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Bridging

ONLINE COURSE

Applied Ethical Reasoning

Presented by:
A n d r e a St u r m

Introduction

B
ri
d
g
i
n
g
e
x
e
r
ci
se
(s
upine) is an exercise which increases muscular
strength of the hip extensors and promotes
trunk stability. When performed correctly, a
bridge exercise can help promote better posture,

1. It is often prescribed for patients with back

pain , and increases the activities of trunk
stabilization muscles such as the
internal oblique, external oblique, and
erector spinae muscles.[1]
2. Individuals with back and hip pathologies
are often taught to perform the bridging
exercise in the crook-lying position,
elevating the pelvis off the floor. This
exercise is particularly useful for
facilitating pelvic motions and
strengthening the low back and hip
extensors, and it enhances motor control of
the lumbo-pelvic region.[2]

Technique: The patient lies down with the

Technique
back, knees in full flexion and feet flat on the
floor and close to the buttock. Then the patient
lifts hip off the floor towards the ceiling/sky as
high as possible.

Viewing

These 2 videos (2 minutes of viewing) introduce

you to the supine bridge.

Pelvic Tilt Into Bridge Exercis…

[3]

Bridging with progression

[4]

Analysis

The movement analysis of bridging / pelvic

bridging reveals the movement comprises of :
Hip Extension; Lumbar extension; and Posterior
Pelvic tilt.

It is a closed chain exercise

Variations

The term bridge exercise sometimes includes the

prone bridge (plank) and side bridge (side plank)
[5]

The supine bridging exercise variations include:

1. With pelvic tilt

2. With straight leg raising (SLR)

3. With SLR and Glutei contraction

Core Activation

Bridge on unstable surface

Prone bridge

The bridging exercise is an effective way to

improve core strength eg clients with LBP,

Different kinds of bridging exercises has

been evaluated, the authors concluding
that bridging exercise in the prone
position (plank) may be a more effective
method of enhancing trunk muscle
activities.[6]

A study by Jeong-Oh Yoon et al, found that

bridging exercise on unstable surface
or with single leg lift hip abduction
facilitated the muscles activity of internal
oblique and rectus abdominis. While no
significant increase was found in back
muscles multifidus and erector spinae.
Internal oblique muscles is connected
indirectly to the lumbar spine through the
thoracolumbar fascia, so its activation
increases the stiffness of the lumbar spine.
It should be noted that, rectus abdominis
muscle activity increase on the same side of
the lifted leg. (Right single leg lift bridging
exercise increased right rectus abdominis
activity).[7]
A study by Chan-Myeong Kim et al, found
that External oblique and erector spinae
muscles activity increased with hip
inversion 25 degrees while gluteus
maximus muscle increased activity in 25
rotation.[8]
degrees hip external rotation
Performing the bridging exercise on
unstable surface increases the muscles
activity of the deep abdominal muscles
(transverse abdominis and internal
oblique) compared to on stable surface.[9]
Some points that could enhance the
exercise include performing the abdominal
draw in maneuver before the bridging
exercise to prevent excessive lumbar
lordosis. Also maximum expiration which
was found to increase the abdominal
muscles activity compared to resting
expiration during side bridge exercise.[10][11]

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to stabilize the the trunklocalwhile stabilising the arms
exercises in a very specific algorithm. Therapeutic
muscles.[1]
and legs move Hodges during et al (1996)[2]movements.
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inner
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pain and dysfunction.
muscles
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Contraction are signs of
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overlying on source]
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transversus | edit source] [12] [13] Functional
relaxing
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or of the abdominus
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exercises
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muscles
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continual | edit source]
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low back pain, | edit source]abdominus
Transversus [15] [16] Hipcan become
indicated
exercise
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2018;30(7):921-5.
muscles.. done further with
The treatment
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deactivated, | edit
leading source]
to an [17]
unstable [18] [19]
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but
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to produce
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global edit source]
musculature [20] [21]
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and
stability
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contracted in an | edit
effort source]
to regain [22]some [23] Hip control. The
to
forthe
abdominala moretolerance in depth
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goal of this exercise | edit source]
is exercise
that patients [24] [25] with
done
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should within
floor not withbe the your
painful same knees or bent, session
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crossed
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pain learn to contract | edit source]transversus [26] [27] abdominus at all
fatigue
your
the healing of
chest and the muscles
process. the feet (in
Apply a
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time [30]
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the ofphase,
shoulders
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to its | edit the
natural source]
state of [31] hours
continuous
after
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physiotherapy
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core supine
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arm
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Content
association
quickly as possible. with rapid This limb willmovement
depend onand thesupport
patient’s
surface translation while global muscle activity is
clinical presentation/performance/adherence.
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increased. People with respiratory disease are
predicted
Categories to have increased incidence of low back
pain. [16] Spine-control exercises[edit | edit source]
Prone kneeling Lumbar-Pelvic Rhythm [6] Goal:
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Facilitate active pelvic tilt. Prone kneeling with
shoulders directly above the hands and hip above
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the knees Phase 1(a): no lumbar or pelvic movement
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should occur Phase 2(b):posterior pelvic tilt and hip
flexion occur Phase 3(c) :Lumbar flexion and some
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thoracic flexion finish the action (d): Faulty lumbar-
pelvic rhythm often shows up when lumbar flexion
and
Legal posterior pelvic tilt occur immediately.
Building: 1) The patient learns the tilting 2) The
tilting
Disclaimer has to be rhythmic [6] The control of the
pelvic muscles is important to move confidently into
a neutral lumbar position. People with low back pain
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don’t have the ability to perform pelvic tilting. They
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exhibit also a limited excessive flexion laxity or
blocked extension. [11] The ability to dissociate
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lumbar movement from pelvic movement is
therefore important and the correction of faulty
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lumbar-pelvic content rhythm is vital. [11] High(two-point)
kneeling (assisted) hip hinge action [6] Goal: Use a
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pelvic tilt action to move the spine forward and
backward. Once you can perform pelvic tilting well,
you should combine it with classic hip in a hinge
action where the trunk moves
Physiopedia on the hip
available in:in a hinge
action and the spine remains straight. Avoid any
increaseFrench or decrease inGerman lumbar lordosis!Italian Draw the
abdominal muscles Spanish and maintain Ukrainian this minimal
contraction throughout the movement! [6] Sitting
pelvic tilt using gym ball [6] Goal: Teach anterior-
posterior pelvic tilt control. Sit on the ball with
knees apart and feet flat on the floor. Both hips and
knees should be flexed to about 90°. Tilt pelvis
alternately in both anterior and posterior directions,
making sure the shoulders and thoracic spine
remain inactive. Start with small ranges of
movement. Gradually work up to larger ranges. [6]
Core training[edit | edit source] Primary
exersice[edit | edit source] Heel Slide – Basic
©Movement
Physiopedia [6] Goal: 2024Place minimal butisprogressive
| Physiopedia a registered
limb loading Say thanks to
charity in the on UK, theno. trunk. 1173185 Slowly straighten one leg
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with the heel resting on the ground. The moment