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The two primary ligaments of the gluteal region are the sacrotuberous ligament and the sacrospinous ligament. The large sacrotuberous ligament (STL) is continuous from the posterior sacro-iliac ligament and spans the length of the posterior superior iliac spine,the lateral portion of the sacrum, the upper coccyx and connects to the ischial tuberosity of the ischium. The most inferior and superficial fibers of this ligament are continuous with the tendon of the biceps femoris muscle. Functionally, the STL plays a significant role in stabilizing the pelvis through inhibiting nutation (anterior and inferior movement of the sacrum), anatomically it serves as a point of origin for the inferior fibers of the gluteus maximus, and structurally along with the contribution of the sacrospinous ligament, divides the sciatic notch into the greater sciatic foramen and lesser sciatic foramen. This creation of the sciatic foramen created via these two ligaments, is an important anatomical division as the greater sciatic foramen serves as the main route for all arterial and nerve structures transitioning from the pelvis to the gluteal region, while the lesser sciatic foramen serves as the route for arterial and nervous structures entering and leaving the perineum.