Transcript Kettlebells: Strengthening the Back and the Core

Using Kettlebells in the
Rehabilitation of the Core
Philip Johnson, MS, ATC
University of Michigan
Purpose of the Presentation
Understand the history of the Kettlebell
 Basic knowledge of the fundamental
exercises
 Uses in rehabilitation of low back injury
 Case reviews


“Core” definition
What is a Kettlebell?
Best described as a “cannonball with a
handle”
 Styles
 Fitness tool
 Rehabilitative tool

History of the Kettlebell
Russian background
 18th Century Russia

◦ Appeared in the Russian dictionary in 1704
 (Cherkikh, 1994)
Red Army
 1900’s Strongman
 1985 Soviet Union Sport

History- continued

Fitness Certifications:
◦ Russian Kettlebell
Certification (RKC)
◦ International Kettlebell and
Fitness Federation (IKFF)
◦ Art Of Strength (AOS)

Military Training/ FitnessSS Snatch test
◦ 10min: snatch 24kg, 200reps




MMA/ UFC
Crazy “fitness trend”??
Rehabilitation
Research???
Kettlebell Vs. Dumbell

Different weighted tools/ different load
◦ KB 6-8 inches out of center of hand
◦ Positions load anterior, posterior, moving

KB: “offset” load
◦ Primary use to reinforce movement patterns
◦ Focus on muscle group function in unison
◦ Less use in isolated strengthening
 Momentum driven
◦ Convenient for explosive patterns
◦ Grip strength
KB vs. DB

Cost $$:
KB
◦
◦
◦
◦
◦
◦
$35/36
45/41
60/55
70/65
80/75
100/95
8kg/ 18lb
12kg/ 26lb
16kg/ 35lb
20kg/ 44lb
24kg/ 53lb
32kg/ 70lb
(PB/PS) DB
$30/26
37/33
52/46
67/60
82/72
104/92
*reference: Perform Better(PB) and Power
Systems (PS)
Kettlebell Manufacturers

Art of Strength
Dragon Door
K2
Kettlebell Concepts
Gill
Perform Better
Ader
Lifeline
Power Systems
Troy
York
Wright
Apollo
Muscle Driver

RETAIL













My Experience



**I am NOT a certified instructor**
Not well educated/ experienced in Weight Room
June 2008: Perform Better Seminar
◦ Anthony DiLuglio
◦ www.artofstrength.com

Enter The Kettlebell –Pavel Tsatsouline
◦ Published 2006
◦ www.dragondoor.com
Additional Resources

Blogs/ Websites
◦
◦
◦
◦

www.begin2dig.com
www.chasingstrength.com Geoff Neupert
www.liftkettlebells.com
www.mikemahler.com
YouTube: “kettlebells”
◦ about 22,000 videos
Google
 DVD’s

Getting Started

Don’t be Intimidated!
◦ “Average” Male 16kg, “Strong” Male 20kg
◦ “Average” Female 8kg, “Strong” Female 12kg
◦ “Heavy” >32 kg; traditionally 48kg is heaviest
 (Tsatsouline, dragondoor.com)
◦ Can Find:
 92kg
Benefits of Kettlebell Use
Strengthening- Muscle integration rather
than Isolation
2. Endurance/ Cardiovascular
3. Power output
4. Grip
5. Efficiency of training/rehab
6. Reduces space needs/ Cost
7. Utilize a Balance of Tension and Relaxation
8. Hip Extension and Deceleration
9. Variety and Versatility
1.
Safety Issues
•
Surroundings- keep clear space
•
Start slow- practice
•
Focus on movements- setting down KB
• Low Back- flat back “anti-slouch”
•
Use Safety “Sense”
Benefits of Kettlebell Use in
Rehabilitation
Postural Correction/Improvement
 Reinforce Movement Patterns
 Strengthen Gross Movements

◦ CORE/HIPS!
Improve Return to Olympic Lifts
 Cardiovascular Stress

◦ (Schnettler, et al., 2010)
“Core” Specific Rehabilitation

Abdominal
◦ Unilateral loads; Single leg stance
◦ Functional abdominal activation

Hip
◦ Anterior (hip flexor)- Reciprocal inhibition
◦ Posterior (Glut/ Prox Ham)- Activation
◦ Restore normal Lumbo-pelvic-hip function

Latissimus Dorsi
◦ Eccentric arm control
◦ Spine stabilization

Upper/Lower Back
◦ Segmental stabilization
The SWING

THE fundamental
kettlebell exercise
◦ Base movement for
other exercises
Great posterior
chain work
 “dynamic” Deadlift
 HIP HINGE!!!

The SWING
The SWING
SWING- Breakdown

Hip Hinge
◦ Push butt back
◦ Keep back flat

Weight on Heels
◦ Wiggle toes
◦ Shins vertical

Eyes ahead
◦ Focus on spot in front

“Hike” hands
◦ Hike football
◦ Thumbs tight
◦ Reach through legs with
straight arms
SWING- Breakdown

Hip Drive
◦ Extend Hips

Chest out/ back flat
◦ Shoulder blades together

KB weightless
◦ Be able to let go- light
grip

Pendulum arms
◦ Move passively- rope like
◦ Momentum dependent
SWING- breakdown

Pull patella superior
◦ Pull knee cap to ceiling

Glut tight/ squeeze
◦ Hold a quarter in cheeks
◦ ER hip joint

Scapula retracted
◦ Chest out

KB to shoulder height
◦ Not crossfit“American” Swing
◦ Control with latissimus
dorsi
SWING- video
Swing- problems

