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  2. Anterior Oblique Subsystem (AOS)
Anterior oblique subsystem (AOS): rectus abdominis, abdominal fascia (anterior layer), external obliques, and anterior adductors. Illustration from Vleeming et al. (2007) (1).
Anterior oblique subsystem (AOS): rectus abdominis, abdominal fascia (anterior layer), external obliques, and anterior adductors. Illustration from Vleeming et al. (2007) (1).

Anterior Oblique Subsystem (AOS)

Anterior Oblique Subsystem (AOS) is comprised of the rectus abdominis, abdominal fascia (anterior layer), external obliques, anterior adductors, and potentially the pectoralis major, serratus anterior, and pyramidalis.

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Course Summary: Anterior Oblique Subsystem

This course describes the anterior oblique subsystem (AOS), a concept originally proposed by Vleeming et al. (1). However, similar concepts have also been proposed, such as the anterior oblique sling, anterior oblique myofascial synergy, myofascial lines, anatomy trains, myofascial meridians, superficial front line, functional line, spiral line, and the serape effect.

The Anterior Oblique Subsystem (AOS) is comprised of:

Function (Brief):

  • Concentric Function: Pushing, rotation "inward," and multi-segmental flexion
  • Isometric Function: Transfer of force between lower and upper extremities and stabilization of the hips, sacroiliac joint, pubic symphysis, lumbar spine, and thoracic spine.
  • Eccentric Function: Decelerate pushing, rotation "outward," and multi-segmental extension.

Practical Application

Common Maladaptive Behavior

  • Over-active

The concepts and techniques described in this course may be particularly beneficial for neuromuscular re-education, coordination, motor pattern integration, whole-body strength, functional strength, and sports performance. Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) should consider adding these exercises to their repertoire to improve the outcomes of their integrated exercise programs, sports performance programs, and therapeutic (rehabilitation) interventions.

Pre-approved for Continuing Education Credits for:

This Course Includes:

  • AI Tutor
  • Study Guide
  • Text and Illustrations
  • Research Review
  • Technique Videos
  • Sample Routine
  • Practice Exam
  • Pre-approved Final Exam

Additional Subsystem Courses

Anterior oblique subsystem (AOS): rectus abdominis, abdominal fascia (anterior layer), external obliques, and anterior adductors. Illustration from Vleeming et al. (2007) (1).
Caption: Anterior oblique subsystem (AOS): rectus abdominis, abdominal fascia (anterior layer), external obliques, and anterior adductors. Illustration from Vleeming et al. (2007) (1).

Course Study Guide: Anterior Oblique Subsystem

Introduction: Anterior Oblique Subsystem (Sling)

Research Corner
6 Sub Sections

Summary of Research Findings

Practical Application
3 Sub Sections

Videos
3 Sub Sections

Sample Corrective Exercise Program

Bibliography

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  1. Donald A. Neumann, “Kinesiology of the Musculoskeletal System: Foundations of Rehabilitation – 2nd Edition” © 2012 Mosby, Inc.

  1. Willard, F.H., Vleeming, A., Schuenke, M.D., Danneels, L., Schleip, R. The thoracolumbar fascia: anatomy, function and clinical considerations. Journal of Anatomy, 2012. 221, 507-536.

  1. David G. Simons, Janet Travell, Lois S. Simons, Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition ,© 1999 Williams and Wilkens

  1. Sanchez ER, Sanchez R, Moliver C. (2014). Anatomic relationship of pectoralis major and minor muscles: a cadaveric study. Aesthet. Surg. J. 34(2): 258-263.

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    • Rectus Abdominis

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  1. Kim, H. J., Chung, S., Kim, S., Shin, H., Lee, J., Kim, S., & Song, M. Y. (2006). Influences of trunk muscles on lumbar lordosis and sacral angle. European Spine Journal, 15(4), 409-414.

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  1. Cholewicki, J., Panjabi, M. M., & Khachatryan, A. (1997). Stabilizing function of trunk flexor‐extensor muscles around a neutral spine posture. Spine , 22 (19), 2207-2212.

