(http://marinosbodyshop.com/posts/1150/ ) – goes through a fairly detailed analysis of the epidemiology of anterior cruciate ligament injuries and how specialized training can prevent, not simply rehab, them.
I’ve written many times on this topic over the years because it’s a fascinating one from a biomechanics and conditioning perspective. Furthermore, it’s an area of study that has unintentionally led to many advances in how we diagnose and treat, and prevent, a variety of other injuries to the lower extremities. If one phrase, one anatomical area, stands out as a result of the studies on ACLs, because of its involvement in hip, knee, ankle and even foot and low back problems, it’s “gluteus medius”. (Gluteus maximus is aslo implicated but not to the extent the glute med is.) And, as such, for all the other exercises that ‘hit’ that muscle group, the one that is chronically and constantly used in a physical therapy environment and should be considered in a pre-hab program even for athletes and the elderly, the clam shell is that exercise. Simple to peform, able to be done at least twice a day by virtue of logistics (as you’ll soon realize), and non-weight bearing so therefore safe and effective early on for novices, injured or hurting people, and for prophylactics, the clam shell is something to add to your regimen.
So how do you do it? Simple: lie in bed! That’s why I say it’s easy to do twice a day – when you wake up and when you go to sleep.
Lie on your side – obviously on each side although if you have an injury to one side that seems to dominate your concerns, do more sets on that side – with a pillow under your head so your neck is neutral. Bend both knees so they are stacked with the top knee on the bottom one; also have your feet stacked likewise. Now – and this is the hard part- raise the top knee off the bottom one WITHOUT turning the trunk backwards. Hold for 3-5 seconds and start with a set of 10. Do 2-3 sets per leg. Gradually add a couple to three reps to each leg on each set every third or fourth session until you can do, without cheating by rolling the butt back, 30 reps of 5 second holds. Oila! you are training the glute med which will help manage and prevent low back, hip, knee and ankle problems, maybe even preventing falls.
Are there better exercises? Sure – squats, lunges, step ups, etc – but these are weight bearing and require the right equipment. You’re in your ‘gym’ twice a day – take advantage of your bed as many ways exist to prevent injury but none so simple as the clam shell exercise.
And if you have trouble making it work right – you should feel it on the back side of the side of your butt – then contact any trainer for guidance on how to do it right. And if you need more information on how to progress to where you are able to reduce your dependence on a bed-based exercise, again, call STEPS Fitness for an evaluation and exercise program that you cannot overvalue even if you don’t have the means. It may make the total difference between injury, pain and disability…or living a life of REAL fitness.