A Simple Tweak to Enhance Glute and Reduce TFL Activity

Hip weakness is a common area of focus in both the rehabilitation and fitness fields.  Combine our excessive sitting postures and the majority of activities during the day that occur in the sagittal plane of motion, and hip weakness in the frontal and transverse planes is common.

There are many exercises designed to address glute medius and glute maximus strength in the transverse plane.  But a simple tweak to your posture during one of the most common exercises can have a big impact on glute activity and the balance between your glutes and TFL.


The Effect of Body Position on Lateral Band Walking

A recent study in JOSPT analyzed EMG activity of the glute max, glute medius, and TFL muscles during two variations of the lateral band walking exercises.

The subjects performed the lateral band walk in a standing straight up posture and a more flexed squat position.

A Simple Tweak to Enhance Glute and Reduce TFL Activity

I’ve personally used both variations in the past but tend to perform the exercise more often in the slightly flexed position, which we consider a more “athletic posture,” as we don’t really walk laterally with our hips and knees straight very often.

Results showed that EMG of both the glute max and glute medius was enhanced by performing lateral band walks in the partial squat position, and that TFL activity was actually reduced.  Glute activity almost doubled.


A Simple Tweak to Enhance Glute and Reduce TFL Activity

The finding of reduced TFL activity is just as important as enhanced glute EMG activity, as the ratio of glute medius to TFL is greatly enhanced by performing the lateral band walk in this athletic position.

Sometimes it’s the simplest studies that make the most impact.

The TFL also acts as a secondary hip flexor and internal rotator of the hip.  In those with glute medius weakness, which is fairly common, the TFL tends to be overactive to produce abduction of the hip.

Considering how our chronic seated posture can cause shortening of the hip flexors and we know many knee issues can arise from too much dynamic hip internal rotation and glute medius weakness, we often try to focus on developing the glute medius ability to become more of the primary muscle involved with abduction, instead of the TFL.

Another interesting finding of the study was that the stance limb, not the moving limb, had higher EMG activity for every muscle in both positions.  This shows the importance of the stance abductors in providing both a closed kinetic chain driving force as well as a lumbopelvic stabilizing force when the moving limb transitions to nonweightbearing.

We focus a lot on abduction based exercises to strengthen the glute medius, but closed kinetic chain exercises in single leg stance may be just as important to train the hip to stabilize the lower extremity.

One thing I would add is that I rarely perform this exercise with the band at the ankles as the authors did.  I much prefer to put the band around the knee and feel it helps develop better hip control.

Based on this study, I’m not sure I see why I would perform a lateral band walk in a tall upright posture.  I’m going to maximize glute activity and reduce TFL activity by doing the exercise in a more flexed athletic position.


Anterior Pelvic Tilt Influence on Squat Mechanics

anterior pelvic tilt influences squat mechanicsI feel like we’ve been discussing anterior pelvic tilt lately in several articles and an Inner Circle webinar on my strategies for fixing anterior pelvic tilt.  I wanted to show a video of a great example of how a simple assessment really tells you a lot about how pelvic positioning should influence how we coach exercises such as squats and deadlifts.

If you haven’t had a chance to read my past article on how anterior pelvic tilt influences hip range of motion, you should definitely start there.

In this video, I have a great example of a client that has limited knee to chest mobility and with boney impingement.  However, if we abduct the leg a bit, it clears the rim of the hip and has full mobility with no impingement.

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As you can see, because he is in anterior pelvic tilt, he is prepositioned to start the motion in hip flexion, so therefor looks like he has limited mobility.  I have a past article on how anterior pelvic tilt influence hip flexion mobility, which discusses this a little more.

While you are working on their anterior pelvic tilt, you can work around some of their limitations.  I hate when people say there is only one way to squat or deadlift.

Our anatomy is so different for each individual.

Some need a wider stance while others need more narrow.  Some need toes out while some need more neutral.  Do what works best for your body, not what the text book says you are supposed to look like.



Should We Stop Blaming the Glutes for Everything?

Today’s guest post comes from John Snyder, PT, DPT, CSCS.  John, who is a physical therapist in Pittsburgh, has a blog that has been honored as the “Best Student Blog” by Therapydia the past two years.  He’s a good writer and has many great thoughts on his website.  John discusses some of our common beliefs in regard to the role of the proximal hip on knee pain.  I’ll add some comments at the end as well, so be sure to read the whole article and my notes at the end.  Thanks John!


