If you’ve been in physical therapy for months and you’re still doing clamshells… you’re probably not getting the strength and stability you actually need.
Clamshells aren’t bad — they have a place early in rehab — but they quickly reach a point of diminishing returns. You can feel the burn, you can feel the muscles working, but they don’t translate well to real-life movement, running, jumping, or lifting.
If your goal is to rebuild function, clamshells alone won’t get you there.
Here are the three exercises every patient should progress to once symptoms calm down and activation is established and why they matter so much more for long-term hip, knee, and low-back resilience.
Clamshells serve a purpose when:
You’re early post-injury
You need gentle activation
You’re calming symptoms
You’re retraining the brain to find the glutes again
But after a few weeks, your body adapts. Clamshells become too easy, too isolated, and too far removed from how your hips actually work during functional movement.
Your hips don’t need more burning reps lying on your side. They need real load, real stability, and real coordination.
That’s where the next three exercises come in.
If the clamshell is the kindergarten version of hip external rotation, the standing hydrant is the high-school level.
It forces your body to:
Control rotation
Stabilize on a single leg
Maintain alignment through the knee and ankle
Keep the trunk organized
Build strength in a standing position — the way you actually use your hip
Place a band around your knees or just above them.
Stand with a soft bend in your knees.
Shift your weight into one leg while keeping your pelvis level.
Push the opposite knee outward against the band without rotating your whole body.
This builds real glute strength and trains your hip the way you actually move in life and sport.
Standing hydrants mimic the stabilization you need for:
Running
Cutting
Squatting
Stepping
Jumping
It’s the first progression after clamshells, not months later.
If standing hydrants teach static control, step outs teach dynamic control — the type your knee and hip need when your foot hits the ground at speed.
Lateral hip strength
Knee alignment control
Foot tripod engagement
Hip-to-core coordination
Stability under movement
Every time you take a step when running, you’re essentially doing a single-leg squat on a moving platform. If your hip or knee collapses inward, that force doesn’t disappear; your tissues absorb it.
This is where IT-band pain, patellofemoral pain, glute inflammation, and even shin splints often begin.
Step outs teach your hip to handle that load the right way, shifting stress away from your knee and distributing it through your posterior chain.
Reverse lunges are the king of progressions from clamshells because:
They load the hip through a large range of motion
They reinforce proper knee tracking
They build single-leg strength
They improve balance and trunk control
They mirror real sport demands
And unlike forward lunges, reverse lunges:
Reduce anterior knee shear
Encourage hip dominance
Are safer for irritated or sensitive knees
When you walk, run, jump, or climb stairs, your knee needs to track in line with your toes while your hip stabilizes from above. Reverse lunges teach that relationship under load.
They also give you something clamshells never will:
Strength
Power
Coordination
Transferable athletic movement
This is one of the most important exercises for anyone recovering from knee pain, hip weakness, or any lower-body injury.
If any of these sound familiar, you should progress immediately:
You’ve been doing clamshells > 4–6 weeks
You feel the burn but notice no improvement in strength
You can’t translate them to standing control
Your knee still collapses inward when you squat
Your hip still feels weak during daily activities
Your PT sessions feel stagnant
You’re not being challenged in multiplanar movement
Your rehab should evolve, always.
If you’ve been stuck in the same place, it’s not because your body isn’t progressing… it’s because your program isn’t.
Real hip stability isn’t lying on your side opening your knees.
Real hip strength is:
Preventing knee collapse during squats
Maintaining alignment while running
Stabilizing through sudden changes of direction
Generating power from the hips, not the knees
Handling load through angles, depth, and movement
Clamshells do not train this. Standing hydrants, step outs, and reverse lunges do.
These are the movements that carry over into lifting, running, sports, stairs, walking, and daily life.
Strength that transfers is strength that lasts.
If your current rehab:
Has you stuck in clamshells
Doesn’t progress intensity over time
Doesn’t teach movement patterns
Doesn’t challenge stability or strength in standing
Doesn’t address how you move under load
…it’s not performance-based rehab.
And it’s not going to take you where you need to go.
At Bax Performance and Rehab, our athletes don’t spend months on the ground.
We get you moving — standing, loading, lifting, and training mechanics that translate directly into the way you live and perform.
Clamshells are not the problem.
Staying in clamshells is the problem.
If you want long-term hip stability, stronger knees, better movement patterns, and true resilience, you need to graduate into exercises that challenge your body the way life — and sport — actually do.
Your hips (and knees) will thank you.
Stop feeling stuck. Stop doing the same exercises. Start progressing.
We help athletes and active adults across Pleasanton and Livermore rebuild strength, stability, and performance from the ground up.
📞 Call/Text: (925) 397-0399
📧 Email: Abigail@BaxPerformanceRehab.com
Journal of Orthopaedic & Sports Physical Therapy – Hip Strength and Lower Extremity Control
Strength & Conditioning Journal – The Role of Lateral Hip Strength in Injury Prevention
British Journal of Sports Medicine – Glute Strength & Running Injury Prevention