11/02/2026
I had a the pleasure of seeing Julie last week who unfortunately sustained a traumatic neck of femur fracture 🦴 7months ago resulting in a total hip replacement.
She has always been a-bit of a force to reckon with, she has high expectations and historically has been physically fit, including weekly Pilates. She’s basically the perfect physio patient.
In Pilates this week her teacher pointed out she couldn’t do an ‘Oyster’/ ‘clam’. Julie said there was no pain but she just physically couldn’t do it, understandably this was upsetting for Julie because to her this is a simple exercise she’s done for years!
Despite Julie thinking this is a simple exercise i think this is actually quite a difficult exercise. It heavily loads the glut medius and more specifically the tendon. It requires joint rotation through range meaning you also need flexibility to do this exercise. It’s not an exercise I prescribe regularly but this was a personal goal and important for Julie’s mental health and grappling with the concept she’s not YET as strong as she once was.
I stupidly didn’t get a video of her before we started but imagine someone who couldn’t get a gap between their knees when trying to do an Oyster. What we then did was start to actively engage the muscles via a warm up, this included work in 4 point kneeling.
Then we moved into an Oyster position but with lumbar support for feedback (we used the foot stool). We used a Pilates ball and practiced the exercise again, this time instead of expecting the muscles to work from outer to inner range, the ball allowed Julie to work from mid to inner range. This meant her gluts were still being loaded but less was being asked of them.
After 2-3minutes of muscle activation doing this with the ball, I took the ball away. Julie was then able to do a full Oyster/Clam through range. We have kept the lumbar support for the moment.
This is about understanding how to regress and progress exercises. It might be progressions in muscle strength involve increasing reps or load, in this case we changed the length the muscle had to work at.
Well done Julie!