KEYPOINTS

• With 23 muscles that attach to it, the femur is an engineering marvel that forms the hip joint at its proximal end.

• Because of how much we sit, hip extension occurs less often than flexion and internal and external rotation, which can eventually cause hip problems.

As Alive as Your Heart 

“‘Bones are as alive as your heart,’ we are asked to consider. And what blood would there be spinning through the 60,000 miles of vessels of our whole hearts if not that which is brought to life from deep within our bones? This is not a book about the skeleton. ‘Skeletos’ means ‘dried.’ The dry bones are quite removed from the experience of bones and bodies. A skeleton, over there, is a rattling thing, an abstraction apart from us. If that is the mirror we look into to enter into relationship with our bones, that relationship will be deeply short-changed. Lauterstein and Rockwell invite us into relationship not with something dead and over there. The relationship to which they call us is with our own life within us, pulsing, watery, green, resilient, musical, and true.”

—Gil Hedley, from the forward to The Memory Palace of Bones: Exploring Embodiment through the Skeletal System

Going Deep

The femur is one of the many bones we look at in our newest book, The Memory Palace of Bones: Exploring Embodiment through the Skeletal System. There is no doubt the femur is an engineering marvel in the human body, but we would argue that this bone is even more than that. As we take a closer look at the femur, each of us authors will explore the bone from their unique professional perspective.

From Jeff Rockwell: The Alpha and Omega of the Femur

As we begin to talk about the femur, one of the most beautiful and sensuous bones in the body, let’s revisit an old riddle—the riddle of the sphinx.

During his journeys, Oedipus passed through Thebes, where the Great Sphinx sat and asked a riddle of everyone who tried to enter the city. If you could answer the riddle, the Sphinx let you in, but if you could not, then the Sphinx ate you. Nobody had ever solved this riddle: What travels on four feet in the morning, two feet at noon, and three feet in the evening? The answer is a person: as a baby in the morning of our life, we crawl on four “feet”—our hands and knees; as an adult in the noon of our life, we walk on two feet; but when we are old, in the evening of our life, we walk with a cane, or three feet. When Oedipus answered the riddle correctly, the Sphinx was so upset that she fainted, and Oedipus went safely into Thebes.

This answer to the riddle of the Sphinx leaves unexamined why we assume that in our later years we will be so decrepit that we need to rely on a cane to get around. The notion that we are doomed to age this way has become a self-fulfilling prophecy. Because many folks stop exercising or exploring movement, or even going for regular walks as they grow older, they lose what they don’t use—the myth of aging is thus fulfilled.

Many of my older patients—some only in their 40s or 50s— were told by their physicians to stop doing yard work because of their age. My favorite excuse: “You’re not as young as you used to be.” Heck, I wasn’t as young as I used to be when I was 2 years old! Prescribing less movement or physical activity is sentencing a person to degeneration.

The “third leg” mentioned in the answer to the riddle is reminiscent of a femur: a long stick or cane with a knob on top, a long shaft to reach the ground, and a flared base for stability. In fact, our femurs are canes on which we are meant to walk, run, explore, and dance. This strengthens them and increases our odds of remaining mobile throughout life and outwitting the myth of aging.

The femur is beautiful and, like anything profound, “contains multitudes.” It is an entire human in miniature. Head, neck, two prominences or trochanters as arms; its long, sinuous shaft winding its way through the forest of the body; two condyles as feet (Image 1).

The head of the femur looks like a ball and articulates with the socket of the pelvis, called the acetabulum. From within this joint exits the round ligament; this is not normal for a joint, but being such a highly mobile articulation, it uses this extra piece of anatomy to lend it extra stability. This ligament travels with its blood supply in a very confined area. Coupled with the fact that we sit so much, this makes it even more important that we move.

A principle of bodywork is that what we imagine is what we touch. Like some version of the Doctrine of Signatures (which dates from the time of Galen, an early Greek physician, and states that herbs resembling various parts of the body can be used by herbalists to treat ailments of those body parts), when I contact a thigh, I am in contact with the entire person. While that could be said of any bone, muscle, or organ, I am reminded of this most strongly when connecting with the femur. When I want to reach someone as deeply as possible, I seek to touch bone—not with brute force, but with the clinical skill called imagination. If I envision bone, then my client feels my work at that deep bone level. When I want to communicate safety or well-being to the whole person, I connect with the femur with that in mind, and often the client feels met.

From an engineering perspective, the femur is a marvel. Twenty-three muscles attach to it, including such muscular superstars as the psoas, all three of the gluteal muscles, the pesky piriformis, four adductors, three quadriceps, one of the hamstrings, and the gastrocnemius. It forms the hip joint at its proximal end—the joint that Ida Rolf said determines symmetry in the body. Another riddle has served as a kind of koan for osteopaths for decades. I call it “The Riddle of the Thighbone.”