  1. Hodges, P. W., & Richardson, C. A. (1997). Contraction of the abdominal muscles associated with movement of the lower limb. Physical therapy , 77 (2), 132-142.

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  1. Fujitani, R., Jiromaru, T., Kida, N., & Nomura, T. (2017). Effect of standing postural deviations on trunk and hip muscle activity. Journal of physical therapy science , 29 (7), 1212-1215.

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  1. Ng, J. K. F., Richardson, C. A., Parnianpour, M., & Kippers, V. (2002). Fatigue-related changes in torque output and electromyographic parameters of trunk muscles during isometric axial rotation exertion: an investigation in patients with back pain and in healthy subjects. Spine , 27 (6), 637-646

  1. Cholewicki, J., Silfies, S., Shah, R., Greene, H., Reeves, N. Alvi, K., Goldberg, B. (2005). Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine. 30(23), 2614-2620

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  1. David G. Simons, Janet Travell, Lois S. Simons, Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition ,© 1999 Williams and Wilkens
    • External Obliques

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  1. McGill, S. M. (1991). Kinetic potential of the lumbar trunk musculature about three orthogonal orthopaedic axes in extreme postures. Spine , 16 (7), 809-815.

  1. McGill, S. M. (1991). Electromyographic activity of the abdominal and low back musculature during the generation of isometric and dynamic axial trunk torque: implications for lumbar mechanics. Journal of Orthopaedic Research , 9 (1), 91-103.

  1. McGill, S. M. (1992). A myoelectrically based dynamic three-dimensional model to predict loads on lumbar spine tissues during lateral bending. Journal of biomechanics , 25 (4), 395-414.

  1. McGill, S. M. (1996). A revised anatomical model of the abdominal musculature for torso flexion efforts. Journal of biomechanics , 29 (7), 973-977.

  1. De Troyer, A., & Estenne, M. (1988). Functional anatomy of the respiratory muscles. Clinics in chest medicine , 9 (2), 175-193.

  1. Danneels, L. A., Vanderstraeten, G. G., Cambier, D. C., Witvrouw, E. E., Stevens, V. K., & De Cuyper, H. J. (2001). A functional subdivision of hip, abdominal, and back muscles during asymmetric lifting. Spine , 26 (6), E114-E121.

  1. Hodges, P., Cresswell, A., & Thorstensson, A. (1999). Preparatory trunk motion accompanies rapid upper limb movement. Experimental Brain Research , 124 (1), 69-79.

  1. Drysdale, C. L., Earl, J. E., & Hertel, J. (2004). Surface electromyographic activity of the abdominal muscles during pelvic-tilt and abdominal-hollowing exercises. Journal of athletic training , 39 (1), 32.

  1. Cresswell, A. G., & Thorstensson, A. (1989). The role of the abdominal musculature in the elevation of the intra-abdominal pressure during specified tasks. Ergonomics , 32 (10), 1237-1246.

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  1. Lehman, G. J., Hoda, W., & Oliver, S. (2005). Trunk muscle activity during bridging exercises on and off a swissball. Chiropractic & osteopathy , 13 (1), 14.

  1. Adductors

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  1. Pool-Goudzwaard, A. L., Vleeming, A., Stoeckart, R., Snijders, C. J., & Mens, J. M. A. (1998). Insufficient lumbopelvic stability: a clinical, anatomical and biomechanical approach to ‘a-specific’ low back pain. Manual Therapy , 3 (1), 12-20.

  1. Snijders, C. J., Vleeming, A., & Stoeckart, R. (1993). Transfer of lumbosacral load to iliac bones and legs: Part 1: Biomechanics of self-bracing of the sacroiliac joints and its significance for treatment and exercise. Clinical biomechanics , 8 (6), 285-294.

  1. Snijders, C. J., Slagter, A. H., van Strik, R., Vleeming, A., Stoeckart, R., & Stam, H. J. (1995). Why Leg Crossing?: The Influence of Common Postures on Abdominal Muscle Activity. Spine , 20 (18), 1989-1993.

  1. Padua, D. A., Bell, D. R., & Clark, M. A. (2012). Neuromuscular characteristics of individuals displaying excessive medial knee displacement. Journal of athletic training , 47 (5), 525.

