Winter is coming to an end and with the arrival of spring comes the beginning of golf season. Golf is one of the most widely played sports in the entire world. People of any age can take part in the sport despite skill level. The United States has over 26 million people who participate in the sport of golf. Research has shown that while golf may seem like a tame sport, there is still a chance for injuries. The lower back is the most injured body region in golf. Low back pain does not discriminate between amateurs and professionals or men and women. All levels, genders and ages are affected.
The back is made up of thirty three vertebrae, the intervertebral disks, the spinal cord and many muscles and ligaments. The intervertebral disks act as shock absorbers between the vertebrae. The vertebrae protect the spinal cord while the muscles control back movement such as flexion, extension, rotation and side bend. These actions are all performed at some point during the golf swing.
There are many theories as to what is the cause of low back pain. One common thought is the change made to the golf swing in the 1960’s. At this time, the “classic” swing underwent change to the current swing, referred to as the “modern” swing. The main difference between these two styles of swing is the switch to more shoulder rotation and less pelvic rotation. The increased shoulder rotation and decreased pelvic rotation leads to an increase in the torque (force) in the low back. In addition to the increase in low back torque, there is also an greater degree of hyperextension (backwards bend). Hyperextension of the low back has been thought to be the cause of many overuse injuries.
It may seem as thought one would just have to live with low back pain if they enjoy golfing, but there are many techniques that can be used to prevent back injuries. The easiest way to prevent these injuries is to warm up prior to every golf game. Warm up should include a short period in which the muscles used for golf are prepared for activity. The first step should include aerobic activity such as walking at a moderate pace, jogging in place or jumping jacks in order to increase body temperature. Static stretching of the “golf muscles” should follow. Areas of the body to be stretched should include hands, wrists, forearms, shoulders, low back, chest, trunk, hamstrings and groin. Finally, series of golf swings that progressively increase in range of motion and intensity should complete the warm up.
Another technique that can be implemented, preferably in addition to a regular warm up, is to perform some simple exercises to increase trunk stability. Not only can these exercises help prevent injury, they can also help to improve performance. Four exercises that can be done easily at home are the curl up, bird dog, side plank and front plank. The curl up involves laying on the back with one knee bent to 90 degrees and the other leg straight. Hands are placed under the low back; be sure to not let your low back bend. The next step involves curling the shoulders two inches from the floor, keeping the neck in a neutral position. This position should be held for 3-5 seconds, 10-15 times with each leg bent. The bird dog starts with the golfer on all fours. Next, one leg and the opposite arm are straightened parallel to the floor. Hold for 3 seconds then lower and switch the other arm and leg; repeat 10-15 times. It is important to keep the back in a neutral position. The side plank has the golfer lie on their side. They then lift their hips up so that only the forearm (bent at 90 degrees with the hand in front) and foot are touching the floor. This position is help for 3-5 seconds. The golfer should “roll” into the front plank. In order to transition from the side plank to the front plank, the golfer needs to rotate so that both forearms are on the floor with the elbows bent to 90 degrees and hands facing forward. The side of the foot is rotated so that the pressure is on the toes. Hold this position for 3-5 seconds before “rolling” back into the side plank position. Repeat 10-15 times.
Remember to make time for a proper warm up and trunk stability exercises when you play golf this season. If you work out in a gym with personal trainers, ask their advice about what exercises can be done to strengthen the low back. If you have already sustained a low back injury and are being treated, ask your doctor, physical therapist or athletic trainer what can be done to prevent another occurrence. Taking the extra time to do the right things, can only help in preventing injury, in turn giving you more time on the golf course.
by Angela M. Spetts, MS, ATC
Genesee Orthopedic and Hand Surgery Associates