Slings (also referred to as chains and/or loops) are a functional component of the musculoskeletal system. If we think of our torso as a core cylinder, there are multiple slings that wrap around the cylinder in different orientations. The cylinder depends on strength and balance from the slings to provide a stable foundation. This article will cover a brief overview of the sling systems, as well as cover the anterior and posterior oblique sling exercise progressions and assessment!

 

Muscle Anatomy of the Core Cylinder Slings

 

So why are slings important The body’s core cylinder depends on the slings to facilitate dynamic movement and stability across multiple joints throughout the body Slings help to transfer force through the trunk and facilitate rotational movements. It is the muscular and myofascial components of slings that make powerful baseball/cricket pitches, baseball/golf swings, and lacrosse/hockey shots possible. This information is based on a functional school of thought viewing the musculoskeletal system. This post does not include every myofascial line/meridian described elsewhere. We did not go into depth describing the respected myofascial components of slings

 

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Learning core exercises as well as movements that address the slings throughout the body, all of which will take your core performance to the next level! Click here to learn more about our Core [P]rehab Performance Program

 

A Quick Tutorial On How To Perform Oblique Sling Exercises

 

Anterior and Posterior Oblique Sling Assessment

As physios, assessing muscle function in our clients is one of our biggest tools for determining tissue sources like contractile vs non-contractile tissues, the extent of the pathology like myotome screening, or muscle weakness. Newer research has shed light that side-to-side differences can only be detected by manual muscle testing if strength is at a minimum less than 75% of the other side, meaning that:

‼ MMTs are a TEST OF WEAKNESS rather than a TEST OF STRENGTH‼

Even so, MMTs still hold significant value in the scenarios listed above and should be in the repertoire of every practicing clinician. Because muscles NEVER work in isolation, wouldn’t it be important to assess if a PATTERN is weak? Rather than a specific muscle?

We sure think so, and that’s why we’ve fallen in love with the anterior and posterior oblique sling MMT shown in the video. It’s particularly useful with athletes who most need the rotational strength and stability required in sports. Try it on your athletes and you’ll be surprised at the HUGE side-to-side differences you may find. In many sports where one arm or leg is dominant like baseball pitchers, it may be expected that one pattern and sling is “stronger” than the other. However, in other sports, while bilateral patterns are necessary and movement coordination/strength should be similar to tennis, hockey, and soccer, you would expect that each side performs similarly when tested. Try it out with your athletes and let us know what you find!

LISTEN: HOW TO IMPROVE LOWER BACK PAIN

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Posterior Oblique Sling Exercise Progressions

Shown in this video clip is a 4 step progression for the POSTERIOR OBLIQUE SLING. The posterior oblique sling consists of the latissimus dorsi muscle, the opposite side gluteus maximus muscle, and the interconnecting thoracolumbar fascia. This sling crosses at the level of the lumbosacral junction and provides what is known as force closure to the sacroiliac (SI) joint. Force closure provides stability to the SI region by allowing it to distribute the load between the lower extremities, spine, and upper extremities. This force closure allows for coordinated movement for activities such as walking, climbing stairs, and just about every single sport-specific movement.

Take throwing for instance: energy is generated in one body region (the legs), transferred through the hips/pelvis, and released through the upper extremity (hand) to deliver a pitch that can be released at over 100 mph. That’s a lot of power that needs to be generated and transferred effortlessly from one body region to another. That power transfer is where myofascial slings come in.

To Perform:

Progression I: Begin in the quadruped position. Perform hip extension using the glute on one side and shoulder extension on the other side using the lat.

Progression II: Progress into a half kneeling position. Focus on driving your front heel into the ground to maintain stability.

Progression III: Next, work into a lunge position. You can hold the lunge position or work through the range of motion. Make sure to keep your weight forward.

Progression IV: Last but not least, incorporate a step up. Really focus on the end position here. Fully squeeze the glutes at the top and come to terminal hip extension while the shoulder is fully extended.

