Shoulder injuries in athletes are on the rise. According to the American Orthopaedic Society for Sports Medicine (AOSSM), surgeons are not only seeing an increase in total injuries, but they are also seeing injuries in youth athletes that are more commonly seen in pro athletes. Shoulder and elbow injuries have increased five times since 2000. Many of these injuries are a result of athletes specializing in a single sport at a much younger age. Add on top of this that the majority of youth athletes are training skill on top of movement dysfunctions and lack of strength and it’s no wonder injuries are on the rise.
The anatomy of the shoulder is very complex. It consists of numerous joints, tendons, and muscles that all work to make it the most mobile joint in the body. This mobility is what allows us to have such a wide range of motion within our upper extremity. The range of motion of the shoulder also makes it extremely unstable.
So why are kettlebells a great tool for improving shoulder strength and stability? Understanding this would require understanding the anatomy of the shoulder. Very simplistically, the shoulder is formed where the humerus fits into the scapula, like a ball and socket. Within the humerus is cartilage, the labrum, which serves as a “cup” for the ball head of the humerus. The shoulder is surrounded by a collection of muscles and tendons that make up the rotator cuff.
The rotator cuff is made up of a group of tendons that work to stabilize the shoulder and muscles that allow the shoulder to rotate. Rotator cuff tears and injuries are one of the most common causes of shoulder pain. Many studies show a direct correlation between grip strength and shoulder health. Proper overhead grip of the kettlebell, i.e., center grip with a neutral wrist, not only recruits the rotator cuff to provide stability of the bell, but also provides for activation of the pectorals, biceps, and anterior deltoid muscles. Strengthening grip has also been shown to improve elbow and wrist injuries.
Exercises for Building and Maintaining Strong Shoulders:
Armbar: The armbar provides many benefits beyond helping to stabilize the shoulder. The armbar begins with the athlete in a supine position with the bell pressed up and the same side knee bent. The athlete will then reach and roll over keeping the bell locked out and wrists flexed. The bottom arm can be walked back to open up the pectorals and rib cage. Working towards getting the hip towards the floor helps to provide mobility of the thoracic spine. Looking away from the bell requires proprioceptive awareness (awareness of where the body is in space) from the athlete. The muscles of the shoulder constantly fire to provide stability of the shoulder while the bell is locked out.
Halo: The halo is a great mobility exercise for the shoulder and thoracic spine. Working from an in-line position challenges the core stability and requires total engagement of the lower extremities, including glute and hip activation.
Turkish Get Up: If you’re only going to perform one exercise to build shoulder stability, this should be your go-to exercise. The TGU is an excellent exercise for preventing rotator cuff injuries. The TGU is an exercise that, when performed correctly, forces the athlete to stabilize the shoulder while moving through planes of motion. The design of the kettlebell forces the rotator cuff to constantly fire to stabilize the bell overhead. The TGU has many other benefits not relating to the shoulder such as proprioceptive awareness, and hip and core activation.
Windmill: The kettlebell windmill requires a similar overhead stabilization as the TGU. The rotator cuff constantly fires to keep the bell overhead while performing a dynamic movement. The windmill is an excellent exercise for hip and thoracic mobility. It also assists in instructing an athlete on how to move through their hip rather than their lumbar spine.
Bottoms up half-kneeling press: Bottoms-up kettlebell movements are an amazing tool to help strengthen and stabilize the shoulder. The bell in the bottoms up position is unstable by nature. With proper form, the force of the bell is transferred to the shoulder. This instability in turn works to stabilize the shoulder. This movement is also an excellent exercise for strengthening the wrist stabilizers. Working in a half-kneeling position requires recruitment of the glute and pelvic stability. Working in-line challenges core stability.
 Swanson, A. (2014, March 24). Grip Strength, the Rotator Cuff, and Kettlebells: How to use grip strength to increase rotator cuff activity and improve shoulder function. Retrieved from http://www.physiospot.com/opinion/grip-strength-the-rotator-cuff-and-kettlebells-how-to-use-grip-strength-to-increase-rotator-cuff-activity-and-improve-shoulder-function/.
Half-Kneeling Overhead Rotation: As with the other overhead kettlebell movement, the half-kneeling overhead rotation requires recruitment of the rotator cuff to stabilize the shoulder in the overhead lock out position. The rotational movement requires constant re-stabilization. This exercise is also a great mobility exercise for the thoracic spine.
One-hand swings: Kettlebell swings are excellent for maintaining shoulder health. When performed using the Russian style technique (versus American style), the rotator cuff is firing to maintain a “packed” shoulder and to maintain connection of the shoulder to the body during the movement. The one-arm swing is also an excellent anti-rotational movement.
We have found that the exercises listed above have helped to reduce the incidence of shoulder injuries in our athletes when performed using proper technique. Incorporating one or a few of these exercises into your athletes strength and conditioning program can help to provide the stability and strength needed to keep the shoulder healthy. Overall programming obviously affects the risk of injury of your athletes so working with an RKC or StrongFirst certified kettlebell instructor to understand proper technique is key in overall injury prevention when using kettlebells.