Weakness in the gluteus maximus and gluteus medius is often cited in contributing to patellofemoral pain, hip pathology and even back pain. Lateral brides (planks) have been shown to be effective ways to strengthen the gluteus medium and maximus. This particular exercise focuses on an isometric pillar bridge, while introducing a dynamic movement for the top leg.


    Execution:
    Begin in a side-lying position on the left side with both legs stacked on one another with the hips in neutral and 90° of knee flexion. Position the left forearm beneath the shoulder on a pad and perpendicular to the torso. The right hand will be placed on the right hip. Press the forearm into the pad and drive the hips off the floor upward toward the ceiling. Hold this lateral pillar position, and subsequently flex the right hip to 90°. Pause, and then return to the start position keeping the knee flexed to 90° while maintaining separation between the left and right legs (right hip is in slight abduction). Perform a set of 5-10 repetitions. Switch sides, repeat and perform 2-3 sets.

    Progressions:
    1. Begin and end the movement with the top leg in full knee extension
    2. Move the right arm against the chest placing the right hand on the left shoulder. This will reduce stability and add an element of rotational stability to the exercise.
    3. Perform the exercise using both progressions listed above in #1 and #2.

    Regression:
    If necessary, place the fingertips or the entire right hand on the floor to help balance the body and assist with keeping the hips in the proper position.

    Application:
    Engaging the gluteus musculature in a way that increases strength and postural stability is effective for runners, athletes and clients struggling with poor proximal stability, dynamic valgus and anterior knee pain. This exercise also adds some variability and instability by adding in a dynamic movement while requiring isometric hip/pillar stability. This dual-task exercise is challenging since the client may lose focus on the bridge as the active hip flexion occurs. In addition, fatigue may impact the height and form of the side bridge portion of the exercise, so it may be necessary to cue the client to push the top hip toward the ceiling throughout.

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