The Anterior Oblique Sling: Pregnancy & the Postpartum

By: Gina Conley, B.S. Exercise Science, Head Coach of MamasteFit

The Anterior Oblique Sling runs diagonal across the front side of the body, connecting the oblique and opposite adductor. This sling system stabilizes the pubic symphysis (front pelvic joint on the pubic arch), and aids with rotational movements (think swinging a baseball bat or throwing a ball).

How is this affected by pregnancy??

As the belly grows, this sling system is overlengthened. Over-lengthened muscles have a harder time contracting and therefore the function is decreased. If this system has a harder time operating, it’s ability to stabilize is probably compromised.

The Anterior Oblique Sling stabilizes the pubic symphysis joint, so if this system is compromised, what happens to the stability of this front joint??

The Posterior Oblique Sling runs diagonally across the backside of the body, connecting the lat to the opposite glute. This sling system stabilizes the SI joint (back two joints of the pelvis). This sling is fairly unaffected by pregnancy. This may be why we tend to see more pubic symphysis issues with our prenatal clients at MamasteFit than we do SI joint issues.

The thought would be all pelvic joints would be affected by pregnancy because of the hormone relaxin, but we rarely see SI joint issues. So our theory is that we tend to see pubic symphysis issues because the sling system that stabilizes it is affected by a growing belly.

We have adapted our programming to meet this new realization by incorporating movements that focus on oblique and adductor co-contraction. We do this by either turning on the adductors together or individually with a ball squeeze or lateral resistance, then add in the obliques with either an anti-rotation movement or a rotational movement.

The pallof press is a great movement to help turn on this sling system, as it activates the oblique. If we can also turn on the adductors, then boom, sling activated.

So how can we turn on the adductors? Squeeze a ball or yoga block between the thighs as you press out. Exhale as you press, squeezing the block. Inhale as you release the tension.

There are several variations to the pallof press that you can incorporate into your workouts to change the movement up and continue to adjust the stimulus and challenge, such as the pallof press with rotation or pallof lunge. Also explore different set ups, such as supine, kneeling, or staggered stance to also adjust the movement to feel new and challenging.

The pallof press and all it’s variations are safe for pregnancy. We tend to program pallof press (a core stability exercise) with an upper body strength movement such as bench press, bent over row (horizontal pull), or cable pull downs (vertical pull).

How is this sling affected in the Postpartum??

After pregnancy, we are in a state of recovery. 9-10 months being pregnant included some rapid growth and change alters our new normal, and may have contributed towards some disconnection with our postpartum body.

After this sling has been over-lengthened for a period of time, we need to focus on reestablishing the neuromuscular connection between the upper and lower body through this system. We can use the same movements from pregnancy, but start with a more supported position (such as supine or seated) and decrease the resistance.

The postpartum is the time to rebuild and recover. We focus on slowly reconnecting this sling. We start in mostly supine positions or kneeling, as we activate the adductors and opposite oblique. Then we slowly progress towards half-kneeling, seated, and standing. The resistance starts either bodyweight or light resistance, then slowly progresses to more intense loading. Key word is slowly. This progress takes about 16-weeks total for both our C-section specific program and Postpartum Return to Fitness.

This sling is especially affected by a cesarean section! The C-section incision severs this sling, and increases the necessity to focus on re-building the neuromuscular connection between the upper and lower body.

We have had a few C-section moms who are years postpartum that have been feeling a change after only a few days of our new Cesarean Specific Recovery Exercise Program.

Gina Conley