Not enough weight
SWING- Problems

“Squatting the Swing”
Swing- problems

Weight Forward
Swing- problems

Hands too Low/ Rounded T-spine
Swing- problems

Low Back Hyperextension
The SWING

Quick Learning Curve

Active Core:
◦
◦
◦
◦
Gluteals
Hamstring- proximal
Upper Back
Low Back- no axial load, single plane, no rotation
 Stabilization
 Load away from body but controlled by hips
◦ Latissimus dorsi

Cardio
◦ 30s on/30s off
Rehabilitative Goals of the Swing
Back stabilization, muscular control
 Posterior hip activation:

◦ concentric glut to extend hip
◦ eccentric to decelerate
Anterior hip- reciprocal inhibition in erect
posture
 Improved hip musculature coordination
 “functional” abdominal contraction 
lower back reciprocal inhibition

Static Carry-McGill Bottoms UpOverhead Carry-Sidebend
Deadlift Variations
Deadlift- SUITCASE
Deadlift- Single leg w/ hand variation
Squat- Sumo
Squat- rack
Squat- Goblet
Squat- Swing flip to a Squat
Turkish Get Up
Turkish Get Up- continued
Figure 8 to a Hold
Clean (and Press)
Hi-Pull to a Snatch
Case #1- L4-L5,L5-S1 Disc

Symptoms:
◦ Pain- limiting hip flex, knee
ext
◦ Radicular symptoms

Started KB
◦
◦
◦
◦
◦

Decreased acute pain/ inflam
~1week post injection
Tolerate ROM,
table (open chain) exercises
Bridge DL ROM DL
wt Static carryswing
Supplement to return to
weightroom
L4-L5, L5-S1 Disc Bulge


*Caution: Anterior load and Opp side load*
Farmer walk
◦ Abdominal bracing

Overhead carry
◦ Abdominal bracing

Sumo Squat
◦ Core control, lumbar stability

Deadlift
◦ Lumbar stability, hamstring flx, gluteal control

Swing
◦ Lumbar stability, dynamic hip
◦ Cardio?
SI Joint Dysfunction
Anterior Hip/Groin pain
 Lateral Hip pain
 Proximal Hamstring pain
 No signs of muscle tissue damage
 May have SI joint pain
 Usually functional but not comfortable
 Innominate rotation on exam

Case #2- SI Joint Dysfunction

Anterior Rotation of the Innominate
◦ Sumo Squat- modify
 Glut/Groin loaded- activate
◦ Single Leg Deadlift- modify
 Unilateral activation
 Reinforce manual therapy correction
◦ Goblet Squat- if ROM tolerated
 Posterior rotation of pelvis
◦ Swing
 Restore normal coordination of hips
Spndylolysis

Typically pre-existing
◦ Overweight
◦ Lordosis
◦ Posterior butt
Aggravated in extension
 Spasm
 Function but pain

Case #3- Spondylolysis- RT L3
*Caution: Posterior and same side load*
 McGill Bottom Up

◦ Abdominal bracing

Rack Squat
◦ Unilateral load, core control

DL- modified ROM
◦ Lumbar stability, glut control

Swing
◦ Lumbar stability, dynamic hips
Other Times of Use

Pre-Lift
◦ Warm Up: 30 swings >150bpm
◦ Poor Squat or Deadlift motion
◦ Chronic Problems: groin/sports hernia

Off Days (10-20min)
◦ Corrective: STM MT/Mob KB exer
◦ Rehab (Fine Tune): ex: chronic hamstring
◦ Cardio: 5 min tabata; circuit
Kettlebell Limitations

Always SAFETY 1st
◦ Common sense dictates

Take time to teach movements
◦ Learning Curve/ Progressions
Hand/Grip/Forearm injury
 Hip joint pathology?

REFERENCES





















Tsatsouline P. Enter the Kettlebell (2006)
DiLuglio A. “Why Choose Kettlebells Instead of Dumbbells?” www.performbetter.com
Brown J. “The Top 8 Reasons Why You Should Kettlebell Train” www.performbetter.com
Tsatsouline P. “Which Kettlebells Should I Get” www.dragondoor.com
Kettlebell Buyer’s Guide www.kettlebellconcepts.com
Kettlebell Safety 101 www.dragondoor.com
“Safety as a part of, not the opposite of, Performance” www.dragondoor.com
Schnettler C, et al. “Kettlebells: Twice the results in half the time?” ACE Fitness Matters.
Jan/Feb 2010 pp. 6-16
Weber K. “The Kettlebell Approach to Physiotherapy” 12/10/03 www.dragondoor.com
McNamara S. “Scientific Evidence for the Russian Kettlebell in ‘Fixing Bad Backs’” 2/24/06
www.dragondoor.com
Tyszkowski R. “Kettlebells and Lower Cross Syndrome” www.performbetter.com
Bonafede B. “A Tip for Mastering the Kettlebell Swing” 10/3/06 www.dragondoor.com
Minute of Strength #92, #112 The Swing www.artofstrength.com
Glassman G. “The Kettlebell Swing” Crossfit Journal (25) 2004
“Why ‘Fire the Lats’ in a Kettlebell Swing?” 12/7/08 www.begin2dig.com
McGill S. “Super Stiffness” www.backfitpro.com
McGill S. “Selecting Back Exercises” www.backfitpro.com
Jones B. “Deadlifting Tips” 1/26/10 Power by Pavel www.dragondoor.com
Cook G. “Deadlifting (Balanced Body Series)” 2007, pp. 1-7 www.functionalmovement.com
“The Refined Turkish Getup: Functional as well as Diagnostic” 8/15/08 www.begin2dig.com
Minute of Strength #30 Windmill www.artofstrength.com
THANK YOU!

Special thanks:
◦ Erik Rodriguez, ATC
◦ Kevin Undeen- UM Football video