Clam

Dose

Perform 3 sets of 5 five-second long holds on each side with 30 seconds rest in between sets

Purpose

Once you are able to activate the lumbopelvic muscles, you can begin to use them to stabilize the pelvis as you move other joints. In this case, you are holding the pelvis steady by Drawing In while you move the hip. Active hip musculature is essential for optimal movement, and deficits in this area are associated with many conditions. This exercise is a way to engage muscles around the hips and lumbar spine without requiring much movement or load that can cause pain.

Method

Start by lying on your side, with your bottom leg straight and the top leg resting in front of the bottom leg. The heel of the top leg should be placed on the ground halfway up the shin of the bottom leg. Try to lie straight , so that the shoulder, hips, and bottom leg are all in line. Then, roll the top hip forward about 30 degrees, so that the hips are tilted towards the ground. Place the top hand on the buttock of the top leg to feel the muscles contract when the exercise is performed.

From this position, draw in the lumbopelvic muscles by performing the Drawing In exercise, and lift the top knee as far as you can off the surface you’re lying on without letting the hips roll back towards the vertical. Hold the knee up for five seconds, feeling the hip muscles contract with your top hand. After five seconds, slowly control the knee back down, and repeat.

You may find that the knee does not lift at all. Don’t worry, the exercise will still be effective if you engage the hip muscles, and hold the contraction for the prescribed time. The knee will start to lift eventually, as your strength and mobility improve.

Common Mistakes

• Letting the hips roll. The body tries to make this exercise easier by rolling backward as you attempt to lift the knee. The trick is to keep the hips tilted forwards and work the hip muscles instead of letting the body roll. Try the Drawing In exercise while you lift the knee to help stabilize the body.

• Arching the back. The body will also attempt to use the low back muscles to help with the task of lifting the knee, creating an arch in the back. Try to prevent this by drawing in, and preventing the belly button from pushing forward towards the surface you’re lying on.

•Lifting the heel of the top leg off of the bed. Initially, you may try to use your foot muscles to help you lift the knee off of the bed. This will result in the ankle lifting off of the bed. Keep the inside of the ankle flat on the bed to engage the hip most effectively.

Progression Threshold

You should be able to bend forward (as if to pick something up from the floor) without experiencing pain that you think is more than 3/10, with 0 being no pain and 10 being the worst pain you can imagine, before progressing