The Back-safe Guide to Kettlebells

These portable powerhouses might be just what you need to strengthen your back muscles and help prevent back pain.

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When you’re experiencing low back pain, about the last thing you might imagine helping would be swinging around a heavy weight. And yet many sports medicine experts recommend kettlebell exercise for back pain.

Person using kettlebells to help back painUsed correctly, kettlebells can strengthen your back and help prevent spine injury.

“If used incorrectly, kettlebells can definitely make back pain worse,” says California-based sports medicine physician John Martinez, MD. “But if used correctly, they can be a great adjunct or even a primary exercise for improving and strengthening the low back and posterior chain, which is really important for a lot of folks who have non-operative back pain.”

What Are Kettlebells?

Named for their shape—like a tea kettle with a big handle on top—kettlebells are cast iron or cast steel weights used for exercise. Most users will work with 10 to 40 lb weights (or 4 to 20 kg, as the weight of kettlebells is often labeled in kilograms, even in the United States), starting out on the lower end and working up. One or two kettlebells may be used at a time, and you can use a single bell for one- and two-handed movements.

What is a kettlebell?Kettlebells are named for their shape: like a teakettle with a handle.

Earlier forms of kettlebells were introduced in ancient times, but they first came into popular use in the 1880s, after Russian physician Vladislav Kraevsky introduced them as a training element for the Russian army. In 1948, Russia declared kettlebell lifting their national sport and began holding kettlebell competitions at the All-Soviet Union Competition of Strongman in Moscow.

Kettlebell Movements for Back Pain

If you’re not yet experiencing any significant back pain, kettlebells can be great for keeping it that way—they’re excellent for strengthening your core and your back muscles, which makes your back less prone to injury and pain.

The kettlebell swing is one of the basic kettlebell exercises, and it’s the one Dr. Martinez thinks is most important when dealing with back pain issues. It starts with one kettlebell weight on the floor about 12 inches in front of you while you stand with feet a bit wider than hips-distance apart.

You’ll then hinge at the hips, extend your arms down to the kettlebell and grip it, and begin swinging it up and down through your legs and then upward and outward to chest level. (This is considered the Russian kettlebell swing. The American version swings up over the head, but is generally not recommended for those with back pain—or anyone who doesn’t have rock-solid technique.)

Woman swinging a kettlebell to prevent back painRussian-style swings, where the bell comes no higher than chest height, are generally considered safer than swings to head height or above.

Shoulders are meant to stay relaxed; hips are used to thrust and create momentum to swing the kettlebell. It’s important to keep the spine neutral throughout the exercise to prevent injury. Your arms are there only to hold the bell—don’t swing with your arms or shoulders, but rather push through with your hips.

From there, Dr. Martinez recommends other kettlebell exercises, such as cleans and goblet squats. With a kettlebell clean, you pick up the kettlebell and spin it to the outside of your wrist, rotating it in a 45-degree angle across your palm as you stand up with the bell facing outward (this is called the rack position).

With a goblet squat, you engage all the muscles of your lower body. You hold a kettlebell with both hands at your chest and then bend your knees and keep your back straight as you squat down until your elbows touch the insides of your knees, then stand up again. Remember to keep your core engaged throughout the movement.

Woman doing kettlebell goblet squats for back painGoblet squats are great for building hip strength and flexibility.

Kettlebell Benefits

One of the strongest benefits of kettlebell for back pain is that they’re portable—you don’t need to go to the gym or have a big home fitness center set up. They also don’t require a lot of space: Roll out a yoga mat and get to work.

Once you’ve learned proper technique, you can follow up regularly at home. With kettlebells, you can train complex ballistic movements such as Olympic lifts like the clean and jerk and snatch more easily than with barbells. Kettlebell workouts can also be a good mix of strength and cardio.

Biggest Kettlebell Mistakes

Proper form is so important here that you must be personally trained and evaluated before you begin, which can be expensive. And unlike barbells or weight machines, you can’t add weight incrementally to kettlebells; when you’re ready to move up, you’ll just need to buy heavier kettlebells. Plus, you may be facing a big jump up in weight—usually 4kg at a minimum, which is almost 9 lbs.

“The primary movement most people have the most difficulty with is actually getting that proper hinging at the hip, rather than flexing at the lumbar spine and putting increased pressure across the discs in the lumbar spine,” says Dr. Martinez. “So we work on a proper hip hinge where they keep the low lumbar back straight, flexing at the hip, pushing back out with the buttocks as they do the swing.”

He suggests avoiding the Turkish get-up if you’re experiencing any back pain. “Unfortunately, it’s done incorrectly more than it’s done correctly. People try to speed. It’s a series of steps, and if you’re doing it properly, you should be able to stop at any step and hold that position. The majority of people I see can’t do that.”

Man performing kettlebell turkish getup for back painThe Turkish getup help builds total body strength, but can be difficult to get right.

Using the incorrect weight can cause problems, whether it’s too heavy or too light. Too heavy and you risk straining yourself, but too light can make it difficult to get the right feedback for proper technique.

Another issue, says Thomas McNally, MD, medical director of the Spine Center at the Chicago Center for Orthopedics at Weiss Memorial Hospital, is that people may overdo their training—particularly those over 50, whose bodies don’t recover as quickly as younger people’s. “It used to be standard advice that you weight train one day, then give yourself a day of rest and resume on day two, but if you're over 50, you might have to spread that out and give more than one day in between,” he says.

Common Injuries Associated with Kettlebells

It’s important to get proper training before working with kettlebells—don’t just check out a YouTube video and go for it! Especially if you already have back pain, you must work with a physical therapist or personal trainer who can teach you proper technique and watch you to make any corrections needed. Dr. Martinez says that it’s best to work with a physical therapist at first if you’re experiencing back pain, but a personal trainer who is certified in kettlebells is a good second option.

Improper technique can lead to muscle strains, compressed or pinched lower spine, shear stresses to those with pre-existing low back conditions, and impact injuries to the wrist and forearm.

Kettlebell Form Tips

Three main form issues with kettlebells include:

  • Squatting: When you pick up your kettlebell, remember to hip hinge instead of squatting to keep the back in a neutral position. Drive your hips back like you’re about to sit down on a curb or a low chair.
  • Banging the kettlebell into your arm during cleans: Loosen your grip on the kettlebell and let it rotate freely around your wrist into the rack position rather than gripping it and swinging it over your hand.
  • Arching the back: If your pelvis is tilted too far forward, your back arches too much, which Dr. McNally says can narrow where the nerves leave the spine in your low back. Keep your abs tight to avoid letting your pelvis tilt forward.

Kettlebells are a versatile form of exercise to prevent and treating back pain, and you don’t need to shy away from them.

“They’re useful for increasing range of motion, teaching better movement patterns, counteracting tight hip flexors and weak or inhibited glutes, and strengthening the posterior chain. It’s a great modality that we underuse in the US,” says Dr. Martinez.

Updated on: 10/04/21
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