12 Things PTs Should Know About Kettlebell Therapy
Know the risks, rewards and patient-specific criteria for using kettlebells
By Debra Wood, RN, contributor
A relatively new tool physical therapists use to help patients build strength and endurance, kettlebells date back hundreds of years. Using them during rehabilitation can prove effective for strength building, but this tool is not for everyone and should be used with caution for certain patients.
“Physical therapists should start getting creative as to whether a kettlebell can help [achieve the patient’s goals],” said Ryan Balmes, PT, DPT, OCS, a spokesperson for the American Physical Therapy Association in Atlanta.
Karena Wu, DPT, MS, COMT, CSCS, CKTP, CPI, with ActiveCare Physical Therapy in New York, uses kettlebells as the last phase of rehabilitation for patients with specific values and abilities.
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12 tips for physical therapists and assistants regarding kettlebell therapy:
1. Know the basics. Kettlebells date back about 350 years, and essentially look like a cannonball with a handle. They come in a variety of sizes, and can be used in different exercises, including the ballistic kettlebell swing, double kettleball swings, the kettlebell snatch, and the kettlebell clean and jerk.
2. Understand the possible benefits. Exercising with a kettlebell can work the entire body and encourage correct posture. A recent study found kettlebell training can improve aerobic capacity in female athletes.
3. Start with the right candidate. Physical therapists should ensure that the patient is a good candidate, Wu advised. Patients must prepare mentally and physically before starting with kettlebells. Consider whether the patient would continue using kettlebell, after physical therapy ends, Wu said.
4. Ensure proper form. If picked straight up, the kettlebell performs rather predictably, but if the ball part is above the handle, performance becomes trickier, Balmes said. Wu added that a dumbbell weight is more static, whereas the weight shifts as the patient swings a kettlebell. That shift can throw the person off, so it requires more core and joint stability and balance.
5. See the possibilities. Kettlebells are primarily used for sports and orthopedic rehabilitation, but can be used in most populations. For example, with an elderly patient, carrying a five-pound kettlebell mimics toting a five-pound shopping bag, Balmes reported. If the patient needs to carry such bags, kettlebells can be a good way to prepare for this activity. Likewise, movement with a kettlebell can simulate shoveling or other work.
6. Assess grip strength. PTs should assess the patient’s ability to grip the kettlebell. Grip strength is important, because the majority of the weight is outside of the hand. Additionally, Wu said to remain aware of the danger of sweaty palms. The kettlebell should never slip out of someone’s hand.
7. Consider baseline ability. Before starting with kettlebells, determine if the patient has a baseline level of strength, endurance, balance and stability to properly carry out the exercise, Wu said. Using kettlebells requires core, shoulder and other joint stability, including knees, hips and wrists. These weights can be dangerous for people with a weak core, back or shoulders. The patient must be able to control the kettlebell. If in doubt, find another tool better suited to the patient.
8. Evaluate the patient’s movement limitations, and if the kettlebell would be appropriate for the patient, Balmes suggested. He added that a physical therapist may be able to modify the planned movement, so the patient can perform correctly everything done with a kettlebell.
9. Monitor ability to maintain form. Avoid using kettlebells if the patient cannot perform the exercise without compensation, Wu advised. If the patient cannot maintain alignment and form, consider using a different tool.
10. Assess the patient’s proprioreception, the ability to know where the body is in space, and do not use kettlebells with someone with poor proprioreception, which is often the case when people are in rehabilitation, Wu said.
11. Start small. When starting out, begin with a smaller range of motion and a lighter weight, Wu suggested.
12. Watch the environment. Avoid using kettlebells in small, enclosed spaces, Balmes recommended. Wu added to avoid using kettlebells near mirrors or other people, since the patient may not perform the exercise correctly, fearing he or she might hit someone.
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