Should We Stop Blaming the Glutes for Everything?

should we stop blaming the glutes

Anterior cruciate ligament (ACL) rupture1,2 and patellofemoral pain syndrome (PFPS)3,4,5 are two of the most common lower extremity complaints that physicians or physical therapists will encounter. In addition to the high incidence of these pathologies, with regards to ACL injury, very high ipsilateral re-injury and contralateral injury have also been reported6,7,8.

With the importance of treating and/or preventing these injuries, several researchers have taken it upon themselves to determine what movement patterns predispose athletes to developing these conditions. This research indicates that greater knee abduction moments9,10, peak hip internal rotation11, and hip adduction motion12 are risk factors for PFPS development. Whereas, for ACL injury, Hewett and colleagues13 conducted a prospective cohort study identifying increased knee abduction angle at landing as predictive of injury status with 73% specificity and 78% sensitivity. Furthermore, as the risk factors for developing both disorders are eerily similar, Myer et al performed a similar prospective cohort study finding that athletes demonstrating >25 Nm of knee abduction load during landing are at increased risk for both PFPS and ACL injury14.


Does Weak Hip Strength Correlate to Knee Pain?

With a fairly robust amount of research supporting a hip etiology in the development of these injuries, it would make sense that weakness of the hip musculature would also be a risk factor, right?

A recent systematic review found very conflicting findings on the topic. With regards to cross-sectional research, the findings were very favorable with moderate level evidence indicating lower isometric hip abduction strength with a small and lower hip extension strength with a small effect size (ES)15. Additionally, there was a trend toward lower isometric hip external rotation and moderate evidence indicates lower eccentric hip external rotation strength with a medium ES in individuals with PFPS15. Unfortunately, the often more influential prospective evidence told a different story. Moderate-to-strong evidence from three high quality studies found no association between lower isometric strength of the hip abductors, extensors, external rotators, or internal rotators and the risk of developing PFPS15. The findings of this systematic review indicated hip weakness might be a potential consequence of PFPS, rather than the cause. This may be due to disuse or fear avoidance behaviors secondary to the presence of anterior knee pain.


Does Hip Strengthening Improve Hip Biomechanics?

Regardless of its place as a cause or consequence, hip strengthening has proved beneficial in patients with both PFPS16,17,18 and following ACL Reconstruction19, but does it actually help to change the faulty movement patterns?

Gluteal strengthening can cause several favorable outcomes, from improved quality of life to decreased pain, unfortunately however marked changes in biomechanics is not one of the benefits. Ferber and colleagues20 performed a cohort study analyzing the impact of proximal muscle strengthening on lower extremity biomechanics and found no significant effect on two dimensional peak knee abduction angle. In slight contrast however, Earl and Hoch21 found a reduction in peak internal knee abduction moment following a rehabilitation program including proximal strengthening, but no significant change in knee abduction range of motion was found. It should be noted that this study included strengthening of all proximal musculature and balance training, so it is hard to conclude that the results were due to the strengthening program and not the other components.


Does Glute Endurance Influence Hip Biomechanics?

All this being said, it is possible that gluteal endurance may be more influential than strength itself, so it would make sense that following isolated fatigue of this musculature, lower extremity movement patterns would deteriorate.

Once again, this belief is in contrast to the available evidence. While fatigue itself most definitely has an impact on lower extremity quality of movement, isolated fatigue of the gluteal musculature tells a different story. Following a hip abductor fatigue protocol, patients only demonstrated less than a one degree increase in hip-abduction angle at initial contact and knee-abduction angle at 60 milliseconds after contact during single-leg landings22. In agreement with these findings, Geiser and colleagues performed a similar hip abductor fatigue protocol and found very small alterations in frontal plane knee mechanics, which would likely have very little impact on injury risk23.


Can We Really Blame the Glutes?

The biomechanical explanation for why weakness or motor control deficits in the gluteal musculature SHOULD cause diminished movement quality makes complete sense, but unfortunately, the evidence at this time does not agree.

