Prone Over Bed Hip Abduction-Extension-External Rotation: An alternative Exercise for Posterior Gluteus Medius (AKA: the clam)

A number of years ago, I saw a need to have an exercise for posterior gluteus medius that solved the issues related to the clam. In a previous post I mentioned some issues

1. piriformis as an external hip rotator
2. instability/microinstability
3. inhibition with chronic pain

This was one option I came up with.

The patient lies prone over the bed (approximately 45° hip flexion). They external rotate the hip to end range and extend and abduct the hip.

This serves to load the hip to overcome the inhibition and engage the extension component of posterior gluteus medius. The angle (and avoidance of extension in the sagittal plane)  protects from extension or end range related instability.

If you are concerned about the unlocking of the SIJ with limb load, this angle also protects against that (most of the time) as well as the extension of the lumbar spine.