Kettlebell Doctor

I was recently asked a question by Trina, a Punch Gym Licensee from Atlanta, about the appropriateness of training kettlebells for someone diagnosed with Cervical Stenosis. I thought that it was an excellent question.

Cervical Stenosis can be a very serious spinal condition. Stenosis can be defined as narrowing of a canal. In the spine, at each level, there are three canals. There are two lateral canals from which exit the spinal nerves. There is also a central canal through which travels the spinal cord. Lateral Canal Stenosis is much more common (and occurs almost exclusively in the cervical and lumbar spines). Causes can range from herniated disks to osteoarthritis. Typical symptoms include significant pain radiating into an extremity, along with neurologic symptoms such as numbness or loss of strength. Central Canal Stenosis is much more serious as it may involve the spinal cord. Compression of the cord can cause severe neurolgic dysfunction.

With both these diseases, it is important for the physician to correlate symptoms with any imaging. Stenosis on an MRI, in the absence of symptoms is not necessarily something to be overly concerned with (although it may indicate an increased risk of future injury). A landmark study published in the New England Journal of Medicine by Jensen et. al. in 1994 showed that disk bulges and protrusions are common even in people with no sympyoms. Thus, a bad looking MRI should not automatically exclude someone from training.

Training of any type by someone with this diagnosis needs to be approached carefully, but not necessarily avoided. A clear determination of the level or neurologic dysfunction is essential prior to beginning. That way symptom progression or regression can be graded and can drive the training accordingly. The training should stress biomechanically sound movements that enhance stability and body control, as well as muscle strength. Kettlebell training more than meets these criteria.