Anatomy slings – a term encompassing vast anatomical and physiological backgrounds. Anterior oblique sling, posterior oblique sling, and lateral oblique slings are different anatomy slings providing lumbopelvic stability during dynamic movements. Do you have heard of lateral sling (LS) system before? If yes then this article will add more to your knowledge bank, and if not, then read almost everything about LS system here.
What do Lateral Sling (LS) constitute?
The lateral sling has the following components;
- Gluteus Medius
- Gluteus Minimus
- Tensor Fascia Lata (TFL)
- Iliotibial Band (ITB)
Anatomy of the Lateral Sling
Origin: It origin points are at gluteus medius and gluteus minimus on the ilium external surfaces.
Insertion: The LS insertion points are at the iliotibial band on the upper tibia. This provides the LS broad coverage of the hip and knee joint lateral aspects.
Drake et al
Drake et al stated that deep fascia in the lower limb forms a thick ‘stocking-like’ membrane covering the limb. Fascia Lata – thick fascia in the thigh and gluteal region. Thick on the lateral aspect of the thigh and forms iliotibial band (ITB) – an integral part of the sling. Gluteus medius and minimus muscle fibers blend with the connecting fascia to the TLF. Tensor fascia lata inserts into the superior aspects of the iliotibial band. LS act as a unit to provide stability while working together with the favor of its interconnecting nature.
What is the role of the Lateral Sling ?
- Used in coronal plane stability
- Involved in pelvo-femoral stability in dynamic movements like stair climbing, lunges, and gait
Before jumping onto the relevance of the sling, first, have a look at the action muscles.
Gluteus Medius and Minimus: Hip Abductors and Medial Rotators
Tensor Fascia Lata – work in synergy with the gluteus medius and minimus to hold the pelvis level in single-leg movement. TFL also works with the gluteus maximus on the iliotibial band to stabilize the hip joint by holding the femur head in the acetabulum.
In all the three planes: coronal, sagittal, and transverse; the pelvic girdle should act neutral functionally. During single leg stance movements, like walking, the LS system comes under pressure to keep the pelvis stable over the stance leg. It prevents pelvic droop on the opposite side of the pelvis. You can noticed Trendelenburg sign or hip droop during the stance phase of gait and single leg stance when lateral sling control fails. Trendelenburg sign can be compensated by doing side flexion of the trunk to the affected side to maintain the level of the pelvis.
It is vital to maintain a neutral pelvis in the correct alignment of the lower extremities during movement, ensuring your hip lines up with your knee and knee lines up with your toes. The best functional positions of joints are attained by this alignment. It also allows the muscles to work in their optimal range. It ensures that forces through the region are distributed appropriately and not putting excessive strain on the structures. Single leg squat is an example of a strengthening exercise for the LS.
Lateral Slings provide lateral stability, don’t confuse with lateral motion
The LS system creates stability in the pelvis when one leg is weight-bearing and allows the other leg to swing through in gait or step up by lifting the leg. While we walk, 80% of the time is spent on one leg, so you can conclude that all the LS muscles should be synced and engaged as needed. As told earlier, in case of dysfunction, Trendelenburg gait will happen and can cause hip pain, poor knee tracking, and issues with an ankle sprain. It can also lead to increased ACL incidences in females.
To know about Anterior oblique sling click here.
Release and strengthen the correct structures in the relationship
It is not always that gluteus medius and minimus is the weak line while Quadratus Lamborum is the overworked structure. It also happens that QL is the weak line and gluteus medius and minimus are overworking. So, it is best to assess ensuring which structure needs to be released and strengthen. Long term improvements in the system can’t be achieved by just correcting only the site of pain. Physiotherapists must know that pain is only a symptom, and asks you to dig deeper and fit the root cause.
We assess and correct this sling system in the clinic regularly if you think you may have an issue with this system get in touch today.
In the case of the Trendelenburg or Stork test, we look for pelvic tilt or shifts. When the LS system is working effectively, the gluteus medius works in harmony with the other muscles in the sling to pre-tension the fascia, and maintain the pelvis in neutral and begin motion. Test shows a Trendelenburg sign is taking place and the fiscal sling is weak, left to its device. The body will modify and move differently to carry out its daily functions and meet its needs.
Enhance your lateral sling system
You can try split stance medicine ball chest passes, kettlebell off-set rack loaded step-ups, and sandbag rotational lunges.
We don’t throw any program into the client’s list until we understand his body. After it, we ultimately make up more specific programs for the clients as they progress from the foundational movement patterns. We believe that when you try to train the body for weight but not for life, there most programs go wrong.