Jeff.. I’ve always been taught to have pt do a pelvic tilt and then squeeze the butt while in this position..before bridging… Is this incorrect?
From the hook lying position, maintain the abdominal brace in order to keep your spine stable.
Have your arms at your side and turn them out so that the back of your thumbs are pressed against the floor. Spread your fingers out as wide as possible.
Keep the spine in a neutral position and slowly raise your pelvis off the floor into the bridge position (at this point you can have the client pre-contract the glutes). I like to observe what strategy they use without coaching on the first several reps. Do they use more hamstrings vs glutes?
Be sure to maintain the abdominal brace throughout the entire movement.
It is also important not to let your low back arch or flatten out at any time during the movement.
Slowly lower back to the starting position.
If getting the spine in a neutral position requires slight pelvic tilt, by all means explore APT or PPT and help them find it. You’ll be amazed at how many low back clients have lost the ability to perform ATP and PPT. Also make sure the knees stay in neutral as well (they don’t drift inward or outward).
Additional bridge progression
Cook Bridge (Hold one knee to chest)
Bridge with strap around the knees
Bridge with heels raised
Bridge with steps
Bridge with one leg extended
Hope this helps.
Let’s talk about your butt. Why? Because the three gluteal muscles in the buttocks – the gluteus maximus, gluteus medius and gluteus minimus – are crucial for low back health, as well as strength and power in athletic movement. The butt is part of your core!
Weak glutes not only cause low back pain but are related to other conditions like patellofemoral pain, knee injuries (anterior cruciate ligament injuries), iliotibial band syndrome, ankle injuries and Achilles tendinopathy.
Regarding the glutes, it is less about the maximum weight they can lift, and more about the ability to recruit the glute muscles to perform proper hip extension and gait movements.
I use the squat to assess the glutes, and I use other tests to check stabilty of the hip in an extended position with the pelvis held in neutral.
Depending on position you are moving around in, the gluteals need to be able to act as either a prime mover or a stabiliser, depending on the task.
It is common in athletes for the gluteal muscles to become lengthened (chronically stretched), thus reducing the tension in the range around hip extension. This undermines athletic performance – and makes them more prone to injury as well.
Some of my favorite glute exercises are:
Theraband side walk
Side lying hip abductionMore
•Side lying against wall hip abduction
•Tube walk or ‘Monster walk’
•Squats with adductionMore
•2 leg bridge
•Cook hip lift bridge
•Foot elevated hip lift (aerobic step, foam roller, med ball)
•Single leg Romanian deadlift – develops posterior chain, improves balance, & decreases load & stress on the back.
•One-leg straight-leg Good Morning
•Slide board leg curls (start with toes up)
•Stability Ball Leg Curl – develops torso stability while strengthening the hamstrings. Heels on ball + curl.More