It sounds too good to be true. How can one exercise have an impact on so many common aches and pains? The answer is that it does an excellent job of targeting the glute muscles, in particular, the critical gluteus medius.

Strong and coordinated glute muscles are essential to stabilize your pelvis, control movement of your hip joint and maintain good alignment of your knee. This is especially true when standing or moving on one leg.

• Who it’s for
• Test your glute strength
• Classic clamshell
• Clamshell with resistance band
• How many and how often
• Final thoughts

Who Should Do Clamshell Exercises?

The Clamshell can benefit a wide variety of people and is used by Physical Therapists as a first step in strengthening the hips and core. This exercise can be used therapeutically to eliminate back, hip or knee pain, or it can be used as a preventative measure to improve strength and prevent painful problems.

Studies have shown that people who suffer from low back pain generally have poor hip strength. And people with patello-femoral knee pain benefit from a hip strengthening program. There are very few sports or activities where it is not critical to have good glute strength.

Test Your Glute Strength

If you do not suffer from back, hip or knee pain but want to know if you are at risk, you can perform a simple test to see if you need to work some clamshell exercises into your routine.

Glute Strength Test for Non-Athletes

1. Lie on your back with knees bent.
2. Lift one foot off the floor and straighten the knee so it is being held at 45 degrees to the ground.
3. Place your hands on your hips and keep elbows off the floor.
4. Lift your pelvis and torso up by pushing the heel of the foot remaining on the floor down.
5. Try to keep your pelvis (hip bones) level.
6. Repeat on each side

If the hip bone on the side with your lifted leg is sagging below the other side - you need to strengthen your glutes.

Glute Strength Test For Athletes

1. Stand in front of a standard height dining chair.
2. Lift one knee up to 90 degrees of hip flexion with the knee bent.
3. Perform a single leg squat until your buttocks touch the surface of the chair (do not sit down)
4. As soon as you make contact with the chair slowly stand back up keeping your opposite leg lifted off the ground.

A failure is an inability to do the exercise without putting the opposite foot down or allowing the knee of the stance leg to collapse toward the midline.

If you passed the tests, congratulations you have strong glute muscles. If not, don’t worry, the clamshell exercise can help.

How are Clamshell Exercises Done?

1. Lie on your side with knees bent and stacked on top of one another.
2. Your lower arm supports your head and the other one monitors the position of your pelvis.
3. Roll forward slightly so that the top hand is in front of your hip bone on the bottom (this ensures we target the glutes and not hip flexors)
4. Tighten abdominal muscles slightly (30% of max)
5. Lift top knee away from the bottom knee while keeping ankles together as far as you can without moving your pelvis.
6. Return to the start position and repeat.
7. Roll over and do the other side!

Variations on the Clamshell Exercise

Add a resistance band.

How Many and How Often Should You Do Clamshell Exercises?

Now that you know how to do the clamshell exercise, how many are enough to get the benefit you are looking for? It depends on your goal. When physical therapists are putting together exercise programs they prescribe different sets and reps based on the outcome they are trying to achieve. Below is a guideline you can use to decide how you should incorporate this exercise into your routine.

To Build Strength

Do 4 sets of 6-10 reps at a resistance that makes the last few reps very difficult to do without cheating (you may need to add a resistance band). Do this once every other day.

To Build Endurance (distance runners and athletes participating in longer duration sports)

Do three sets for as many reps as you can without stopping or cheating. Rest for 90 seconds between sets. Do this twice a day, every day.
A failure is an inability to do the exercise without putting the opposite foot down or allowing the knee of the stance leg to collapse toward the midline.

To Improve Activation/Coordination (for those having a hard time getting those glutes to contract at all)

Do 4 sets of 20 reps with no external resistance. Do each rep slowly and as perfectly as possible. Palpate your glute muscle to feel it contracting while you do the movement. Do this once a day, every day.

Build this very valuable exercise into your routine to alleviate pain, prevent injuries and function better overall. Once you can pass the athletes test for glute strength you can move on to glute exercises done in standing to progress your strength and improve performance.

Final Thoughts

Adam Brown talks about some clinical pearls to consider when performing clamshell exercises