The Shoulder - Prosection Case
Most people know what the rotator cuff is, and most know that with the majority of shoulder injuries there should be an element for rotator cuff strengthening in their rehab program. The majority of clients are pretty savvy too, and they know they should add some release work around their shoulder and work on some thoracic mobility, which is great! Some clients come to us and they reel off all the exercises they are doing for their rehab and what they are doing actually sounds pretty good. So the question is, why aren’t they getting better? Most of the time it's because the quality or intensity of their rehab isn’t up to scratch. This brings me back to my last blog on about quality being the key factor that can make or break your rehab.
To illustrate my point, let's break down one of my favorite shoulder exercises - the Kettlebell Bottom Up Press. This exercise is a staple in our upper body rehab programs because it’s challenging (and very humbling), it allows us to highlight some key muscles and areas that need work, and most importantly it works. This exercise has also been described as a good predictor for shoulder injury (Shank, 2016). Generally, if your bottom up press is more than 10kg off your standard kettlebell press then your shoulder stability needs work. That’s pretty much most people I know! Most athletes are pretty strong in their shoulders globally but their stability sucks. It’s like driving a Ferrari with bald tires and using the braking system of my beloved Toyota Corolla. And I know you will all be thinking yeah but Corolla's are awesome, and they are, but you get the point.
Now the guys at Evolutio HQ in Richmond know that I get pretty pedantic about how I go about the majority of my exercise and I am forever talking to my clients about some weird and wonderful ways to get their bodies to work better. Here are my specific, but general cues for the kettlebell bottom up press.
The key is quality. So let's discuss some of the key aspects where we can improve this exercise to ensure you get the most out of it.
Key #1 I usually start this exercise in ½ kneeling to help limit any compensation through the lower back and pelvis. This will most likely be the topic of a later blog. You can see below the picture on the right - my pelvis is tucked under which gives me more engagement of the glutes and lower abdominals, which actually makes holding holding the kettlebell a lot easier and it looks stronger too!
Key #2 During the exercise the center of the bell should stay over the elbow - ie forearm remains vertical. The act of pushing the elbow under engages an awesome muscle call the serratus anterior, which is crucial to optimal shoulder function.
Key #3 Wrist stays strong, think punch the roof. If the knuckles fall backwards you lose a lot of strength and quality of movement. Grip the bell with all your fingers, but pay attention to the 4th and 5th (little and ring finger). These guys are linked to some funky primal neurological wiring to when we were swinging in trees (Horsley et al. 2016). Firing up your little and ring fingers in grip will help supercharge your grip strength but also engage your rotator cuff, big time! If you don’t believe me, try it, experience it and feel it. There are also so many studies that suggest that grip strength is a big predictor of total body strength, so get gripping.
All these cues achieve subtle differences to the quality of the exercise performed but each one has the potential to drastically improve the quality of the exercise and in a rehab and performance world that is huge. The Kettlebell Bottom Up press is a great accessory exercise for any power or Olympic Lifter as well as an awesome exercise in its own right for any fitness enthusiast. There are heaps of variations out, which are fantastic, the technique I described above I find great for rehab. It has become a staple exercise in our shoulder rehab programs and if done well can really hit some shoulder aches and pains on the head and take your performance to the next level.
Bayden is one of the new generation. Motivated, driven and skilled beyond belief. He adds youth to our ageing side and has just been awarded the VAFA trainer of the year award in 2016 (No biggie). He works as a Physio with us Mondays, Wednesdays, Friday and Sat mornings. You can book in with him here
Horsley, I., Herrington, L., Hoyle, R., Prescott, E., & Bellamy, N. (2016). Do changes in hand grip strength correlate with shoulder rotator cuff function?. Shoulder & Elbow, 8(2), 124-129.
Shank, M. (2016) Shoulders: One Move to Reintegrate your Mobility into Strength (Part 3), http://maxshank.com/shoulders-one-move-to-reintegrate-your-mobility-into-strength-part-3/1398/