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Clamshell

Draftstrength90%beginnerstrong evidence
View FHIR resourceFHIR R4 ActivityDefinition — the interoperable form of this exercise

Positions & Range of Motion

Start
sidelying with hips stacked vertically, hips flexed ~45°, knees bent ~90°, feet together, trunk neutral
End
top knee rotated open toward the ceiling via hip external rotation while feet stay in contact and the pelvis stays stable (no posterior roll)
Range of Motion
hip external rotation, roughly 0 to ~30–45° of knee separation, then controlled return

How to Perform

Sidelying hip external rotation exercise. Patient lies on side with hips and knees bent, feet together, and opens top knee like a clamshell.

Watch on YouTube

Opens a YouTube search for “Clamshell

Equipment:resistance band
Starting position: sidelying

Coaching Cues

  1. 1

    Quiet trunk, stacked hips — glute med rotates the femur

    (verbal)
  2. 2

    Open the top knee toward the ceiling

    (verbal)
  3. 3

    Keep the feet glued together throughout

    (verbal)
  4. 4

    Hand on the top hip stops it from rolling backward

    (tactile)

Evidence-Based Dosing & EMG Data

Recommended Dosing

3×15-20 reps per side, 2-3x/week

EMG Activation Data

Glute med 26-67% MVIC; highest glute med-to-TFL ratio (115) among exercises [Selkowitz 2013]; 60° hip flexion optimal [Willcox 2013]

Muscles Involved (5)

Primary Movers

Gluteus MediusPosterior fibers

Secondary Movers

Tensor Fasciae Latae20-34% MVIC — monitor for over-activation [Selkowitz 2013]

Synergists & Assistors

PiriformisSynergist14.5% T2 change (fMRI) [Kim 2025]
Gluteus MinimusSynergist4.5-7.2% T2 change [Kim 2025]

Easier Variations ↓

1

Reduced Range Clamshell

Open the knee only partway. Focus on maintaining pelvic stability.

Harder Variations ↑

1

Resisted Clamshell

Add a resistance band around the thighs just above the knees.

2

Elevated Clamshell

Lift feet off the surface while performing the clamshell. Increases gluteus medius demand.

Target Movements (2)

Hip External RotationHip Joint (Coxofemoral)
Hip AbductionHip Joint (Coxofemoral)

Why This Exercise Matters

Everyday activities this exercise helps you do — essential means it directly trains the capacity the task needs:

Goals This Helps With

Rehab, performance, prevention, and mobility goals this exercise supports — essential means it's a cornerstone:

Evidence Sources (10)