Dead bugs are a common exercise prescribed for lower back stabilization.
Pictured above, it involves the actions of both hip flexion and shoulder flexion.
I have mentioned in my previous posts that while most people, measure hip flexion range of motion within normal limits, they lack the ability to flex the hip without compensating into the pelvis and lower back.When we consider this fact, stabilization in the lumbar spine would not be possible for many to achieve. For those individuals, this exercise would be a harmful waste of time.
To determine if this is the case in your patient, place them in supine or sidelying, gently palpate just above ASIS or just below PSIS, and have the patient slowly flex their knee toward their chest. At the point in the range of motion when the ASIS or PSIS begins to move, is their uncompensated hip flexion range of motion.
Beyond that range they will be achieving motion in
their pelvis which could lead to SI problems or motion in their lumbar spine
leading to pathology there.
For me it is about 70 degrees.
Every time I sit, squat or lift my leg
higher than 70 degrees of flexion, I am getting motion in my lower back. This
explains why sitting for a period of time aggravates my back.
If I performed Dead bugs as outlined above, it would aggravate my back.
Uncompensated motion needs to be restored or range of motion
for the needs to be limited or modified before any exercise is prescribed;
otherwise the exercise may be contributing to our patient's problem.
Post Script:
While the focus of this entry was on the hip, it is important to
note that a patient performing dead bugs may also lack shoulder flexion that is
compensated for with back extension.
