I am a self-described kettlebell nerd. One of the ongoing jokes when I teach seminars is if you come to me with an orthopedic issue, I will tell you to do a Turkish get-up (TGU). There is truth behind every joke, though.
The TGU is an elegant exercise that combines almost every shape your body needs to move through and every motor pattern necessary for human development and function. There is a reason this exercise has been around for such a long time. In fact, I believe in the old strongman days, when a physical culture was valued, that this was the first exercise taught to aspiring strongmen, and nothing else was taught until competency with respectable weights was achieved with each hand.
Why I continuously return to the TGU when evaluating an athlete is because I can slow them down and put them in the positions I want them to be in and see what is truly going on. It is nearly impossible to see what is happening with an athlete at speed. You need to have consistent and effective ways to break down movement patterns and see the underlying problem. The main emphasis in this article is evaluating the mechanics of the shoulder.
The evaluation process when looking at the shoulder begins with pressing the kettlebell into the start position. I am looking to see if in a stable mid-range pressing position you create a strong externally rotated shoulder (your hand is in a position like you would swing a hammer) with the lat contracted and the shoulder packed.
Errors here tell me you do not have a fundamental understanding of creating a stable shoulder position in mid-range flexion. We must first teach you the stable position for the shoulder in this shape before we begin to roll and move. Your ability to create this externally rotated position in flexion is paramount to shoulder health and proper mechanics.
See this video clip from a recent SFG Certification discussing the shoulder position:
Turkish Get-Up Evaluation Part 2
Pressurizing and creating a stable trunk to keep your shoulders and pelvis connected as you roll to your elbow is the second part of the evaluation. Faults in the initial roll, either the leg coming off the ground or you allowing the kettlebell to change position in your hand are the next things I look for.
An issue with either tells me there is a fundamental problem with your ability to stabilize your spine and trunk. If you have a fault in primary stability of your spine, we will never fix the problem with your shoulder. There is a reason why, when I deal with an athlete with shoulder dysfunction, we spend so much time on these first two pieces of the TGU. It allows them to get the feel for creating a stable shoulder and trunk without making them take the kettlebell all the way overhead and without making the move too complicated.
Turkish Get-Up Evaluation Part 3
The next step, posting to the hand from the elbow, is a critical step, and often overlooked. This shows me your ability to simultaneously create rotation off a fixed object (the ground) and off a non-fixed object (the kettlebell). Due to the angle of your torso, that arm is actually in flexion so an external rotation force needs to be created to stabilize the shoulder. You also have to push down into the ground, contract the lat hard and depress the shoulder blade.
A big fault here is allowing the shoulder to drift toward the ear, creating an unstable and impinged shoulder position. This is another place you will see the position of the kettlebell start to drift if the athlete is not concentrating on keeping proper shoulder position.
Turkish Get-Up Evaluation Part 4
As we move to the bridge, we are starting to combine shapes of the hip with shapes of the shoulder. This is why I stop the TGU halfway for a lot of athletes until they smooth it out and have proper shoulder engagement with both arms. This is our first look at the ability to fully extend the hip.
If full hip extension cannot be achieved while maintaining active stable shoulders, sweeping the leg under to transition to the lunge position will be difficult. As you are well aware, athletes do more sitting today then pretty much any other time in human history. This leaves many of your athletes with chronically tight hip flexors and anterior hip capsules and underactive glutes — a recipe for disaster.
I’m not going to detail how to remedy these problems with lots of different mobilizations and soft tissue work. I will tell you time spent repeatedly taking people into and out of the hip bridge is not time wasted. These transitions where we start adding the hip demand is where people tend to “dump the kettlebell.” So practice, practice!
Turkish Get-Up Evaluation Part 5
The leg sweep to the lunge position is where a lot of people start to show their true colors as far as shoulder stability. If they are not actively creating rotation in the shoulder, they will be exposed immediately as they drastically change positions from the bridge to the lunge. It also shows me if they are loading the hip to drive themselves into the overhead lunge position from the kneeling windmill position.
You will see a lot of people try to move to the upright torso by pulling themselves up with their back instead of using hip extension. This is also where you will begin to see a loss of connection between the rib cage and pelvis. If they do not keep the glutes active, the back will default into hyperextension. If they do not keep the abdominals tight, the rib cage will flare up. Both destabilize the spine, which leads to a loss of power transfer and stability in the shoulders and hips. You will see this as they stand, either the lead knee will cave in or the KB will start to turn forward.
When they finally hit that standing position, do they keep their ribcage down and locked over top of the pelvis with glutes tight and arm still in external rotation and full overhead position? Of course you have to return to the floor for it to be a total repetition, but I have usually seen what I need to by this point.
The TGU in Summary
The get-up is a long technical move, and it gives me so much information as a clinician. I can slow the athlete way down and get a look at their tendencies. If they cannot maintain proper shoulder, hip, and spinal mechanics during the TGU, I have a pretty clear idea where they are failing at speed.
The tempo at which athletes perform the TGU also tells me a lot about their ability to be patient and understand the importance of grinding and building a proper foundation. I have found that athletes who try to rush through the move, even if they have decent positions, tend to rush other things and not pay attention to the details and what the move is trying to teach them.
The ability to create rotational force to stabilize the shoulder is not only important in maintaining the health of the joint under load, but also in maintaining a stable and strong spinal position. A loss of rotational force in the shoulder under load will cause a loss in spinal stability and vice versa.
This is why I call dumbbells, kettlebells, and gymnastics rings lie detector tests for shoulder and spine stability. Athletes can hide some dysfunction when using a fixed object (barbell, the floor for push-ups, bar dips, etc.) but if you take away the connection, you can quickly see underlying issues with joint stability.