While the evidence itself does not allow the gluteal musculature to shoulder all of the blame, this does not mean we should abandon addressing these deficits in our patients. As previously stated, posterolateral hip strengthening has multiple benefits, but it is not the end-all-be-all for rehabilitation or injury prevention of lower extremity conditions. Proximal strength deficits should be assessed through validated functional testing in order to see its actual impact on lower extremity biomechanics on a patient-by-patient basis. Following this assessment, interventions should be focused on improving proximal stability, movement re-education, proprioception, fear avoidance beliefs, graded exposure, and the patient’s own values, beliefs, and expectations.


John SnyderJohn Snyder, PT, DPT, CSCS received his Doctor of Physical Therapy degree from the University of Pittsburgh in 2014. He created and frequently contributes to (Formerly, which is a blog devoted to evidence-based management of orthopedic conditions.  


Mike’s Thoughts

John provides an excellent review of many common beliefs in regard to the influence of the hip on knee pain.  While it is easy to draw immediate conclusions from the result of one study or meta-analysis, one must be careful with how they interpret date.

I think “anterior knee pain,” or even PFPS, is just too broad of a term to design accurate research studies.  It’s going to be hard to find prospective correlations with such vague terminology.  Think of it as watering down the results.  Including a large sample of people, including men, women, and adolescents and attempting to correlate findings to “anterior knee pain” is a daunting task.

Imagine if we followed a group of adolescents from one school system for several years.  Variations in gender, sport participation, recreational activity, sedentary level, and many more factors would all have to be considered.  Imagine comparing the development of knee pain in a 13 year old sedentary female that decided she wanted to run cross country for the first time with an 18 year old male basketball player that is playing in 3 leagues simultaneously.  Two different types of subjects with different activities and injury mechanisms.  But, these two would be grouped together with “anterior knee pain.”

What do we currently know?  We know hip weakness is present in people with PFPS and strengthening the hips reduces symptoms.  As rehabilitation specialists, that is great, we have a plan.  I’m not sure we can definitely say that hip weakness will cause knee pain, but I’m also not sure we can say it won’t.  Designing a prospective study to determine may never happen, there are just too many variables to control.

John does a great job presenting studies that require us to keep an open mind.  I’m not sure we can make definitive statements from these results, but realize that there are likely many more variables involved with the development of knee pain.  Hip strength and biomechanics may just be some of them.  Thanks for sharing John and helping us to remember that it’s not always the glutes to blame!



Updated Strategies for Anterior Pelvic Tilt

The latest Inner Circle webinar recording on the Strategies for Anterior Pelvic Tilt is now available.

Updated Strategies for Anterior Pelvic Tilt

strategies for anterior pelvic tiltThis month’s Inner Circle webinar was on Strategies for Anterior Pelvic Tilt.  This is actually an update on one of my most popular webinars in the past.  I am doing a couple new things and wanted to assure everyone has my newest thoughts.  In this webinar I go through my system of how I integrate manual therapy, self-myofascial release, stretching, and correcting exercises.  To me, it’s all how you put the program together.  My system builds off each step to maximize the effectiveness of your programs.

Hip Rotator Cuff

Hip Rotator CuffThe latest Inner Circle webinar recording on the Hip Rotator Cuff is now available.

Hip Rotator Cuff

This month’s Inner Circle webinar on the rotator cuff of the hip was great.  We discussed how our knowledge of the hip has continued to increase over the last decade and has resulted in a much better understanding of how the hip is involved in the mechanics of the lower body and stabilization in multiple planes of motion.  We then broke down the hip musculature as either prime movers or prime stabilizers, and discussed how different positions and exercises impact both of these different muscles groups.

If this sounds familiar, it is, we use the analogy of the shoulder to show the similarities between the hip and the shoulder.

To access the webinar, please be sure you are logged in and are a member 0f the Inner Circle program.

A Simple Dynamic Stability Exercise for the Leg [Video Demo]

This week’s post is a video demonstration of a simple way to integrate reactive neuromuscular training (RNT) into your programming to enhance dynamic stabilization of the lower extremity.

Reactive Neuromuscular Training for Dynamic Stabilization of the Lower ExtremityIn this video, I show a client that has an ankle sprain.  While going through her rehabilitation, it became clear that she also needed balance training to really work her ankle, knee, and hip to stabilize during functional tasks.

