Kettlebell & Shoulder Rehab/Performance Program: Phase 1

May 24, 2019 | Aaron Crouch, DPT, CSCS, SFG1

As discussed in our previous Kettlebell (KB) and Rotator Cuff blog, there are specific drills that exist to enhance upper quarter development from both a rehabilitation and performance aspect. Assuming baseline capabilities have been established such as adequate manual muscle strength testing, clean movement patterns, body weight stability holds, and proficiency with research supported jobe exercises, there is a specific progression through the KB drills that is both linear and safe for your client. This is the beginning of a series of blog discussions that breaks down the programming for implementing the KB into your client’s upper quarter development.

Kettlebell Arm-Bar
The arm-bar is a versatile and excellent corrective drill that can be a staple stand-alone exercise for your client, as well as set the stage for more advanced drills such as the overhead carry and Turkish Get-up. Use the arm-bar as the first kettlebell drill that you implement for your client following satisfying baseline skills stated above. Three different positions can be achieved, starting with the least difficulty in supine.

In this position, scapular depression (without a side bend compensation) and an external rotation bias is the goal. Sufficient exercise prescription is for 20-30 seconds, or if form is being lost, for 2-3 repetitions each arm. Increasing the challenge in this position can be done by flipping the KB upside down for a bottoms up hold.

**CLINICAL PEARL – Manual resistance from the clinician is a great starting point for rehab oriented clients, and can be progressed with rhythmic stabilization perturbations.

Once stable and demonstrated proficiency in supine, the arm-bar is progressed to sidelying. In sidelying, the arm-bar becomes an open chain side plank challenge. Initially, the transition from supine to sidelying is a foreign task for the client, and will present some hurdles. The video below demonstrates the correct maneuvering for the client, as well as correct spotting for the clinical/coach/professional.

The sidelying arm-bar provides an excellent opportunity for gravity assisted scapular depression holds, and allowing the client to feel the skill of “pulling” the load into their column. The tendency is to stabilize with scapular elevation and glenohumeral internal rotation, but AVOID this position. See the video below that moves in and out of the correct and wrong positioning.

Exercise prescription is similar to the supine positioning: 2-3 repetitions of 20-30 second holds. Also, increasing the challenge involves flipping the KB upside down for the bottoms up version. Grip engagement, amongst a plethora of other benefits, causes an irradiation effect through the upper quarter and increases the activity of the rotator cuff in this drill. The hand is so well represented along the homunculus of our brain, that there is an enormous amount of feedback filtering through the arm during the arm-bar.

Final progression moves the client into a prone position.
**CAUTION – this progression is not for all clientele due to its high level demand for thoracic rotation/extension and deep scapular control.
From sidelying, the progression to prone is slow and methodical, and should be closely monitored from a spotter with a sharp eye.

At first glance, it would seems that this position promotes an excessive amount of horizontal abduction, which exposes the anterior shoulder to a high degree. HOWEVER, movement should NOT occur at the glenohumeral joint to achieve this position, ONLY thoracic rotation and extension. Exercise prescription remains the same as the previous two positions. A bottoms up challenge is not necessarily warranted for an additional challenge in prone.

Programming

How does one go about fitting this into their client’s routine? The following guidelines should help with choosing the right position, prescription, and load for your clients:

Position progression: Supine → Sidelying → Prone

Transition when demonstrates proficiency

Prescription

2-3 repetitions for 20-30 seconds

Supplement with combinations of jobe exercises and side plank holds for early stability routine

Use for a priming drill BEFORE major compound exercises

Load

Rehab clients = manual resistance from clinician

Learning weight = 5-15 lbs

Progress load by demonstrating minimal shake for 30 seconds, great technique, confidence in not needing a spotter (be honest!)

Female goal KB weight = 12-16 kg

Male goal KB weight = 20-24 kg

Hopefully this helps guide your initial participation in KB use for shoulder development. Stay tuned for progressive episodes!

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