The Overhead Kettlebell Carry and Shoulder Impingement

I was recently fortunate enough to have the pleasure of seeing Gray Cook, PT and Dan John discuss progressions for the Kettlebell swing and the push press.  As coaches and therapists we’re always trying to see what is superfluous.  Both made it clear they felt these are exercises that you make room in your program for.  While they’re both great exercises, what made me most excited was a preparatory drill they showed and its implications for rehab.  Four volunteers lined up holding a Kettlebell that they could bottoms-up press in one hand.  With a normal KB grip pressed it overhead.  The arms remained vertical, and folks were cued to try and hold their bicep close to their ear.  They walked until they could not maintain perfect form, then brought it down to shoulder height, until they fatigued again and switched to carrying it in suitcase fashion. Then they switched arms.  

The elbow stays straight, the shoulder blade in the back pocket and the armpits forward.

I've seen these exercises before (sometimes called the waiter's carry) and I had filed it, along with most carries, under 'generally not necessary'.  But this time something clicked for me regarding the first exercise.  What I loved about the exercise was that it really cues the athletes to maintain a vertical arm and great posture.  Any break in form and you become immediately aware due to the KB’s weight.  It does require good mobility, but it is a great way to engage the lower traps and de-emphasize the upper if that is a goal, and to do so in a vertical posture.  A lot of folks with impingement syndrome related to poor scapular upward rotation can find a pain-free overhead position; getting them there and loading them with this exercise can be a great way to improve motor control of the shoulder complex.

You can then increase functionality by doing the hustle with the kettlebell overhead.