Side Bridge Exercise-Phase 2
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Loading ...Here’s the progression for the initial side bridge exercise for the lateral low back stabilizers on the website, FixYourOwnBack.com. Make sure you go there to become proficient on the initial versions before progressing to the more advanced ones.
The side bridge exercise here was refined by renowned low back pain researcher, Stuart McGill, PhD. It targets the QL (quadratus lumborum) and internal/external obliques, muscles that are frequently needing help in those with back pain. If it hurts when you roll over in bed, or when you bend forward and to the side…this is your guy.
Some important things to remember: Practice does not make perfect…Perfect practice makes perfect. IOW, if you don’t use good form on these, you just continue programming poor function into your body’s computer. The most common mistake with this exercise is not locking the hips and shoulders together as one integral unit. Do not lead with either the hip or shoulder on the roll to the plank position! If you watch carefully on the video, you’ll see me blow it on the first rotation (BAD DOCTOR!) before correcting form on the next roll.
What’s the best number of reps? Based on new evidence, we are not holding a static posture until exhaustion anymore. That tack has been theorized to cause poor blood flow through the muscle and set up bad muscle behavior due to ischemia and hypoxia. Instead, train endurance in these muscles with repeated 10 second holds of the posture on one side, before doing the same on the other side. Continue performing reps until you feel like you’ve done about 80% of what you think you could do maximally.
One more thing…I was reminded of this yesterday in the gym with my 13 year old. He was performing his lifts with very good form, just like he was taught ;-). Later, at home, he completely botched the lifting of the lightweight trash can, totally lapsing into lumbar flexion and risking injury to his back. Remember folks, we do these exercises to train the back to manage daily life. If you exhibit flawless form in the gym, but lousy form at home/work, you will likely still get injured. Work to bridge your workout mindset and form with your daily activities, so that you automatically adopt more stable, functional positions. Your attention to detail will be rewarded with remarkably less pain and improved function. Be well!
Dr. Snell
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7 Responses
Melissa
October 2nd, 2009 at 8:45 am
1Really great to see a Chiro teaching good exercises, so many I see treat a patient and don’t look into this area but invite them back for more treatment. Nice website.
Mel
Annie
January 27th, 2010 at 3:48 pm
2I’m commenting here but I really have a question about the basic side bridge. I have a somewhat problematic right shoulder but I DESPERATELY need to do this exercise as I have some bad QL stuff on right. I could feel a difference in 2 days. Is there any way I can prop myself up to alleviate some of the pressure that my shoulder has to bear?
Dr. Snell
January 27th, 2010 at 5:20 pm
3Hey Annie,
I think you may find some work around solutions for the problem shoulder on the beginning side bridge video at the website. You can check there, but to recap, most shoulder discomfort with the exercise is alleviated with one of 2 tricks.
1) Before lifting your body off of the floor, strongly pinch both shoulder blades back together and down, anchoring them to your chest wall so that you have a powerful fulcrum to work off of.
2) If that doesn’t help, take your “up” hand and put it on your active shoulder’s deltoid muscle and pull the arm bone into the socket while you pull the “up” arm’s elbow tightly against your chest.
See if those help. If not, let me know and we can talk about alternative QL exercises. Good luck!
Mila
May 20th, 2010 at 2:36 am
4Hi Dr.Snell,
Thank you for all these great videos and explanations.
Some of my clients still have a problem with a shoulder ( even after the tricks you recommended). What is an alternative for those who can’t perform side bridge?
Also what is an alternative for Bird-Dog if somebody have a problem with the wrists?
I am looking forward to hearing from you.
Thank you!
Mila
Dr. Snell
May 24th, 2010 at 3:26 pm
5Hi Mila,
For the shoulder issue, consider a referral to a physical medicine specialist to correct the shoulder problem if that hasn’t been done. Otherwise, for the side bridge, you can use a Roman chair or a partner stabililizing the feet of a side-lying client. Then have the client do lateral trunk raises against their own body’s weight.
For painful wrists with the Bird dog, have the client do them on their fists if they have wrist problems. Good luck!
Ema
July 31st, 2010 at 6:32 pm
6I have a very tight right QL and a more extended left QL (which Kendall says is characteristic of right-handed posture). In fact, the whole right side of my body feels shortened (also very tight iliopsoas on the right and right anterior tilt). I often feel as if my right hip was pinned to the right lower ribs and my diaphragm can also be very tight at times (right side in particular). For instance, I may feel nauseous if I lie with my xyphoid process on a Swiss/stability ball.
I can do the side bridge on both sides, also advanced level (one would hope so as I am a personal trainer), though I find it tougher (some QL discomfort, burning sensation and shoulder a bit “wobblier”) on the right if I hold it for say 30 or 45 seconds (I won’t be doing this anymore after reading your article, thanks).
1) How come? Could this be due to muscle ischaemia/hypoxia affecting the right QL?
2) Do I even need to do this exercise at all (on the right side anyway)? I will try the repeated 10 second bouts and see if that makes things better.
3) Is the slight lack of right shoulder stability/discomfort likely due to underactive serratus anterior and tight pec minor and overactive infraspinatus?
4) When doing this exercise on the left side, there is no pain or discomfort, just a feeling of being slightly less strong (but again, I could hold this for over 1m 30s, as I had to do for an assessment once). I am aware of the distance between ribs and hips being longer. Hard for my brain to tell what the optimal “distance” (and degree of muscule activation/strength) is. Any suggestions?
(not all the venues where I work have mirrors)
Thank you very much.
Ema.
Dr. Snell
August 1st, 2010 at 9:12 pm
7Hey Ema,
Good Q’s! I will reply as best as possible, with an understanding that much of this is guesswork without hands-on evaluation.
You may very well have a myofascial trigger point affecting the right QL. Research on trigger points shows that when active, they 1) make a muscle hyperirritable 2) easily fatigued 3) shorten the muscle. All of these could explain your observations of that muscles’ performance.
Should you perform the exercise on both sides? Definitely, since the research on the lumbar FCE suggests that one of the ratios of endurance values which bests predicts back pain is side-to-side imbalances of >5% (if memory serves, since I’m at home at present).
Your assessment of the right shoulder sounds mostly right. Typical presentation is tight internal rotators, inhibited external rotators and depressors.
As to the distance between the ribs and pelvis while doing the side bridge, that’s parsing it too fine. Address the chronic QL shortening with 30 sec stretch every 4 hrs for several weeks to show the muscle full length. Get a myofascial release specialist (DC, LMT, PT, Rolfer, etc) to help deactivate trigger point there. Then show the muscles these exercises and others like the Farmers Walk and Single Arm Kettlebell Carry to integrate the muscle into functional activities. It will find it’s way home from there.
You may want to check out the FMS screen to help you with these things too, Ema. As a trainer, you can learn how to use it on yourself and on clients. Check out http://www.functionalmovement.com for more info. Good Luck!
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