I utilize bridging as an assessment and exercise tool in my training and rehab programs. Posterior chain/hip stability is poor in many clients. The ability to maintain a neutral spine, engage the glutes and fight rotation is NOT an easy task by any means. So, coaching and cueing proper bridging is a great way to enhance pillar strength and reduce injury risk, while facilitating better movement patterns in sport.
I wrote a recent column for PFP magazine entitled iso bridge with alternate knee extension. Click here to read the column and the application, regression and progression of the exercise. In addition, I have included a short video below showing double leg and single leg bridge exercises that can be used to work on the hips and core. The second exercise is the dynamic version of the iso alternate knee extension bridge I write about. I show you some of the single leg progressions that come after mastering the iso bridge as well.
I hope this video and article is useful to you. I also want to take this opportunity to thank you for reading my blog and wish you a very Happy New Year!
I work with lots of patients and clients who consistently demonstrate inadequate hip and core stability. I see this show up routinely as asymmetrical 1’s for the trunk stability push-up, in-line lunge, hurdle step and rotary stability movements on the FMS. Unfortunately, this has been a recurring them in many of my females recovering from ACL reconstruction as well as runners with persistent pain/dysfunction in one lower extremity.
I am always looking for better ways to train the body in whole movement patterns as well as functional positions. One of my preferred positions is to test and challenge my clients in a split squat position. I begin with an isometric split squat cueing proper alignment and muscle activation. As clients master isometric postural control, I will allow them to add an isotonic movement by squatting in the position.
As they progress, I will add in perturbations to stimulate changes or challenges to their center of gravity. Often, you will see them struggle much more on the involved side. But to be honest, I find most people have an incredibly hard time maintaining proper alignment for long without cheating or falling forward or to the side. Allowing clients to lose form is okay provided they are cued to fix their alignment or they naturally self correct.
An additional wrinkle I throw in for this training is using the BOSU Balance Trainer. Below is a video that shows how I use this progressing from shin down to just the toes as a support on the trail leg. The second version will burn up your clients’ thighs and quickly become one of their least favorite exercises. The great thing is that you do not have to offer much resistance to create a significant perturbation.
For more detail on this exercise and application, click here to read my PFP column featuring it this week.
While I treat a vast number of knee ailments in my practice, the focus of my training and rehab is often more proximally directed at the hip. Understanding the role of hip muscles and how the hips and pelvis work together to impact knee alignment and closed chain function is critical in resolving knee pain and dysfunction.
Below is a “go to exercise” exercise I use for gluteus medius activation and core/pelvic stability training. Using a mini-band provides an adduction force cueing the client to abduct and activate their external rotators to maintain proper alignment. Additionally, they need to avoid a drop on one side of the pelvis (look at the ASIS).
Click here to read my entire column dedicated to this exercise in PFP’s online magazine. I hope you find this exercise and information useful for you and/or your clients.
Let me start off by saying I have the privilege to assess and treat many avid runners on a weekly basis. Some of them are triathletes and others just dedicated runners. While the age and experience level varies, I see more female runners in all.
Recently, a woman in her mid thirties came in for PT after being referred by a physician’s assistant (PA) with a working diagnosis of hip flexor tendinitis. She had developed pain running in the past few weeks. It was now at a level preventing her from running despite using NSAIDS to reduce inflammation.
Specifically, she complained of increased pain with figure 4 sitting, difficulty and pain getting up from a chair, and increased pain with running. Her pain level at the eval was 2/10 but went as high as 9/10 with running. Lots of things can cause pain in the hip joint.
Summary of clinical findings:
I have been a bit behind on blogging as of late. I try to aim for one per week, but I also strive to deliver sound and relevant content. Additionally, I do not seek outside contributors so finding time to write can be tricky with work and family life too. So, forgive me for any apparent inconsistency in posting. Just know that I will always try to provide valuable content. Today’s post centers around an article in the July 2012 edition of AJSM.
My work at the Athletic Performance Center has provided me an increased opportunity to work with FAI and athletic hip injuries. This is an area of evolution and growth in our field, so I find it particularly interesting to see rationale and thought processes centering around the timing, contribution and selection of hip exercises for active patients/athletes.
This article comes from the Steadman Philippon Research Institute in Vail, CO. The purpose of the study was to measure the highest activation of the piriformis and pectineus muscle during various exercises. The hypothesis was that highest pectineus activation would occur with hip flexion and moderate activity with internal rotation, whereas the highest activation with the piriformis would be with external rotation and/or abduction.
Methods: 10 healthy volunteers completed the following 13 exercises:
All of these exercises have been reported to be used in hip rehab following arthroscopy or recovery from injury. The exercises were executed slowly and methodically with a metronome to reduce EMG amplitude variations.