using kettlebells in the rehabilitation of the core philip johnson, ms, atc university of michigan
TRANSCRIPT
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Using Kettlebells in the Using Kettlebells in the Rehabilitation of the CoreRehabilitation of the Core
Philip Johnson, MS, ATCUniversity of Michigan
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Purpose of the Purpose of the PresentationPresentation
Understand the history of the Kettlebell
Basic knowledge of the fundamental exercises
Uses in rehabilitation of low back injury
Case reviews
“Core” definition
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What is a Kettlebell?What is a Kettlebell?Best described as a “cannonball
with a handle”StylesFitness toolRehabilitative tool
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History of the KettlebellHistory of the KettlebellRussian background18th Century Russia
◦Appeared in the Russian dictionary in 1704 (Cherkikh, 1994)
Red Army1900’s Strongman1985 Soviet Union Sport
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History- continuedHistory- continuedFitness Certifications:
◦Russian Kettlebell Certification (RKC)
◦ International Kettlebell and Fitness Federation (IKFF)
◦Art Of Strength (AOS)Military Training/
Fitness- SS Snatch test◦10min: snatch 24kg,
200repsMMA/ UFCCrazy “fitness trend”??RehabilitationResearch???
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Kettlebell Vs. Dumbell 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
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KB vs. DBKB vs. DBCost $$: KB (PB/PS) DB
◦8kg/ 18lb $35/36 $30/26◦12kg/ 26lb 45/41 37/33◦16kg/ 35lb 60/55 52/46◦20kg/ 44lb 70/65 67/60◦24kg/ 53lb 80/75 82/72◦32kg/ 70lb 100/95 104/92
*reference: Perform Better(PB) and Power Systems (PS)
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Kettlebell ManufacturersKettlebell Manufacturers Art of Strength Dragon Door K2 Kettlebell Concepts Gill Perform Better Ader Lifeline Power Systems Troy York Wright Apollo Muscle Driver
RETAIL
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My ExperienceMy Experience**I am NOT a certified instructor** Not well educated/ experienced in
Weight RoomJune 2008: Perform Better Seminar
◦ Anthony DiLuglio◦ www.artofstrength.com
Enter The Kettlebell –Pavel Tsatsouline◦ Published 2006 ◦ www.dragondoor.com
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Additional ResourcesAdditional ResourcesBlogs/ Websites
◦www.begin2dig.com◦www.chasingstrength.com Geoff
Neupert◦www.liftkettlebells.com◦www.mikemahler.com
YouTube: “kettlebells” ◦about 22,000 videos
GoogleDVD’s
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Getting StartedGetting StartedDon’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
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Benefits of Kettlebell UseBenefits of Kettlebell Use1. Strengthening- Muscle integration
rather than Isolation2. Endurance/ Cardiovascular3. Power output4. Grip5. Efficiency of training/rehab 6. Reduces space needs/ Cost7. Utilize a Balance of Tension and
Relaxation8. Hip Extension and Deceleration9. Variety and Versatility
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Safety IssuesSafety Issues• Surroundings- keep clear space
• Start slow- practice
• Focus on movements- setting down KB• Low Back- flat back “anti-slouch”
• Use Safety “Sense”
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Benefits of Kettlebell Use in Benefits of Kettlebell Use in RehabilitationRehabilitation
Postural Correction/ImprovementReinforce Movement PatternsStrengthen Gross Movements
◦CORE/HIPS!Improve Return to Olympic LiftsCardiovascular Stress
◦(Schnettler, et al., 2010)
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““Core” Specific Core” Specific RehabilitationRehabilitation
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
functionLatissimus Dorsi
◦Eccentric arm control◦Spine stabilization
Upper/Lower Back◦Segmental stabilization
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The SWINGThe SWINGTHE fundamental
kettlebell exercise◦ Base movement
for other exercisesGreat posterior
chain work“dynamic”
DeadliftHIP HINGE!!!
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The SWINGThe SWING
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The SWINGThe SWING
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SWING- BreakdownSWING- BreakdownHip 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
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SWING- BreakdownSWING- BreakdownHip Drive
◦ Extend HipsChest out/ back flat
◦ Shoulder blades together
KB weightless◦ Be able to let go-
light gripPendulum arms
◦ Move passively- rope like
◦ Momentum dependent
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SWING- breakdownSWING- breakdownPull 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
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SWING- videoSWING- video
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Swing- problemsSwing- problemsNot enough weight
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SWING- ProblemsSWING- Problems“Squatting the Swing”
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Swing- problemsSwing- problemsWeight Forward
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Swing- problemsSwing- problemsHands too Low/ Rounded T-spine
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Swing- problemsSwing- problemsLow Back Hyperextension
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The SWINGThe SWINGQuick 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
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Rehabilitative Goals of the Rehabilitative Goals of the SwingSwing
Back stabilization, muscular controlPosterior 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
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Static Carry-McGill Bottoms Static Carry-McGill Bottoms Up-Overhead Carry-SidebendUp-Overhead Carry-Sidebend
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Deadlift VariationsDeadlift Variations
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Deadlift- SUITCASEDeadlift- SUITCASE
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Deadlift- Single leg w/ hand Deadlift- Single leg w/ hand variationvariation
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Squat- SumoSquat- Sumo
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Squat- rackSquat- rack
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Squat- Goblet Squat- Goblet
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Squat- Swing flip to a Squat- Swing flip to a SquatSquat
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Turkish Get UpTurkish Get Up
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Turkish Get Up- continuedTurkish Get Up- continued
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Figure 8 to a HoldFigure 8 to a Hold
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Clean (and Press)Clean (and Press)
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Hi-Pull to a SnatchHi-Pull to a Snatch
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Case #1- L4-L5,L5-S1 Case #1- L4-L5,L5-S1 DiscDisc
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 carryswingSupplement to return
to weightroom
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L4-L5, L5-S1 Disc BulgeL4-L5, L5-S1 Disc Bulge*Caution: Anterior load and Opp side
load*Farmer walk
◦Abdominal bracingOverhead carry
◦Abdominal bracingSumo Squat
◦Core control, lumbar stabilityDeadlift
◦Lumbar stability, hamstring flx, gluteal control
Swing◦Lumbar stability, dynamic hip◦Cardio?
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SI Joint DysfunctionSI Joint DysfunctionAnterior Hip/Groin painLateral Hip painProximal Hamstring painNo signs of muscle tissue
damageMay have SI joint painUsually functional but not
comfortableInnominate rotation on exam
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Case #2- SI Joint Case #2- SI Joint DysfunctionDysfunction
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
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SpndylolysisSpndylolysisTypically pre-existing
◦Overweight◦Lordosis◦Posterior butt
Aggravated in extensionSpasmFunction but pain
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Case #3- Spondylolysis- Case #3- Spondylolysis- RT L3RT 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
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Other Times of UseOther Times of UsePre-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
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Kettlebell LimitationsKettlebell LimitationsAlways SAFETY 1st
◦Common sense dictatesTake time to teach movements
◦Learning Curve/ ProgressionsHand/Grip/Forearm injuryHip joint pathology?
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REFERENCESREFERENCES 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
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THANK YOU!THANK YOU!Special thanks:
◦Erik Rodriguez, ATC◦Kevin Undeen- UM Football video