Bridging

Original Editor - Daan Vandebriel Sheik Abdul Khadir.

Top Contributors - Sheik Abdul Khadir, Lucinda hampton, Kim Jackson, Uchechukwu Chukwuemeka, Lilian Ashraf, Mostafa Shahien, Daan Vandebriel, Garima Gedamkar, WikiSysop, Claire Knott and Evan Thomas  

Description

Bridging exercise, a closed chain weight-bearing exercise,is an exercise which increases muscular strength of the hip extensors and promotes trunk stability. 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.

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.

Bridging Exercise and Low Back Pain

Bridging exercise is most commonly used with patients complaining from low back pain and has many benifits as:

• It improves the proprioception in the lumbar spine as it evident by researches prone bridging improve the proprioception.

• Researches also find that prone bridging is more effective in activating back muscles in patients with low back pain

• Also prone bridging icreases the thickness of intrenal oblique,external oblique and transversus abdominal muscles

So we can conclude that,not only supine bridging is essential for patients with low back pain but also prone bridging is mandatory and has a major role.

 Technique

The patient lies down with the 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.

Starting Position  to end:

Movement Analysis

The movement analysis of bridging / pelvic bridging reveals the movement comprises of 

• Hip Extension
• Lumbar extension
• Posterior Pelvic tilt.

Variations 

The pelvic bridging exercise can be varied as:

• With pelvic tilt                                                                

• With straight leg raising (SLR)                                                

• With SLR and Glutei contraction                                   
  
• Recently , changes in the activity of the trunk muscles in different kinds of bridging exercises has been evaluated by Kong YS et al  The authors concluded that bridging exercise in the prone position may be a more effective method of enhancing trunk muscle activities.

• 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).
• 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 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.
• 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.