READ: DEADLIFTING WITH LOW BACK PAIN

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Anterior Oblique Sling Exercise Progressions

The anterior oblique sling consists of the external and internal obliques, the opposite side adductor muscle, and the connecting adductor abdominal fascia. The anterior oblique sling plays a huge role in accelerating and decelerating the body during sport-specific movements including changes of direction. While most exercises like planks or crunches can strengthen isolated sections of the anterior oblique sling, it is most beneficial to progress into dynamic training utilizing myofascial slings.

Shown in this video is one of my favorite progressions of anterior oblique sling training! To perform:

Progression I: Begin in supine. Maintain an isometric squeeze of a ball in between your legs. The most important part of the curl up is that the motion and power come from the bottom up. Think of activating the adductor first, then the internal oblique, then the external oblique. Remember: you are curling up from your legs, NOT curling down from your torso.

Progression II: Progress to tall-kneeling. The same rules apply as above. Notice the order of movement. Pelvis, torso, arms. Bottom up again.

Progression III: Move to half-kneeling. Use a theraband to provide some resistance into hip adduction.

Progression IV: Finally, assume a split stance. The same rules apply. Bottom up. Use a theraband for resistance. These exercises should hit your core much differently than traditional core training. Pay attention to your order of recruitment. Remember – bottom up, not top down!

 

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Closing Thoughts

There are many ways to fine-tune your programming to incorporate sling-based exercises. This will help optimize your core and low back stability while enhancing functional movement capacity!

 

Take Your Core Performance To The Next Level

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The outcome of a great core program is NOT a 6-pack but it if does happen we are sure you wouldn’t be upset! The core should be thought of as both a dynamic suitcase and an energy transfer center. The goal is to build a rock-solid suitcase for each aspect of the core and to improve its ability to transfer energy to and from the legs and arms.

 

About The Author

Michael Lau, PT, DPT, CSCS

[P]rehab Co-Founder & Chief Product Officer

michael lau the prehab guysMichael was born and raised in Northern California but now currently resides in Sunny SoCal ever since attending the University of California, Los Angeles as an undergraduate majoring in physiology. After his undergraduate studies, he received his Doctorate in Physical Therapy from cross-town rival the University of Southern California. As a licensed physical therapist with a strong background in strength and conditioning, Michael likes to blend the realms of strength training and rehabilitation to provide prehab, or preventative rehabilitation, to his patients. A common human behavior is to address problems after they become an issue and far often too late, which is a reactionary approach. He believes the key to improved health care is education and awareness. This proactive approach-prehab-can reduce the risk of injuries and pain in the first place. He is a huge proponent of movement education and pain science. Clinically, he has a special interest in ACLR rehab and return to sport for the lower extremity athlete.

 

 

 

 

 

DISCLAIMER – THE CONTENT HERE IS DESIGNED FOR INFORMATION & EDUCATION PURPOSES ONLY AND IS NOT INTENDED FOR MEDICAL ADVICE.

About the author : Michael Lau PT, DPT, CSCS

28 Comments

  1. Brittany April 11, 2018 at 7:37 pm

    I’ve learned about this concept in the clinic, but are there specific sources or research articles you found this information in? Would love to be able to cite this as evidence for a class

    • Michael Lau April 28, 2018 at 3:30 pm

      “research” is very scare for slings as its more of a theoretical approach. Sorry we can’t direct you anywhere!

      • Monty July 11, 2018 at 7:59 am

        Look at Vladamir Janda’s work on upper and lower crossed syndromes.

    • Tamara Bonarrigo April 21, 2019 at 11:53 am

      Look for the work of Andry Vleeming

  2. Monty July 11, 2018 at 8:02 am

    Look at Vladamir Janda’s upper and lower crossed syndromes.

  3. couples bracelets August 8, 2018 at 1:56 am

    Can you tell us more about this? I’d want to find out some additional information.

