Jeff.. I’ve always been taught to have pt do a pelvic tilt and then squeeze the butt while in this position..before bridging… Is this incorrect?
Answer: From the hook lying position, maintain the abdominal brace in order to keep your spine stable. Have your arms at your side and turn them out so that the back of your thumbs are pressed against the floor. Spread your fingers out as wide as possible. Keep the spine in a neutral position and slowly raise your pelvis off the floor into the bridge position (at this point you can have the client pre-contract the glutes). I like to observe what strategy they use without coaching on the first several reps. Do they use more hamstrings vs glutes? Be sure to maintain the abdominal brace throughout the entire movement. It is also important not to let your low back arch or flatten out at any time during the movement. Slowly lower back to the starting position. Repeat.
If getting the spine in a neutral position requires slight pelvic tilt, by all means explore APT or PPT and help them find it. You’ll be amazed at how many low back clients have lost the ability to perform ATP and PPT. Also make sure the knees stay in neutral as well (they don’t drift inward or outward).
Additional bridge progression Cook Bridge (Hold one knee to chest) Bridge with strap around the knees Bridge with heels raised Bridge with steps Bridge with one leg extended
Hope this helps.