Kettlebell Carries for Scapular Dyskinesis | Modern Manual Therapy Blog

Kettlebell Carries for Scapular Dyskinesis


I learned this from Charlie Weingroff and immediately started implementing in my shoulder patients with scapular dyskinesis.

Using motor control theory as a basis for training leads to a very simple premise. If you are performing exercises like rotator cuff strengthening, T's and Y's, loaded or unloaded but the scapula is still almost poking you in the eye, are you really promoting stability?

The kettlebell carry exercise (straight arm overhead) leads to loaded scapula setting. I have patients perform this for a goal of 5 minutes per day. Try it, it's a lot harder than it sounds. They should walk around, forward, backward, they can turn, braid, whatever it takes to get to 5 minutes as a progression.

This patient had left anterior shoulder pain, upper trap pain, and radiating lateral upper arm complaints. Most of that was successfully treated with IASTM, neurodynamics and MDT to the cervical spine. The only thing that bothered him was reaching forward unloaded, either in the shower for his soap or when reaching for weights when resistance training.

I tried scapula setting cuing prior to Charlie's course for a few weeks along with the typical Y's and T's. I also tried plus pushups partially loaded, used PNF to facilitate the mid/lower traps, scap protraction work... all of my previous go to exercises. Following up once a week, there was no real change. Enter the Carry. Here are some before and during KB carry ex pics.
before
during

great loaded set position!
I followed up with him once weekly to work on remaining ST and neurodynamic dysfunction, and after 3 weeks of carrying, his scapula was much more stable during reaching and WB (lifting himself up onto a plinth). He also only had an estimated 5% discomfort and that was intermittent. We agreed that he could keep up with his HEP and he would email me if he needed anything else.

8 comments:

  1. Hey, I have 2 questions.
    1. Do you instruct the clients to stop if it becomes painful?
    2. Do you do this with the bottom 'up' or as demonstrated in the picture?

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  2. 1) Absolutely, pain alters motor control and it will not be as reliable. 2) Start with traditional grip and progress to bottoms up to increase the challenge and proprioceptive awareness

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  3. Dr Erson, Do you have pics from the before pic you showed after your treatment period?

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  4. You mean before the before pics I posted above? I have two before pics and two after pics.

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  5. I'm at almost eight months of rehab for scapular dyskinesis. Had shoulder MRI. No tears, it's just taking a while.

    I tried this two weeks ago and I feel it helps a lot. I used a five lb weight as I don't have a kettlebell but with both hands. I started three minutes and am at four this week. I do it every other day with my regular exercises.

    Do you suggest lower weight and use one hand instead of both? Should I push it with five lbs one hand? Should I push to every day?

    I ask bc I've had at least five setbacks in rehab by pushing too hard.

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  6. Adam, 8 weeks is a long time! You are only supposed to carrying the weight in one hand (reaching overhead) to set your scapula in place. Not sure what your build is, so it's hard to recommend resistance level. Also, to be responsible, I would need to evaluate you to really give you any advice. My advice is go see a new pracitioner, 8 months for this condition is too long... and I originally thought you said 8 weeks!

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  7. Thanks for the response doc. I am aware its been longer than most cases. I played baseball for a while and hurt it last june. I did nothing about it until september so it made it worse. I also have pretty bad posture that i've been working on. Anyway, my shoulder clicks pretty good and is most likely some shoulder impingement too.

    Just wanted to let you know your exercise has helped me in my slow and long rehab and wanted to get advice on doing it the right way.

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  8. I'd also have someone screen your neck, that's often missed.

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