To perform this exercise, you simple need a large resistance band (which are great from many stretching, strengthening, and stability exercises – here are the ones I use).  Loop the band around a rack or other object and step within the loop.  Place the band just above your knee.

I show a few exercise ideas in the video, progressing from simple balance, to unstable surfaces, to incorporating functional movements.  By using the band, you can emphasize training the bodu’s ability to stabilize in the frontal and transverse planes while performing a sagittal plane exercise.  This is essential to optimal function and a big key to my Functional Stability Training program.

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Groin Injuries in Hockey Players

Today’s guest post on Groin Injuries in Hockey Players is from Peter Nelson.  Peter is currently working in collegiate hockey and has shown great interest in understanding why groin injuries are so common and what we can do about it.  Peter does a great job thinking outside the box and taking a look at the bigger picture.  Thanks Peter, great article, I’ll add some of my own comments at the end.


Groin Injuries in Hockey Players: An All-Too-Common Problem With a Not-So-Commonly Known Solution

going injuries in hockey playersBeing a former competitive hockey player (admittedly not a very good one—fourth line for life!) and working predominately with hockey players in a strength and conditioning capacity for the last few years, it has become clear to me that hockey players and groin injuries go together like the artist formerly known as Ron Artest and his psychiatrist.  Gold star if you get the reference.   (photo by David Shane)


Examining the Prevalence of Groin Injuries Among Hockey Players

While this relationship exists at almost all levels of the game, it has been particularly well documented in elite players.  Several studies have been conducted to assess the prevalence of this specific injury at the professional level.  The results have been consistent, and they are troubling.

A 1978 study by Sim et al. concluded that “ice hockey players are at high risk for noncontact musculoskeletal injuries because of the excessive force generated during the acceleration and deceleration phases of skating.”

A 1997 study by Molsa et al. reported that 43% of muscle strains in elite Finnish hockey players were involving the groin region.

A 1999 study by Emery et al. found that “the impact of groin and abdominal strain injury at an elite level of play in hockey is significant and increasing.”  According to their data, the rate of groin/abdominal strains in the NHL increased from about 13 injuries per 100 players per year during the 1991-1992 season to almost 20 injuries per 100 players per year during the 1996-1997 season.  Furthermore, the recurrence rate was 23.5%, meaning that injuries of this nature went on to plague a significant percentage of players for an extended period of time.

More recently, a study by Tyler et al. found that out of 9 NHL players evaluated, all of whom had suffered from groin injuries, four had sustained multiple strains.


The Long and Short of Groin Injuries: Muscular Imbalances in Athletes

With the strong correlation between hockey players and groin injuries established, it becomes important to understand why this is the case.  Many would be quick to attribute it to the violent nature of the sport, but research indicates that this is unfounded.  The study by Emery et al. found that upwards of 90% of all groin injuries were non-contact in nature.  Others posit that strains are due to the muscles involved being too short and lacking flexibility.

Sports physicians, physiotherapists, and strength coaches who fall under this category often prescribe stretching of the groin musculature to remedy the issue.  The study by Tyler et al., however, found that preseason flexibility of the hip adductors, the primary muscles that make up the groin region, did not differ between NHL players who went on to sustain groin strains and those who did not.  This indicates that stretching of the groin is probably not an effective approach toward preventing or treating this type of injury.

What the Tyler et al. study did find was that preseason hip adduction strength of the players who sustained groin injuries was 18% lower than that of the healthy players.  They also found that adduction strength was 95% of abduction strength in the uninjured players, compared to only 78% in the injured players.  This suggests that a muscular imbalance between the weak adductors and the relatively strong abductors plays a large role in groin issues.  The Sim et al. study also supports this view, suggesting that “in ice hockey players, adductor strains may be caused by the eccentric force of the adductors attempting to decelerate the leg during a stride.”  The researchers further went on to state that “a strength imbalance between the propulsive muscles and stabilizing muscles has been proposed as a mechanism for adductor muscle strains in athletes.”


Detective Work: Delving Deeper to Identify the Root of the Problem

The logical conclusion then should be that the solution is to strengthen the adductors and stretch the abductors, right?  Well, yes, but a more in-depth look at the problem is necessary to determine exactly why this imbalance is present in the first place, that way we can most effectively remedy the issue.  As a sports physician, physical therapist, or strength coach, you are not truly solving the problem unless you address the root cause.

