In the previous article, you heard about anatomy slings. This content captures three things. First the types of anatomy sling, second manual muscles testing (MMTs) and third exercise possessions of the Anterior oblique sling (AOS ) training. Let’s have a read on these three interesting topics.
What is Anterior oblique sling (AOS)?
External oblique and internal oblique constitute the anterior oblique system. By adductor-abdominal fascia, it connects with contralateral adductor muscles. When contraction happens in this muscle group, acting as an abdominal binder provides stability. And compress the entire pelvic girdle which results in force closure of the symphysis pubis. Relative movements of pelvis occur when it works interchangeably with the other Anterior Oblique Sling, and in harmony with other anatomy slings.
What happens when you walk?
- While you walk, the Anterior oblique sling plays a significant role in providing stability.
- The adductors utilize a balance of force of vectors to both stabilize the body on the top of the stance leg. Also to rotate the pelvis forward while working in harmony with the internal oblique and external oblique muscles. This happens to position the pelvis and hip optimally for the succeeding heel-strike.
While looking at the EMG recordings of the oblique abdominals during gait, Basmajian derived a conclusion. His findings made it clear that both sets of muscles, together, contribute to stability at the initiation of the stance phase of gait, as well as to rotating the pelvis and pulling the leg throughout the swing phase of gait. The findings of Basmajian also supported that AOS activation becomes more prominent as the speed of walking progress to running. Reciprocal action take place by the opposite AOS – lengthen whilst the on and shorten to allow the hip extension at back, with control.
In multi-directional supports such as tennis, basketball, hockey, soccer, rugby, and football, the demands on the anterior oblique sling are great. Well, in such a sporting environment, the AOS contribution must be seen in rotating and decelerating the body during directional changes rather than just contributing to accelerate the body. Due to the presence of both abdominal and groin strains or tears, immediate pain results in all activities while accelerating, decelerating, and changing directions. This also suggests a link within the anterior oblique sling and its function.
Training To Strengthen Body Parts:
Individuals can strengthen isolated parts of the AOS, much as they strengthen specific body parts. To do this, static resistance and isometric training such as planks and crunches can be used. While addressing a specific dysfunction within an anatomy sling that was identified earlier, it seems beneficial. Though in dynamic training, whole anatomy slings are used. It sounds more appropriate as allow us to cope with stresses and demands placed upon us throughout dynamic movements. Russian twists and hill sprints are an example of more dynamic exercise incorporating the AOS.
Physiotherapists can train and appreciate the AOS while making the patient run in the sand. This is because sand gives way during the stance initiation and following the contact phase of gait. Poor use of thoracolumbar fascia and posterior systems happens when the ground reaction force that aids dynamic movement is disrupted. Hence, the AOS activation increases to compensate for the lost kinetic potential and muscular energy of the posterior systems. In turn, the AOS is trained in a good manner in this way. Physiotherapists must consider that this increased work may result in an injury. Be more cautious if there is an underlying dysfunction within the AOS.
ANTERIOR OBLIQUE SLING ASSESSMENT
Being a physiotherapist, we approach muscle testing to assess muscle function in our clients. It is one of the prime tools to determine;
- contractile vs non-contractile tissues – tissue source,
- the extent of pathologies like myotome screening or muscle weakness.
New researches revealed that side to side differences can only be detected by MMT (Manual Muscle Testing) if strength is at minimum less than 75% of the other side, which means that:
** MMTs refers to a TEST OF WEAKNESS but not a TEST OF STRENGTH **
MMTs should be in the repertoire of every practicing clinician because muscles NEVER work in isolation, so isn’t it important to assess if a PATTERN sounds weak? Rather than going for a specific muscle?
MMTs are a must to do the diagnostic pattern. These are particularly useful with athletes who are more acquired to rotational strength and stability in sports. Try them on the athletes. The side to side differences will surprise you. In many of the sports like baseball pitchers one leg or arm sounds dormant. You may expect that one pattern and sling is “stronger” than the other. In sports bilateral patterns are obligatory. And movement coordination/strength should be alike tennis, hockey, soccer, you could anticipate that each side performs correspondingly wen tested.
ANTERIOR OBLIQUE SLING EXERCISE PROGRESSIONS
One of the best Anterior Oblique Sling training exercise progressions to perform is structured below.
- Start in a supine position.
- In between the legs, maintain an isometric squeeze of a ball.
- The motion and power originate from the bottom up. It is the most of the curl up.
- Think of first activating the adductor, then the internal oblique, and at last the external oblique.
Remember: You curl up from your legs, NOT to curl down from your torso.
- Make progression to tall-kneeling.
- Follow the same rules as of Progression I. Order of movement should be noticed and avoid wrong moves. First the pelvis, then the torso, and then arms. After it, bottom-up again.
- Progress to half-kneeling.
- To provide some resistance into hip adduction, use a theraband.
- At the final stage, now assume a split stance.
- Follow the same rules as applied above. Bottom up and use a theraband for providing resistance.
- These exercises should target your core in a much different manner than traditional core training.
- Be attentive to the order of recruitment.
Remember – You need to bottom up, not to top down!
Slings or chains or loops are a functional component of the musculoskeletal system. Like if we look upon our torso as a core cylinder, we will find multiple slings wrapping around the cylinder in multiple orientations. The cylinder shows a dependency on strength and balance from the anatomy slings to provide foundational stability. Don’t miss out trying MMTs on your athletes and asking them to perform progression exercises.