  1. Mauntel, T., Begalle, R., Cram, T., Frank, B., Hirth, C., Blackburn, T., & Padua, D. (2013). The effects of lower extremity muscle activation and passive range of motion on single leg squat performance. Journal Of Strength And Conditioning Research / National Strength & Conditioning Association , 27 (7), 1813-1823

  1. Bell, D. R., Vesci, B. J., DiStefano, L. J., Guskiewicz, K. M., Hirth, C. J., & Padua, D. A. (2012). Muscle activity and flexibility in individuals with medial knee displacement during the overhead squat. Athletic Training and Sports Health Care , 4 (3), 117-125.

  1. Hungerford, B., Gilleard, W., Hodges, P. (2003) Evidence of altered lumbopelvic muscle recruitment in the presence of sacroiliac joint pain. Spine 28(14), 1593-1600

  1. Hägglund M, Waldén M, Ekstrand J. Risk factors for lower extremity muscle injury in professional soccer: the UEFA Injury Study. The American Journal Of Sports Medicine . February 2013;41(2):327-335. Available from: MEDLINE Complete, Ipswich, MA. Accessed May 4, 2016.

  1. Ekstrand J, Hägglund M, Waldén M. Epidemiology of muscle injuries in professional football (soccer). The American Journal Of Sports Medicine . June 2011;39(6):1226-1232. Available from: MEDLINE Complete, Ipswich, MA. Accessed May 4, 2016.

  1. Naal F, Dalla Riva F, Wuerz T, Dubs B, Leunig M. Sonographic prevalence of groin hernias and adductor tendinopathy in patients with femoroacetabular impingement. The American Journal Of Sports Medicine . September 2015;43(9):2146-2151. Available from: MEDLINE Complete, Ipswich, MA. Accessed May 4, 2016.

  1. Robinson, P., Barron, D. A., Parsons, W., Grainger, A. J., Schilders, E. M. G., & O’Connor, P. J. (2004). Adductor-related groin pain in athletes: correlation of MR imaging with clinical findings. Skeletal radiology , 33 (8), 451-457.
    • Pectoralis Major

  1. Sanchez ER, Sanchez R, Moliver C. (2014). Anatomic relationship of pectoralis major and minor muscles: a cadaveric study. Aesthet. Surg. J. 34(2): 258-263.

  1. Harms-Ringdahl, K. (1986). On assessment of shoulder exercise and load-elicited pain in the cervical spine. Biomechanical analysis of load--EMG--methodological studies of pain provoked by extreme position. Scandinavian journal of rehabilitation medicine. Supplement , 14 , 1-40.

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  1. Marchetti, P. H., & Uchida, M. C. (2011). Effects of the pullover exercise on the pectoralis major and latissimus dorsi muscles as evaluated by EMG. Journal of applied biomechanics , 27 (4), 380-384.

  1. Pearl, M. L., Perry, J., Torburn, L. M. S. P. T., & Gordon, L. H. (1992). An electromyographic analysis of the shoulder during cones and planes of arm motion. Clinical orthopaedics and related research , (284), 116-127.

  1. Pink, M., Jobe, F. W., & Perry, J. (1990). Electromyographic analysis of the shoulder during the golf swing. The American journal of sports medicine , 18 (2), 137-140.

  1. Jobe, F. W., Moynes, D. R., & Antonelli, D. J. (1986). Rotator cuff function during a golf swing. The American journal of sports medicine , 14 (5), 388-392.

  1. Gowan, I. D., Jobe, F. W., Tibone, J. E., Perry, J., & Moynes, D. R. (1987). A comparative electromyographic analysis of the shoulder during pitching: professional versus amateur pitchers. The American journal of sports medicine , 15 (6), 586-590.

  1. Ryu, R. K., McCormick, J., Jobe, F. W., Moynes, D. R., & Antonelli, D. J. (1988). An electromyographic analysis of shoulder function in tennis players. The American journal of sports medicine , 16 (5), 481-485.

  1. Rokito, A. S., Jobe, F. W., Pink, M. M., Perry, J., & Brault, J. (1998). Electromyographic analysis of shoulder function during the volleyball serve and spike. Journal of Shoulder and Elbow Surgery , 7 (3), 256-263.