In order to identify the root cause, it is important to first consider three main concepts.  First, it is imperative to understand the biomechanics of skating.  This brief excerpt from the study by Sim et al. sums it up very well:

“During the powerful skating stride the hip extensors and abductors are the prime movers, while the hip flexors and adductors act to stabilize the hip and decelerate the limb.”


Janda Lower Body Cross SyndromeThe second concept to understand is that these specific movement patterns have a profound effect on the relative strength—and consequently length—of the muscles involved.  Because hockey players, like most athletes, spend so much time in extension, the spinal erectors become extremely tight.  The same is true of the hip flexors, which become tight due to the constant forward lean seen in an “athletic stance” as well as the strength required to overcome the aforementioned eccentric force needed to slow down the leg in the recovery phase of a skating stride.

Consequently, since the hip flexors pull the pelvis down from the front and the spinal erectors pull the pelvis up from the back, the pelvis becomes tilted anteriorly.  This lengthens the hamstrings, putting them at a leverage advantage and forcing them to take on more of the load in extending the hips than the glutes.  The glutes then become relatively weak, as does the anterior core.  The end result is a player with what Janda called “lower-crossed syndrome”, illustrated below, who is at risk for both low back and hamstring injuries.

How does this play into groin injuries?  In order to make that connection, you need to understand the third concept, which is a central tenet of the Postural Restoration Institute (PRI): while muscles are often prime movers in a single plane, they must actually be considered as having an effect on movement in all three planes—sagittal, frontal, and transverse.

The perfect example of this is the hip extensors.  While the hip extensors are mostly responsible for movement generated in the sagittal plane, these same muscles—most notably the gluteus maximus—function as external rotators and abductors.  This is relevant to hockey because the nature of a skating stride requires players to have strong abductors—they are prime movers in this movement—as well as spend a lot of time in external rotation.  This tightens both the external rotators and abductors and pulls the hips into chronic external rotation and abduction, or in other words causes them to become “flared”.  Adductor muscles like the adductor magnus, which also contribute to internal rotation, become lengthened and, like the hamstrings in the sagittal plane, are put at risk for injury.  This clearly fits the theory of a muscle imbalance as the potential contributor to groin injuries, and it becomes clear from the analysis above that pelvic alignment is important in understanding the root cause of this imbalance.

It also makes it apparent that stretching the groin is not only ineffective; it can actually feed right into the problem!


Shifting Into Neutral: Correcting Pelvic Positioning

That brings us to the million-dollar question: how do we fix it?  After coming to the understanding that groin issues are caused by pelvic misalignment in all three planes of movement, you can see why I suggested that strengthening the internal rotators and stretching the external rotators is not a comprehensive solution to the problem.  We must address muscular imbalances with the triplanar perspective in order to effectively prevent injuries of this nature.

The first plan of attack should be to rectify the imbalances in the sagittal plane.  The reason being is simply that extension limits rotation, and since I already explained that hockey players—and athletes in general—tend to live in chronic extension, it makes sense to resolve that problem first in order to maximize the effectiveness of attempts at repositioning an athlete in the other two planes.  I group the frontal plane with the transverse plane, even though I am talking about rotation being limited, because there is significant overlap between the prime movers in abduction/adduction and internal/external rotation.

Addressing the imbalances in the sagittal plane is fairly straightforward.  I like the approach Mike Robertson takes in identifying two “force couples”.  The posterior force couple consists of the anterior core and the posterior chain (primarily the glutes and hamstrings), and these two will be weak in athletes living in extension, as I previously mentioned.  Hammering the glutes and hamstrings with exercises like hip thrusts (demonstrated by Bret Contreras below) and Romanian Deadlifts, respectively, will strengthen the posterior chain and tilt the hips posteriorly by pulling them down from the back, the net result being a more neutral alignment since the athlete was in anterior tilt to begin with.  With the anterior core, it is important to note that it is the internal obliques, external obliques, and transverse abdominis that are usually weak, as opposed to the rectus abdominis.  Strengthening these muscles will tilt the hips posteriorly by pulling them up from the front, also resulting in a more neutral alignment.

