How to Enhance Your Clam Shells Part 2

Introduction

If you haven't seen Part 1 of this article, I suggest you go back before reading this one. In part 1, we discussed the "why" and the biomechanics behind the two archetypes. In this article, we'll break down the "how" so we can stop guessing and start setting our patients up for success.

Topics discussed in this article:

• Text Book Execution
• Determination of Modifications
• Considerations for the Wide ISA
• Considerations for the Narrow ISA

If you're a visual learner, click the link below to watch the same topics discussed in this article

 "Text book" Execution

The foundations of teaching a clam shell a clam shell without adding the specific archetype considerations is as follows:

1. Have your patient in a side-lying position with their hips and knees bent around 75°
2. Make sure the head is neutral (use a pillow or patients other arm)
3. Keep shoulders stacked (shoulder over shoulder position)
4. Kip hips stacked (hip over hip position)
5. Slight posterior pelvic tilt
6. Keep knees stacked (knee over knee position
7. Keep angles stacked (foot over foot position)
8. Cue your patient to raise their knee as high as they can WITHOUT rolling the pelvis back

Determination of Modifications:

Although the wide and narrow ISA concepts may seem daunting at first, it's actually a more straightforward method to describe and represent the human body. There are only two concepts to remember for the modifications: compression and expansion.

You need to ask yourself, what part of my patient is being compressed and what part is being expanded? From there, you want to put them in positions and biomechanical advantages of what they usually lack. For example, if they're biased towards a compressed posterior pelvis, we want to bias an expanded posterior pelvis. Likewise, just the opposite will be prescribed for the opposite pattern.

Considerations for the Wide ISA

• Biomechanical Weakness: External Rotation, Abduction, Flexion
• Starting Position of Clam Shell: Weak
• Typical Clam Shell Response: Barely Feel Glute Contraction
• Modification: Posterior Pelvic Tilt, Increase Hip Flexion, Avoid anterior pelvic tilt

Considerations for the Narrow ISA

• Biomechanical Weakness: Internal Rotation, Adduction, Extension
• Starting Position of Clam Shell: Strong
• Typical Clam Shell Response: Complaining of Strong Glute Contraction
• Modifications: Potential Different Exercise (Single leg deadlift), Neutral pelvis, decrease hip flexion, avoid posterior pelvic tilt, may need anterior pelvic tilt