  1. Scovazzo, M.L., Browne, A., Pink, M., Jobe, F.W., and Kerrigan, J. (1991). The painful shoulder during freestyle swimming: An electromyographic cinematographic analysis of twelve muscles. The American Journal of Sports Medicine. 577-582.

  1. Paton, M. E., & Brown, J. M. M. (1994). An electromyographic analysis of functional differentiation in human pectoralis major muscle. Journal of Electromyography and Kinesiology , 4 (3), 161-169.

  1. Glass, S. C., & Armstrong, T. (1997). Electromyographical Activity of the Pectoralis Muscle During Incline and Decline Bench Presses. The Journal of Strength & Conditioning Research , 11 (3), 163-167.

  1. Harms-Ringdahl, K. (1986). On assessment of shoulder exercise and load-elicited pain in the cervical spine. Biomechanical analysis of load--EMG--methodological studies of pain provoked by extreme position. Scandinavian journal of rehabilitation medicine. Supplement , 14 , 1-40.

  1. Welsch, E. A., Bird, M., & Mayhew, J. L. (2005). Electromyographic activity of the pectoralis major and anterior deltoid muscles during three upper-body lifts. Journal of Strength and Conditioning Research , 19 (2), 449.

  1. Lehman, G. J., MacMillan, B., MacIntyre, I., Chivers, M., & Fluter, M. (2006). Shoulder muscle EMG activity during push up variations on and off a Swiss ball. Dynamic Medicine , 5 (1), 7.

  1. Steenbrink, F., De Groot, J. H., Veeger, H. E. J., Meskers, C. G. M., van de Sande, M. A. J., & Rozing, P. M. (2006). Pathological muscle activation patterns in patients with massive rotator cuff tears, with and without subacromial anaesthetics. Manual therapy , 11 (3), 231-237.

  1. Santana, J. C., Vera-Garcia, F. J., & McGill, S. M. (2007). A kinetic and electromyographic comparison of the standing cable press and bench press. Journal of Strength and Conditioning Research , 21 (4), 1271.

  1. Schick, E. E., Coburn, J. W., Brown, L. E., Judelson, D. A., Khamoui, A. V., Tran, T. T., & Uribe, B. P. (2010). A comparison of muscle activation between a Smith machine and free weight bench press. The Journal of Strength & Conditioning Research , 24 (3), 779-784.

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  1. Uribe, B. P., Coburn, J. W., Brown, L. E., Judelson, D. A., Khamoui, A. V., & Nguyen, D. (2010). Muscle activation when performing the chest press and shoulder press on a stable bench vs. a Swiss ball. The Journal of Strength & Conditioning Research , 24 (4), 1028-1033.

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  1. Saeterbakken, A. H., van den Tillaar, R., & Fimland, M. S. (2011). A comparison of muscle activity and 1-RM strength of three chest-press exercises with different stability requirements. Journal of sports sciences , 29 (5), 533-538.

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  1. Hirashima, M., Kadota, H., Sakurai, S., Kudo, K., & Ohtsuki, T. (2002). Sequential muscle activity and its functional role in the upper extremity and trunk during overarm throwing. Journal of sports sciences , 20 (4), 301-310.

  1. Glousman R, Jobe F, Tibone J, Moynes D, Antonelli D, Perry J. Dynamic Electromyographic analysis of the throwing shoulder with glenohumeral instability. J Bone Joint Surg 70A(2):220-226, 1988.

  1. Park, K. M., Cynn, H. S., Kwon, O. Y., Yi, C. H., Yoon, T. L., & Lee, J. H. (2014). Comparison of pectoralis major and serratus anterior muscle activities during different push-up plus exercises in subjects with and without scapular winging. The Journal of Strength & Conditioning Research , 28 (9), 2546-2551.

  1. Park, K. M., Cynn, H. S., Yi, C. H., & Kwon, O. Y. (2013). Effect of isometric horizontal abduction on pectoralis major and serratus anterior EMG activity during three exercises in subjects with scapular winging. Journal of Electromyography and Kinesiology , 23 (2), 462-468.
    • Serratus Anterior

  1. Kao, J. T., Pink, M., Jobe, F. W., & Perry, J. (1995). Electromyographic analysis of the scapular muscles during a golf swing. The American journal of sports medicine , 23 (1), 19-23.

