Begin in supine placing the feet flat on a stability ball and flexing the knees to about 90 degrees. Initially position the arms in a T position with the palms facing down. Drive through the bottom of the feet and push up into a table top position. Hold for 20-30 seconds and then relax. Repeat 2-3 sets using a 1:1 or 1:2 work to rest ratio.
The goals is to maintain full hip extension while not allowing the ball to shift or the hips to drop and/or move side to side. The head should remain on the floor at all times. This horizontal T-position affords the client added stability from the upper extremities as they can push into the floor and better manage small losses of balance.
1. Horizontal T-position with the palms facing up
2. X position - cross the forearms and placing the hands on the opposite shoulder
3. Vertical T position - extend the arms toward the ceiling with palms facing and touching one another (arms are perpendicular to the body)
4. Start with vertical T position and add horizontal abduction motion bringing the arms to the floor lightly touching the back of the hands and then returning to the upright position. Perform 5-10 repetitions.
5. Extend the arms toward the ceiling perpendicular to the body and at shoulder width apart. Slowly flex the right shoulder toward the floor, pause and then return to upright. Repeat this sequence with the left shoulder. Perform 5-10 alternating repetitions on each side.
Increasing gluteal and hamstring strength improves hip stability, running economy, reduces injury risk and improves posterior chain strength. Utilizing time under tension with isometrics is a an excellent way to challenge the CNS and increase muscle activation. Once a client can master a stationary double leg bridge, this exercise sequence offers some fun and challenging progressions to an otherwise standard and perhaps otherwise boring isometric exercise.
I like to think of these types of exercises as a way to fine tune motor control and resist unwanted motion in a static position as well as with dynamic movement. Not all clients will be able to progress to the dynamic portion, but use these variations to progress and regress the exercise accordingly. Adjust the length of the isometric based on the ability of the client. Beyond a great training tool for the hamstrings, you will realize greater hip, core and pelvic control too.
Be sure to spot the client and remain close to the ball in case he/she suddenly loses control. You may also offer some small corrections or choose to add difficulty with light perturbations of the ball along the way based on form and skill levels.
Brian Schiff, PT, OCS, CSCS, is a licensed physical therapist, respected author and fitness professional. Currently, he serves as the supervisor for Athletes' Performance at Raleigh Orthopaedic in Raleigh, NC. Brian conducts live continuing education webinars and presents nationally at professional conferences and seminars on injury prevention, rehab and sport-specific training. For more information on his products and services, visit www.BrianSchiff.com.