Swinging Away Back Pain
Swinging Away Back Pain By Dr. Ben Fung
© 2011 Dr. Ben Fung, PT, DPT
There have been estimations stating that 80% of Americans will experience back pain some time in their life1(Web MD, Mayo Clinic). Choosing an appropriate therapeutic, corrective exercise to address back pain can be quite the conundrum. One of the many goals in addressing back pain with movement is not only to modulate the pain, but to keep the pain at bay during functional activities. Of the many therapeutic exercises available to address back pain, preserving functionality can be a challenge. Correction during specific and isolated movements is more easily achieved than it is maintained during an actual functional performance.
As therapeutic relief and maintaining correct movement are central goals in movement based therapy, an ideal exercise for a back program would be that which both relieves pain and prevents further injury by fortifying functional spine mechanics. Kettlebells have recently garnished considerable attention in the world of Physical Rehabilitation. Despite the kettlebell being nothing more than a cast iron wrecking ball with a handle on top, there have been studies exploring kettlebell exercise for lower extremity sports rehabilitation2, musculoskeletal health3, and cardiovascular exercise response4, 5.
Kettlebells offer a wide array of advantages as a therapeutic exercise. Outlined in my previous article, “Kettlebell Therapy: Restoring Movement with Natural Physics”, I discussed several advantages from the perspective of physics and movement science. Applying these advantages specifically for the concern of back pain, I suggest three specific attributes which are of essential benefit to a therapeutic back program.
A therapeutic back program should be corrective, dynamic, and functional:
Recently, a study published by the Journal of Strength and Conditioning presented an interesting reverse shearing component seen during the kettlebell swing. The study noted a “posterior shear of the L4 vertebra on L5, which is opposite in polarity to a traditional lift” of which they stated “provides an insight into why many individuals credit kettlebell swings with restoring and enhancing back health and function6”. The insight from my Bioengineering background would suggest that the ballistic nature of the kettlebell swings allows for a more natural co-activation of spinal musculature in kinetic chains which allow the body the work together more effectively than the linear physics as seen in traditional lifting exercises. While both exercises are functional, dynamic, and even offer corrective benefits; the distinct elemental difference in physics between the two proves a fundamental advantage to the kettlebell.
A suggested progression to the kettlebell swing begins with the Functional Wall Squat to screen and correct proper squatting and thus swinging mechanics.
For more on the Functional Wall Squat, please see my post, “Breaking Down The Functional Wall Squat.” (http://www.kettlebelltherapy.com/2011/08/breaking-down-functional-wall-squat.html)
Once the progression is in full swing (sorry for the pun)…
Move onto one handed swings to gain counter-rotational stabilization training. This ultimately yields high carryover potential to functional activities as most functional activities are asymmetric in nature. After a bout of ballistic kettlebell exercise(s), it is wise to stretch the hip flexors, the hamstrings, and to initiate a short preventive bout of prone press ups in the unlikely event that spinal flexion occurred during exercise.
While prescribing a progression of one handed kettlebell swings may seem like an over simplification of a program for back pain, I humbly refer you to a former patient who has experienced the therapeutic effects of Kettlebell Therapy™ and was kind enough to make a video testimonial. For this particular patient, I exclusively prescribed kettlebell exercises to aide in his recovery.
In closing, I leave you with the encouragement to experience kettlebells for yourself and perhaps claim them as good practice for an ironclad spine.
1. Web MD. http://www.webmd.com/back-pain/default.htm
2. Brumitt et al. Incorporating kettlebells into a lower extremity sports rehabilitation program. N Am J Sports Phys Ther. 2010 Dec;5(4):257-65.
3. Jay et al. Kettlebell training for musculoskeletal and cardiovascular health: a randomized controlled trial. Scand J Work Environ Health. 2011 May;37(3):196-203. doi: 10.5271/sjweh.3136. Epub 2010 Nov 25.
4. Fung B, Shore S. Aerobic and Anaerobic Work During Kettlebell Exercise: A Pilot Study. Medicine and Science in Sports and Exercise, Volume 42:5 Supplement: S588-S589. June 2010.
5. Farrar RE et al. Oxygen cost of kettlebell swings. J Strength Cond Res. 2010 Apr;24(4):1034-6.
6. McGill et al. Kettlebell Swing, Snatch, and Bottoms-Up Carry: Back and Hip Muscle Activation, Motion, and Low Back Loads. Journal of Strength & Conditioning Research:
January 2012 - Volume 26 - Issue 1 - pp 16-27 doi: 10.1519/JSC.0b013e31823a4063