Limbo-Pelvic and hip weakness may predispose people to pain or dysfunction. Improving lateral pillar strength can reduce injury risk and optimize movement and stability. The following exercise progressions offer a sequential way to challenge clients while maintaining proper alignment.
Execution:
Begin in a side-lying position resting the forearm on a balance cushion. Stack the hips/legs together in line with the body with the knees flexed to 90 degrees. Position the top arm along the side of the body. Next, lift the pelvis up as high as possible by pushing down through the bottom knee keeping the body in a straight line. Hold for 30 seconds. Repeat 2-3 times on each side.
Progressions:
1. Increase the hold time.
2. Elevate the top arm so it is perpendicular to the body. Add a dumbbell or kettlebell to increase load. You may also provide small perturbation to challenge stability.
3. Maintain the static bridge and add a clamshell movement. Further increase the load using a resistance band placed around both thighs just above the knees.
4. Progress to a static hold with the top leg extended.
5. Perform active hip abduction while holding the isometric lateral bridge.
Application:
This exercise is designed to strengthen the lateral myofascial chain and improve functional stability and neuromuscular control of the shoulder, torso and hips. It effectively targets the gluteus medius, obliques, quadratus lumborum, multifidus, tensor fascia lata and erector spinae. The gluteus medium in the down hip is instrumental in holding the pelvis up, so be sure to cue away from pelvic drop and be prepared to regress the exercise intensity of the client cannot maintain proper form.
Using these exercises can help address muscle imbalances, weakness and poor trunk stability. In addition, strengthening the lateral pillar will help reduce patellofemoral pain, knee values collapse and pain related to hip/low back pathology. Keep in mind the tensor fascia lata tends to dominate the gluteus medius, so the client will have to work hard to properly activate the gluteus medius and avoid hip flexion particularly in the version with the top leg suspended and/or performing active abduction.
