In my last blog I promised that I’d show you how to tweak the glute bridge to get much more load through the distal hammy and proximal gastroc. Since implementing these tweaks into my clients’ rehab programs I’ve seen some great results, and been able to speed up rehab times for a lot of tricky cases by working smarter, not harder.
If you haven’t read the previous blog, make sure you check that out first to really understand why this tweak is so important.
Single Leg Glute Bridge Through Midfoot
Get your patient into a traditional single leg glute bridge, then once they are in that position get them to shift the weight from the heel towards the midfoot/forefoot. The key here is you don’t want the knee to be in too much flexion. You are trying to mimic the foot hitting the floor in gait (albeit this position is not perfect because of the amount of plantar flexion), so you don’t want the knee bent too far into flexion.
To correct the issue of too much plantar flexion I have toyed around with, and do sometimes use a variation against the wall. But this version is much easier to cue and implement and gets the result I need which allows me to progress the patient to standing much more quickly.
When the patient shifts the weight forward onto the forefoot they are going to shorten the distal gastroc. The progression for this can be taking the heel slightly off the floor so all the weight is on the forefoot. In this position, it’s going to be a lot more difficult for the distal gastroc and soleus to overcome muscle slack, and the distal hamstring and proximal gastroc are going to have to work harder.
As well as being a great exercise, I use this as part of my assessment process to ensure the patient can tolerate higher loads through the hamstrings before progressing them to the next level rehab. I find it minimises the risk of regressions once I take them up to the higher stages of rehab.
Check out the video above where Dave coaches Robyn through the exercise.
Give it a try yourself and see how it feels. If you like it, start to implement it with your patients and let me know the results!
Until then,
Dave O’Sullivan
If you want more information on how exercises like this fit into your graded exposure rehab programme, click the link below, claim your FREE strategy call and we will share exactly how to get complete patient adherence and how we design treatment plans to get consistent results even with the most complex cases.