Dr. A. T. Still, the founder of osteopathy, would hold up a femur and ask his students what he held in his hands. The obvious answer was a thighbone, but Still wanted his students to dig deeper (in fact, Still often said that the initials “D. O.,” which ordinarily are short for Doctor of Osteopathy, metaphorically stand for “Dig On,” meaning to pursue continual learning).

The answer he was looking for was “the Alpha and Omega.” Yes, he was holding a femur, a simple thighbone, which also contained the whole body, the whole person, the universe disguised as a humble bone. He wrote, “To answer all the questions that are suggested by a human thighbone would open and close an eternity.” 

What makes the positive changes we routinely observe in massage therapy, osteopathy, chiropractic, Rolfing, and other forms of body-mind work? To me, it is awareness—not pressure, force, or any other mechanical measures. When I work with or around the femur, I may be addressing hip or low-back pain. Perhaps I am intending to relieve some form of pelvic dysfunction. But I also open my awareness to include other deeper things that this bone may represent: territorial stability, familial attachments, losing and regaining one’s bearings. But first and foremost, I hold in my awareness the whole person, the fullness of the miracle of human embodiment. 

From David Lauterstein: Looking for Answers

A famous photo of Still looking at a femur (Image 2) has the quality of the femur regarding him as much as he is regarding it—not like a ventriloquist’s dummy on his knee, or like a baby perched there; they are engaged in nonverbal conversation. Perhaps the femur and Still, like all of us, are looking for answers:

Femur: “Tell me about your life, Doctor.”

Still: “What mysteries and truths do you hold for me?”

What messages about life and death might we receive? The longest bone in the body might have the largest stories passing through it, more a novel than a poem. And in its marrow is conveyed the deepest vitality through the red blood cells made and pouring continuously from it during life. When it is done, its form yet remains. 

The dances, the walks, the leaps that the hip joint takes over the course of life have given us both the stability and the freedom we have needed. Indeed, one might imagine Still lifting the femur overhead in a gesture of triumph: the triumph of the femur, celebrating the role it played in every moment of a life.

As we move down through the shaft to the knee, the more the relationship of the pelvis to the hip flows into the whole body’s relationship to the ground. And it is this living conversation between pelvis, thigh, leg, foot, and earth that is an archetypal alliance, giving common ground to all animals on this planet.

The grace from socket and ball, to neck, to trochanters, to the long and graceful shaft, to its swelling into the epicondyles that constitute the tops of the knees has given us the strength to live—not it alone, but without it we can’t make it through with the same sense of support and movement.

As noted, Oedipus’s answer to the Sphinx’s famous riddle was “Man: as an infant, he crawls on all fours; as an adult he walks on two legs; and in old age, he uses a walking stick.” 

May we not be struck down when we say the Sphinx and Oedipus were wrong! For most older people, the walking stick, thanks to the femur, is not necessary. 

This rather slender passageway, this graceful stem of life, adorned by the strong muscles of the thigh, the loins of the warrior, the thighs that involve us in acts of love and the issuing of new life—these forms speak to us in the language of life. It is an unending story told not in words but in authentic, articulate connection through time as if between one life and another. These joints connect us and let movement happen, from one person to another, from birth to death, from one time to another time, stretching out until our last long walks take us as far as we can go.

Embodiment—Hip and Leg

As mentioned earlier, joints that do not naturally have much movement tend to lose that movement before other, more freely moving joints do. For example, the pubic symphysis almost always loses its motion before the sacroiliac joints, and the sacroiliac joints tend to lose their motion before the lumbosacral joint does. This results in widespread shortening of muscles and fascia that cross these joints, as the brain and nervous system valiantly attempt to correct these restrictions.

The hip joint—the confluence of the acetabulum and head of the femur—is clearly a freely moving joint. However, because of how much we sit, hip extension occurs less often than flexion and internal and external rotation. This can eventually cause hip problems. Let’s look at movements that can deter that.

Lie prone on a yoga mat or soft carpet. Keeping your knee locked, gently lift one leg. Notice how that feels. How easily and how far can you extend that hip? Repeat on the other side. What follows is a combination of a proprioceptive and interoceptive exercise. Turn onto your back to lie faceup. You will press one leg, with the knee locked again, into the floor. And because the brain thrives on and improves with novel, safe input, we’ll take it slowly.

First, notice what your hip joint feels like. Extend your awareness to the shaft of the femur. You may want to move the thigh slightly or touch the bones with one hand. For 3 seconds, press your lower extremity into the floor without straining. Take another 3 seconds to release the contraction. Place your mind into the hip joint and notice what sensations present themselves to your awareness. Repeat this; then repeat these steps with the other leg.

Turn over into the prone position and extend the legs again. What do you notice now?

Beyond the Bone

The femur, like each bone in our body, bears a message, a unique form of wisdom. Bones embody lessons from eons—how to support us in the gravitational field, how to channel energy and force through us. Each bone can tell us so much about its role in our lives and in the countless lives through which it has evolved. Each bone speaks to us. And it is in many ways as important that we listen to our living bones as much as to the voice in our heads. Try as much as possible to let these bones speak.