Anatomy of the lumbar dorsal fascia: The lumbar dorsal fascia and tendon membrane start from the chest and end at the sacrum in the sacral region; the superficial layer starts from the lumbar vertebral spinous process and supraspinous ligament, the middle sacral crest, the posterior superior iliac spine, and the medial edge of the sacroiliac joint. The lumbar dorsal tendon and tendon membrane has a tough structure with three layers: anterior, middle and posterior. The posterior layer of the lumbar dorsal tendon and tendon membrane covers the back, and the posterior layer can be further divided into two layers: the superficial layer is the tendon membrane of the latissimus dorsi muscle, and its fibers reach the spinous process inwardly and downwardly from the lateral suture of the latissimus dorsi muscle; and the deep and superficial layers are fused with the fibers of the deep and superficial layers and the superficial layer in the opposite direction. Together, these two layers form a strong triangular structure. It is attached medially to the spinous process and supraspinatus ligament, intertwined with the fascia of the pincer muscles above, attached to the sacrum and intertwined with the fascia of the gluteal muscles below (i.e., the superficial lumbar dorsal tendon is continuous with the superficial gluteal tendon), and attached externally to the ribs and the middle of the iliac crest of the ilium; the middle layer of the lumbar dorsal tendon and tendon membrane consists of strong transverse fibers attached medially to the lumbar vertebral transverse process, and externally to the 12th rib and the transversus abdominis muscle, which in the central part of the outer side becomes the starting point of the internal abdominal oblique muscle. The anterior lobe of the lumbar dorsal fascia is the deepest, covering the lumbar square muscles and attaching to the erector spinae, internal obliques, inferior posterior serratus, sacrospinous ligament, posterior sacroiliac joint ligaments, iliac crests and anterior transverse processes of the lumbar spinal vertebrae, iliac crests, and iliolumbar ligaments. The lumbar dorsal fascia thickened near the transverse processes of the lumbar vertebrae to form a joint; in the L4 and 5S1 segments, its transverse fibers were closely connected to the midline structures. Lumbar fascial space: the anterior wall of the lumbar osteofascial interval is the deep lumbar dorsal fascia, transverse process and intertransverse process ligament, vertebral plate and ligamentum flavum, and intervertebral joints. The deep lumbar dorsal fascia was attached upward to the 12th rib, downward to the iliac crest, and medially to the transverse processes of the lumbar vertebrae, which were membranous or tendinous, and the posterior wall was the superficial lumbar dorsal fascia. The superficial fascia was weak in the upper part, reinforced by the tendinous membrane of the inferior posterior serratus muscle origin, thickened in the lower part by the tendon of the latissimus dorsi muscle origin, tendinous in nature, healed in the posterior midline with the supraspinous ligament, and continued in the outer edge of the sacrospinous muscle with the deep lumbar dorsal fascia; the medial wall consisted of the spinous process, interspinous, and suprascinous ligaments. The lateral wall is the superficial and deep layers of the lumbar dorsal fascia at the outer edge of the sacrospinal muscle, where the internal and external oblique muscles and the transversus abdominis muscle begin. The anterior, medial, and lateral walls of the sacral osteofascial septum were the back of the sacrum, the median sacral crest and the posterior part of the iliac crest, and the sacroiliac ligament, while the posterior wall was the superficial lumbar dorsal fascia and the tendon of the sacrospinous muscle. The same side of the lumbosacral fascial interval for the same fascial chamber, the left and right sides do not communicate with each other, the sacral and lumbar compared to the four walls of the fascial interval is more tough, lack of elasticity, there is no cushioning margin. There are sacrospinal muscle, transverse spinous muscle group, posterior medial and lateral branches of lumbar nerve and accompanying blood vessels in the interosseous fascial interval. The lumbar dorsal fascia in the sacral part and the sacrospinous tendon phase healing, in the lumbar part and the sacrospinous muscle health between a small amount of loose connective tissue and fat, the formation of lumbar dorsal fascia subgap. The lumbar dorsal fascia has the function of wrapping and fixing the sacrospinous muscle, increasing the stabilizing effect of this muscle on the spine, and effectively preventing the sacrospinous muscle from slipping and ejecting, similar to the tendon sheath of the tendon of the finger flexor. The loose connective tissue and fat have the effect of cushioning and reducing the friction between the lumbar dorsal fascia and the sacrospinous muscle, similar to the lubricating effect of synovial fluid. Latissimus dorsi muscle: in the lumbar back and thoracic posterior lateral subcutaneous, for the body’s largest broad muscle, right-angled triangle, the upper medial part of the obliques covered by the tendon membrane from the lower 6 thoracic vertebral spinous processes, all the lumbar vertebral spinous processes, the sacral crest of the posterior labrum. 