  1. McHardy, A., & Pollard, H. (2005). Muscle activity during the golf swing. British journal of sports medicine , 39 (11), 799-804.

  1. Maffet, M. W., Jobe, F. W., Pink, M. M., Brault, J., & Mathiyakom, W. (1997). Shoulder muscle firing patterns during the windmill softball pitch. The American journal of sports medicine , 25 (3), 369-374.

  1. Seo, S. H., Jeon, I. H., Cho, Y. H., Lee, H. G., Hwang, Y. T., & Jang, J. H. (2013). Surface EMG during the push-up plus exercise on a stable support or Swiss ball: scapular stabilizer muscle exercise. Journal of physical therapy science , 25 (7), 833-837.

  1. Park, Se-yeon, and Won-gyu Yoo. “Differential activation of parts of the serratus anterior muscle during push-up variations on stable and unstable bases of support.” Journal of Electromyography and Kinesiology 21.5 (2011): 861-867.

  1. Kibler, W. B., Chandler, T. J., Shapiro, R., & Conuel, M. (2007). Muscle activation in coupled scapulohumeral motions in the high performance tennis serve. British journal of sports medicine , 41 (11), 745-749.

  1. Ryu, R. K., McCormick, J., Jobe, F. W., Moynes, D. R., & Antonelli, D. J. (1988). An electromyographic analysis of shoulder function in tennis players. The American journal of sports medicine , 16 (5), 481-485.

  1. Pink, M., Perry, J., Browne, A., Scovazzo, M. L., & Kerrigan, J. (1991). The normal shoulder during freestyle swimming: an electromyographic and cinematographic analysis of twelve muscles. The American Journal of Sports Medicine , 19 (6), 569-576.

  1. Nuber, G. W., Jobe, F. W., Perry, J., Moynes, D. R., & Antonelli, D. (1986). Fine wire electromyography analysis of muscles of the shoulder during swimming. The american journal of sports medicine , 14 (1), 7-11.

  1. Witt, D., Talbott, N., & Kotowski, S. (2011). Electromyographic activity of scapular muscles during diagonal patterns using elastic resistance and free weights. International journal of sports physical therapy , 6 (4), 322.

  1. Diederichsen, L. P., Nørregaard, J., Dyhre-Poulsen, P., Winther, A., Tufekovic, G., Bandholm, T., … & Krogsgaard, M. (2009). The activity pattern of shoulder muscles in subjects with and without subacromial impingement. Journal of Electromyography and kinesiology , 19 (5), 789-799.

  1. de Morais Faria, C. D. C., Teixeira-Salmela, L. F., de Paula Goulart, F. R., & de Souza Moraes, G. F. (2008). Scapular muscular activity with shoulder impingement syndrome during lowering of the arms. Clinical Journal of Sport Medicine , 18 (2), 130-136.

  1. Wadsworth, D. J. S., & Bullock-Saxton, J. E. (1997). Recruitment patterns of the scapular rotator muscles in freestyle swimmers with subacromial impingement. International journal of sports medicine , 18 (08), 618-624.

  1. McMahon, P. J., Jobe, F. W., Pink, M. M., Brault, J. R., & Perry, J. (1996). Comparative electromyographic analysis of shoulder muscles during planar motions: anterior glenohumeral instability versus normal. Journal of shoulder and elbow surgery , 5 (2), 118-123.

  1. Phadke, V., Camargo, P. R., & Ludewig, P. M. (2009). Scapular and rotator cuff muscle activity during arm elevation: a review of normal function and alterations with shoulder impingement. Brazilian Journal of Physical Therapy , 13 (1), 1-9.

  1. Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, Stergiou N. (2010). Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. Journal of Electromyography and Kinesiology . 20: 701-709.

