Back Pain and The Bridge Exercise
- by Joanna Blair
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- 19 Jan, 2025
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What the Studies Say and Exercise Video
Introduction
Slumped half way down one's armed chair listening to a respected consultant during a six hour talk at a lower back pain conference, a question needed to be further explored after a splendid South London accent asked; 'Is it best practice to teach clients to lift their bottoms off the ground and hope that they might understand the benefits of such exercise...?'. A half slump changed to a sat upright posture and a temporary pause for teaching the bridge exercise. A modification of the exercise technique and experience has taught the author, here, that the bridge exercise still has a place within the physical therapy world provided that it is taught in a way that helps teach spinal positioning and alignment. When performed correctly, the bridge exercise helps to improve muscular efficiency of the core and gluteal muscles and most importantly of all - it needs to be performed pain free.
The following post will explore the benefits for the bridge exercise, its relevance and question the adequacy of the regularly prescribed exercise throughout the rehabilitation world across the country and indeed the globe.
Chronic Lower Back Pain
Chronic lower back pain (CLBP) is often associated with muscular weakness, pain and local structural damage such as disc height reduction, as these individuals experience a decline in physical activity (1). The condition tends to cause long-term physical inactivity leading to muscle atrophy or wasting, as muscles are unused. Studies show that the activation of transverse abdominis (TrA) and multifidus (deep back) muscles (MM) are more delayed in those with CLBP (1). Muscles showed a slower response and worsened atrophy in CLBP patients compared to those without CLBP (1).
An unstable spine reduces endurance, flexibility and range of motion of the lower back in addition to causing pain. Should one’s lower back pain intensify, patients are limited with what type of physical activity they may perform and their symptoms can lead to physical dysfunction including muscular weakness and imbalance, poor posture, weakened deep abdominal (core) muscles, inadequate trunk stabilisation and neuromuscular disorders (1). Thus, the strengthening of muscles within the lumbar spine is essential for treating lower back pain, improving one’s proprioception or joint positioning of the lumbar spine (1).
Appropriate exercise programs are an essential component of physical therapy for back pain patients after their symptoms have been evaluated (1). In particular, lumbar stabilisation exercises (LSE) can help prevent repetitive injuries to the intervertebral discs, small joints, surrounding tissues and minimise compressive stress in the spine during activities by strengthening core muscles (1).
Regular LSE in patients with low back pain strengthens ligaments, bones, tendons, and muscles and supplies sufficient nutrition to several joints and cartilages, including the spinal disc, thereby improving motor control (1). In addition, it restores muscle strength, functional mobility, balance, improves muscle activity of the lower trunk and core, enhances health and makes LSE effective not only for patients with low back pain but also for athletes (1).
The Bridge Exercise
Due to their strengthening effects on the gluteal muscle and lower limbs, bridge exercises are widely prescribed in clinical practices to improve torso stability and strengthening muscles, joints and ligaments within the legs and spine (1). Clinically the exercise has found to be a form of low- intensity training of trunk muscles and effective for achieving trunk stability (1).
Kong et al., (2016) compared different variations of the bridge exercise and found that the prone bridge exercise (PBE) was more effective than the conventional bridge exercise in increasing the muscle activity of the trunk.
A study by Ynag and Uhm (2020) found a significant improvements within individuals in their step width and length in stroke patients after performing the general bridge exercise, bridge exercise on an unstable support surface and bridge exercise combined with whole body vibrations. It is interesting to read that the bridge exercise combined with whole body vibrations (by using a power-plate machine) group showed a statistically significant improvement compared to the other two groups. The study found that bridge exercises can be used as an effective program for not just patients with central nervous system damage but also to normal people and athletes (2).
In conclusion, the bridge exercise has proven to be an effective, appropriate and powerful exercise to regularly perform by all individuals with or without neurological defects to help improve muscular and joint strength, co-ordination, sensory feedback and stability.
Bridge Exercise Video
The clinic's YouTube Channel can be viewed the vie the link here.
References
1. Kong, Y-S., Park, S., Kweon. M-G., Park, J-W. (2016) Change in Trunk Muscle Activities with Prone Bridge Exercise in Patients with Chronic Low Back Pain, J. Phys., 28: 264-268.
2. Ynang, D-J., Uhm, Y-H. (2020) Effects of Various Types of Bridge Exercise on the Walking Ability of Stroke Patients, J Kor Physical Therapy, The Korean Society of Physical Therapy, 32; 3: 137-145.