  4. alu foldeknive August 22, 2018 at 8:48 am

    What a informati᧐n of ᥙn-ambiguity annd preserνeneѕs of
    valuable experience about unexpectеd emotions.

  5. Ruth Boyle December 12, 2018 at 11:51 pm

    It has been explained very simply.very easy to carry out these exercises.Thank you for updating my knowledge.

  6. Anis January 26, 2019 at 2:14 am

    Hi friends! just wanna make sure here. am I extending the overactive lat and overactive hamstring? thanks!

  7. Chappy wood February 2, 2019 at 7:45 pm

    Quick question: So when I find a sling issue, do I prescribe unilateral exercises? After I muscle activate of course. Is there a rx like 1×10 of each progression or 3×10 of 1st then progress next session?

    • Michael Lau February 6, 2019 at 8:46 am

      It really all depends on what your goal is when it comes to sets and reps. I’m a big fan of high reps when learning a movement like 15+

  8. CHRISTIAN ARIAS February 19, 2019 at 10:02 am

    Just wondering if you could provide your references please

  9. Gene March 22, 2019 at 1:24 pm

    Great article. If people are looking for more reading material on slings/meridian lines, read Anatomy Trains.

  10. Yaasar March 26, 2019 at 11:39 pm

    Please look at Anatomy Trains by Thomas Myers for muscle slings or chains.

  11. Yaasar March 26, 2019 at 11:41 pm

    Also look at research papers by Snijders and Vleeming for pelvic girdle muscle slings. If my memory serves me right, they were the first or one of the first to talk about this.

  12. Mark April 28, 2019 at 7:01 am

    Is the progression supposed to be completed over weeks, as strength builds at each phase, or is the entire progression set 1-4 completed every time?

    • Michael Lau May 12, 2019 at 8:56 am

      Up to you/your client! Everyone will be different. The point of the article is to just draw attention to the different progressions and to give ideas, they could be done all at once and build up, or weeks at a time. No right/wrong answer here

  13. Alyson Friedlander August 9, 2019 at 4:18 am

    Great information! How would you work these into a program for the general population? Most of my clients are middle aged and don’t have specific goals other than staying healthy and strong – would it make sense to use these progressions and how would I explain why I am putting them into their back without? Sorry, lots is questions… I’m an over thinker 🙃.( Ps – I have a hard time creating a program that has progressions and direction.)

    • Michael Lau August 14, 2019 at 7:38 am

      Ultimately your exercise prescription needs to directly relate to your patient’s goals. So as long as you relate them to your patient’s goals, you are golden!

  14. Monkey Boots September 21, 2019 at 8:27 am

    I’ve just recently fallen in love with the functional impact that working with the sling systems can have. Thanks for a really great, straightforward article and including exercise progressions. Very exited about this!

  15. Jay Welk November 18, 2019 at 6:21 am

    Hi, Great information!

    How do you go about assessing the 1) Lateral sling and 2) Deep Longitudinal Sling?

    Can you make a article with video of you showing/describing how you assess these other slings?

  16. Omalone1 May 19, 2020 at 10:46 am

    Gwiz has anyone healed themselves doing this?

  17. Alfred Eric Jones III February 7, 2022 at 5:56 am

    Like you, Jay, I’d like to hear about the lateral sling, and the deep longitudinal sling.
    How about it Prehabguys! Please. :)

    • Team [P]rehab February 9, 2022 at 3:01 am

      Hi Alfred!

      We are working on putting together some content related to these questions we have been receiving! Thank you so much for your request, as well as taking the time to interact with our content!!

      All The Best,

      Team [P]rehab

  18. Erin Leek February 8, 2022 at 2:20 pm

    Here’s some clinical research that may help….https://journals.humankinetics.com/view/journals/jsr/30/3/article-p384.xml

    • Sherif Elnaggar February 9, 2022 at 2:52 am

      Thank you Erin!!

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