  1. Kwon JW, Son SM, Lee NK. (2015). Changes in upper-extremity muscle activities due to head position in subjects with a forward head posture and rounded shoulders. J Phys Ther Sci. 27: 1739-1742

  1. Helgadottir, H., Kristjansson, E., Einarsson, E., Karduna, A., & Jonsson, H. (2011). Altered activity of the serratus anterior during unilateral arm elevation in patients with cervical disorders. Journal of electromyography and kinesiology,21(6), 947-953.

  1. Weon, J. H., Oh, J. S., Cynn, H. S., Kim, Y. W., Kwon, O. Y., & Yi, C. H. (2010). Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. Journal of Bodywork and movement therapies , 14 (4), 367-374.

  1. Ludewig, P. M., & Cook, T. M. (1996). The effect of head position on scapular orientation and muscle activity during shoulder elevation. Journal of Occupational Rehabilitation , 6 (3), 147-158.

  1. Cools, A. M., Witvrouw, E. E., Declercq, G. A., Vanderstraeten, G. G., & Cambier, D. C. (2004). Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms. British journal of sports medicine , 38 (1), 64-68.

  1. McQuade, K. J., Dawson, J., & Smidt, G. L. (1998). Scapulothoracic muscle fatigue associated with alterations in scapulohumeral rhythm kinematics during maximum resistive shoulder elevation. Journal of Orthopaedic & Sports Physical Therapy , 28 (2), 74-80.

  1. Borstad, J. D., Szucs, K., & Navalgund, A. (2009). Scapula kinematic alterations following a modified push-up plus task. Human movement science , 28 (6), 738-751.

  1. Cools, A. M., Witvrouw, E. E., Declercq, G. A., Vanderstraeten, G. G., & Cambier, D. C. (2004). Evaluation of isokinetic force production and associated muscle activity in the scapular rotators during a protraction-retraction movement in overhead athletes with impingement symptoms. British journal of sports medicine , 38 (1), 64-68.

  1. Lawrence, R. L., Braman, J. P., Laprade, R. F., & Ludewig, P. M. (2014). Comparison of 3-dimensional shoulder complex kinematics in individuals with and without shoulder pain, part 1: sternoclavicular, acromioclavicular, and scapulothoracic joints. journal of orthopaedic & sports physical therapy , 44 (9), 636-A8.

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  1. Ludewig, P. M., & Cook, T. M. (2000). Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physical therapy , 80 (3), 276-291 .

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    • Additional Research on Function

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  1. Kang, T., Lee, J., Seo, J., & Han, D. (2017). The effect of bridge exercise method on the strength of rectus abdominis muscle and the muscle activity of paraspinal muscles while doing treadmill walking with high heels. Journal of physical therapy science , 29 (4), 707-712

  1. Yoo, W. G. (2014). Effect of the individual strengthening exercises for posterior pelvic tilt muscles on back pain, pelvic angle, and lumbar ROM of a LBP patient with excessive lordosis: a case study. Journal of physical therapy science, 26(2), 319-320.

  1. Chang, M., Slater, L. V., Corbett, R. O., Hart, J. M., & Hertel, J. (2017). Muscle activation patterns of the lumbo-pelvic-hip complex during walking gait before and after exercise. Gait & posture , 52 , 15-21.

  1. Brookbush, B. Lumbo Pelvic Hip Complex Dysfunction. https://brentbrookbush.com/articles/postural-dysfunction-movement-impairment/lumbo-pelvic-hip-complex-dysfunction-lphcd/

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  1. Kang, T., Lee, J., Seo, J., & Han, D. (2017). The effect of bridge exercise method on the strength of rectus abdominis muscle and the muscle activity of paraspinal muscles while doing treadmill walking with high heels. Journal of physical therapy science, 29 (4), 707-712.

  1. Yoo, W. G. (2014). Effect of the individual strengthening exercises for posterior pelvic tilt muscles on back pain, pelvic angle, and lumbar ROM of a LBP patient with excessive lordosis: a case study. Journal of physical therapy science, 26(2), 319-320.

  1. Chang, M., Slater, L. V., Corbett, R. O., Hart, J. M., & Hertel, J. (2017). Muscle activation patterns of the lumbo-pelvic-hip complex during walking gait before and after exercise. Gait & posture , 52 , 15-21.

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