3 ~ 4 muscle teeth from the lower 3 ~ 4 ribs outside, and sometimes there is a small portion of the muscle fibers from the back of the lower angle of the scapula. The muscle fibers were obliquely superior to the outside, gradually concentrated, and circled around to the front of the vastus lateralis muscle through the posterior wall of the axilla and the medial side of the humerus, and moved to the flat tendon on the lateral side of the vastus lateralis tendon, and ended at the crus of the humerus lesser tuberosity. The superficial gluteal fascia is well developed with a thick layer of adipose tissue, and its posterior lower part is thick and dense, forming a fat pad, which can withstand pressure when sitting. Gluteal Fascia: The gluteal fascia is the deep fascia located in the gluteal region, the upper part of the gluteal fascia is connected with the iliac crest, and the lower part of the gluteal fascia is connected with the broad fascia. In the lateral gluteal region, the gluteal fascia moves to the broad fascia and participates downward to form the iliotibial bundle. The deep fascia of the gluteal region is called the gluteal fascia, which attaches to the iliac crest superiorly, to the back of the sacrum and coccyx inferiorly, to the iliotibial bundle inferiorly outwardly, and to the deep fascia of the posterior femur downwardly. The gluteal fascia is thin and dense, and the fibrous septum extends into the muscle bundles and is not easily separated. The thickness of the various parts of the fascia varies, covering the gluteus medius muscle part of the thick and tough, and part of the muscle fibers in the deep surface of the fascia, encircling the gluteus maximus muscle part of the thin and dense, and sends out the fiber septum into the muscle bundles between the muscle layer is difficult to separate. The gluteal skin is innervated by the superior, middle and inferior cutaneous gluteal nerves, and injury to the gluteal fascia is one of the causes of low back pain. Gluteus maximus: (innervated by the L4-S2 inferior gluteal nerve and sciatic nerve). : Located subcutaneously, it is large and hypertrophied, forming the characteristic gluteal bulge, and is an irregular quadrilateral broad muscle. It originates from the posterior superior iliac spine to the tip of the coccyx, outside the iliac wing behind the posterior gluteal line, the lower part of the sacrum and the back of the coccyx, the thoracolumbar fascia, the sacrococcygeal ligament, and the bundles of the muscle are obliquely downward and outward, and end at the gluteal ramus and iliotibial fascia of the femur. It stops at: 1. The upper part of the femur mostly migrates to the deep surface of the iliotibial bundle; 2. A small part of the gluteus maximus of the femur is innervated by the inferior gluteal nerve and the sciatic nerve. Between the gluteus maximus and the sciatic tuberosity there is the sciatic bursa of the gluteus maximus, and between the tendon membrane of the gluteus maximus and the greater trochanter of the femur there is the rotator capsule of the gluteus maximus. Function: posterior extension and external rotation of the thigh; when the lower limb is fixed, it can straighten the trunk and prevent the trunk from leaning forward to maintain a standing posture. According to the above anatomical relationship is not difficult to see, the gluteus maximus and lumbar dorsal fascia, latissimus dorsi muscle, sacrospinal muscle has a close anatomical connection between the relationship between the lumbar spine and the hip and leg in a variety of functional movements, between them to bear the relationship between the transfer of stress, so when the lumbosacral soft tissues in the production of soft tissue damage, not only the lumbar dorsal fascia and the sacrospinal muscle, sacroiliac joints, the region of the local area, must be involved in the continuation of the close relationship between the gluteus maximus attachment place at the same time. The attachment of the gluteus maximus muscle is damaged at the same time. If the soft tissue damage in the lumbosacral region is addressed without treating the gluteus maximus attachment, the degree of pain relief from soft tissue damage in the lumbosacral region, gluteal region, and lower extremities will be greatly affected. To summarize: the gluteal fascia and gluteus maximus attachments are equally important as primary soft tissue damage to the lumbosacral region.