Advanced Transversus Abdominis Retraining (Dead Bugs)

  • The patient is lying on their back with both hips flexed to approximately 90º. Ask the patient to find a neutral lumbar spine by having them roll the pelvis from 12 to 6 and find the midpoint.
  • The patient monitors the ASISs with their thumbs to keep them level.
  • Instruct the patient to slowly touch one heel to the table, alternating between the right and left sides while monitoring the ASISs and not allowing an ASIS to drop inferiorly on either side.
  • As their strength improves, they can start extending the hip out further to touch the heel (bottom picture).
  • Have them repeat 3-5 times and increase repetitions as their strength improves.
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