philadelphia, US: F. A. Davis Company. Anatomy of the joints and their function

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