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The anterior force couple consists of the spinal erectors and the hip flexors, and these two will be tight.  Stretching the hip flexors is crucial; this can be accomplished with stretches like the Bench Hip Flexor Stretch, illustrated by Tony Gentilcore.  Self-myofascial release can also be useful.

groin injuries

With the Bench Hip Flexor Stretch, the harder the athlete squeezes the glutes and extends at the hips, the greater the stretch on the rectus femoris.  Be careful, however, not to allow the athlete to extend at the lumbar spine, as this reinforces the incorrect movement pattern we are trying to move away from.

Stretching the spinal erectors can be accomplished with “prayer position”-type stretches.  Self-myofascial release with a lacrosse ball peanut can also be effective.  In working with Head Strength Coach Rob McLean and the Pennsylvania State University Men’s Ice Hockey team, we tend to use exercises with movement patterns that inhibit the paraspinals while also activating the anterior core, such as the exercise from the Postural Restoration Institute shown below, demonstrated by Kevin Neeld.

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In this case, we are killing two birds with one stone in strengthening the weak muscles and teaching the athletes to inhibit the tight muscles (notice how Kevin’s back is rounded; this helps to inhibit the spinal erectors) at the same time.  You can also see that in the video there is a ball between Kevin’s knees—this is to activate the internal rotators/adductors, which I will discuss next.

Addressing the frontal and transverse planes when it comes to fixing pelvic alignment is overlooked too often.  Again, we want to strengthen the internal rotators and adductors—the muscles might largely overlap but it is important to pattern both movements individually—and stretch the external rotators and abductors.  For internal/external rotation, med ball crushes is a good one to strengthen internal rotation (note that this exercise can also pattern the adduction movement, depending on how it is performed), and knee-to-knee mobilization is good for both activating the internal rotators and stretching the external rotators.  Any exercises that target the semimembranosus (the most medial hamstring muscle) will also help strengthen the internal rotation movement.  An easy modification to an already great exercise, which I mentioned earlier, that will help in this regard is having athletes internally rotate the legs during the hip thrust.  Here at Penn State we have started doing band-resisted hip thrusts with internal rotation, and Coach McLean and I both like how it hits the internal rotators.  Considering that it also strengthens the posterior chain, you’re really killing two birds with one stone in repositioning the pelvis with this small tweak.

There are also a number of good exercises for patterning and strengthening the adduction movement.  Adductor Side Bridges, demonstrated below by Kevin Neeld, are great in this regard.

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The adductor pullback exercise from PRI, demonstrated below also by Kevin Neeld, is another good one.

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We have our players perform the adductor pullback exercise only on the left side (so they would be lying on their right side, as Kevin is in the video) to address the left AIC alignment that I mentioned earlier.  Doing the opposite by lying on your left side and shifting your right hip forward and externally rotating it (since the right leg tends to be internally rotated) also helps correct this particular alignment.



Simply put, pelvic positioning is an important piece in preventing groin injuries, which affect athletes in all sports, but are especially a problem amongst hockey players.  The three main concepts to remember in assessing pelvic positioning in any athlete are 1) understanding the biomechanics of the sport, 2) identifying the effects these movements have on the muscles involved, and 3) considering muscles as contributors to movement in all three planes, even if they are not prime movers in one or more of those planes.  These concepts can be applied in order to identify imbalances in an athlete and the effects they have on the position of the pelvis. Once this is accomplished, a program can be designed so that the imbalances can be corrected and the pelvis returned to neutral.  After all, neutral is where we want our athletes to be, as that puts them at the lowest risk for injury.  And any reputable strength coach knows that keeping athletes healthy is the primary objective in any program.  You can’t translate gains in strength and power to the playing field if you’re stuck on the sidelines.


Mike’s Thoughts

I think Peter did a great job with this article, highlighting the need to start thinking about alignment and triplanar function of the body.  These are often missed in our critical thinking.  The only thing I would add to this great article is that the real goal of working to enhance alignment is to then allow you to train the body in better neutrality.  We may not function in neutral, but you don’t want to be stuck in our poor alignment.  You want to be able to get out of your asymmetry when needed.

Every athlete I have worked with that is “stuck” in their asymmetry is prone to recurrent injuries.  We’ve all had them, right?  The person that just keeps straining their groin, or hamstring, etc.  Take a step back and think of the 3 principles that Peter summarizes in his conclusion.

If you like information like this, I’ve discussed concepts like triplanar training of the glutes.  These are some of the fundamental principles in my Functional Stability Training of the Lower Body program with Eric Cressey.  We discuss a lot of concepts related to alignment, triplanar function of the body, and training the body in 3D.

Functional Stability Training for the Lower Body

About the Author

Peter Nelson is a Strength and Conditioning Staff Intern with the Pennsylvania State University Men’s Ice Hockey Team.  He graduated in 2012 from Phillips Academy Andover, and is currently a sophomore at Penn State’s University Park Campus.  Peter is a former competitive hockey player, having played for Andover’s Varsity Hockey Team for three years in Division 1 of the New England Prep School Ice Hockey Association.  While he no longer plays competitively, his longtime involvement in sports has driven his interest in research fields such as nutrition and strength and conditioning.  He has previously interned at NIKE SPARQ-affiliated Athletic Evolution in Woburn, MA.  Peter is greatly looking forward to continuing to work under Head Strength and Conditioning Coach Robert McLean of the Penn State Men’s Hockey Team and continuing his education in pursuing a career in the health and fitness realm.

Note: I’d like to thank Coach Rob McLean, Head Strength and Conditioning Coach for the Pennsylvania State University Men’s Ice Hockey Team, for taking me under his wing and introducing me to and helping me understand important concepts like those presented by the Postural Restoration Institute.  Much of this article reflects what I have learned over the course of the past year while working with him and the hockey team as an intern.  I sincerely appreciate the opportunity.



  • Sim FH, Simonet WT, Melton LJ III, et al: Ice hockey injuries. Am J SportsMed 15: 30–40, 1987.
  • Molsa J, Airaksinen O, Näsman O, Torstila I. Ice hockey injuries in Finland: a prospective epidemiologic study. Am J Sports Med. 1997;25(4):495-499.
  • Emery CA, Meeuwisse WH, Powell JW. Groin and abdominal strain injuries in the National Hockey League.. Clin J Sport Med. 1999;9(3):151-156.
  • Tyler TF, Nicholas SJ, Campbell RJ, McHugh MP. The association of hip strength and flexibility on the incidence of groin strains in professional ice hockey players. Am J Sports Med. 2001;29(2):124-128.
  • Robertson, Mike. March 3, 2007. “Hips Don’t Lie: Fixing Your Force Couples.T Nation.






Simple Tweak to Maximize the Hip Clam Exercise

This week I wanted to share a quick video of a very simple tweak to maximize the hip clam exercise by really firing the glutes.  Rather than perform a standard hip clam exercise, the tweak is what you do after you lay down on your side with your hips bent to 45 degrees and knees at 90 degrees.  From this position, I want you to push your top knee outward, as if it were longer than the bottom knee.

Hip Clam Exercise with a Plus - Mike ReinoldI like to coach this by placing the hand on your hip to assure that you stabilize the upper half of your body from rolling too much.  In this position you can also really palpate the glutes with that hand while they are firing.  I also like to again coach them to push their knee out at the top of the clam, as well.

Notice that the amount of hip opening is not that much.  Essentially, by pushing your top knee outward, you are rotating your pelvis and placing the hip in a more abducted and externally rotated position.  This will allow the posterior fibers of the gluteus medius to really turn on, and also kick in the external rotation fibers of the gluteus maximus.  But you also preposition yourself in some external rotation, so the amount of clam opening will be less.  You should avoid opening the knees too much and rocking your upper body backward.  This is a common goal in the PRI world, who often describe this exercise and use it for pelvic reposition and integration exercises on the right side.  (For the PRI clinicians reading, this will obviously be familiar, for the fitness enthusiasts reading this, I recommend you get evaluated to see exactly what your body needs).

I’ve talked about how important the hip clam exercise is in the past and my past videos were pretty popular on the Mike Reinold Youtube page, so this is just another tweak you can add to your toolbox.

Simple tweak, right?  Try it!  Do a set of standard clams and then another with your top knee pushed outward, your glutes will be on fire!

If you are wondering, I called this the “Hip Clam Exercise with a Plus” in an article in Men’s Health, sort of like the “Push Up with a Plus” exercise for the serratus anterior.


Hip Clam Exercise with a Plus

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Did you try it?  Are your glutes on fire?  What did you think about this simply variation of the hip clam exercise?




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