The popularity of golf has exploded in the last several years, and is still consistently growing at such a pace that approximately 30 million people in North America are now classified as "regular golfers". With this growth comes research and development into improving all types of golf equipment to help enhance the players' game. However, the most important piece of equipment is often overlooked ...

        The Human Body

Everyone from those who are just starting to enjoy golf, to seasoned veterans, will tell you that although golf may appear harmless, it is in fact extremely taxing on the human body. Not only does it require miles of walking, carrying/lifting of golf clubs and repetitive bending to place or pick up the balls, but the golf swing itself is very demanding. It requires a combination of muscle and joint motions to coordinate an efficient and effective energy transfer from the body to the ball. Most often these movements are at extremes of range, at high velocities and are repetitive in nature. Some touring professionals will repeat their swing up to 500 times a day. Inevitably the above factors can make golfers highly prone to injury. In fact 30% of golfers have golf related injuries and approximately 50% of injuries become chronic.

Why Back Injuries?

The leading cause of injury in golf is overuse, although poor technique, a decreased fitness level and an increase in age are also key factors. The most common area injured in golf is the low back, followed by injuries seen to the lead arm (left arm in right handed golfers).

During the golf swing the spine moves through flexion (bending forward), extension (bending backwards), side flexion (bending sideways), and rotation. From addressing the ball, through to take away, back swing, downswing, impact and to the finish position, the body goes through many extremes of spinal movement. Occasionally these can be harmful to the body if performed improperly, or if subtle changes in strength, flexibility or coordination in certain joints or muscles create a less than optimal golf swing. Furthermore, the repetitive compressive forces on the spine can lead to wear and tear on the spinal joints. This has been shown on CT scans and MRI diagnostic studies particularly on the trail side (right side in right handed golfers).

Tips for Preventing Golfer's Back

1. WARM UP - How often have you stumbled to the first tee struggling to make your tee off time, and hit your first shot completely cold? You have probably heard it before, but warming up the muscles with stretching is important to maintain flexibility and prevent injuries in not just the back, but other body parts as well. Take a few minutes to stretch your muscles from your neck to your ankles. Here are a few good ones you can do at the driving range or while you are waiting to tee off:



 
NB: Your physiotherapist, massage therapist or athletic therapist can show you more stretches or modifications if you have any specific injuries that need attention. He/she can also provide you with more details on technique as well.
 


2. FITNESS - As with all sports, the more fit the body, the better your performance will be. Golf is no exception. Walking approximately 7 miles on the course can be tiring in itself, but add trying to hit a small white ball into a tiny hole hundreds of yards away 18 times! It really can come down to "survival of the fittest". Strength and flexibility training is a mandatory part of many professional golfers' regular routine these days. They are learning the importance of staying fit and how it improves their golf game and decreases the risk of injury. Core stability training plays a large part in fitness as well. The most important muscles in golf are the deep abdominal and deep back muscles that provide power and acceleration to the swing and protection to the spine. The body's "core muscles" have received a lot of attention lately in research related to back pain and chronic back injuries. You may have heard of this term if you are familiar with Pilates or Yoga. Back rehabilitation will often focus on core stability as a part of treatment for back pain and dysfunction. (You can learn more about core stability in detail in the May 2003 issue of The SEMI eReport)

    

3. EARLY TREATMENT - Seeking early treatment for injuries has been shown to increase the likelihood of a full recovery. Your physiotherapist, sports medicine physician, or chiropractor can assess your back for problems with weakness, stiffness or imbalances that may be contributing to your back pain. He/she will then develop an appropriate treatment plan to get you back on the links as soon as possible. If your clinician is familiar with the proper golf swing, he/she can assess it to determine what may be the cause of your pain. For example, during impact, the trunk will side bend and the hips will slide towards the target. If this motion is excessive, there is a strong chance that it will cause back pain, as the joints and discs of the spine undergo a lot of compressive force. This leads us to the next tip ...

4. TECHNIQUE -If you are having pain during golf, it may be a good idea to visit a teaching professional to have your swing analyzed. Perhaps your swing plane is too steep or your posture at address is incorrect. These problems can be investigated by your local teaching pro. However, if you still continue to have pain after rehabilitation, you may need permanent modifications in your technique that adapt to your bodies limitations. For example the aging golfer will be less flexible than when he was in his earlier years. He may need to change certain parts of his swing to accommodate to his changing abilities. Both your trained health care clinician and golf professional together can help problem solve your specific needs.

5. TRANSPORTATION OF CLUBS - If you have back pain but prefer to carry your clubs around the course, use a light weight bag with double padded straps, and lighten the load of your bag. Take out anything extra you may not use - including clubs! Hand held carts are likely the best option for back pain sufferers. Ideally pushing rather than pulling the cart would provide the least harmful forces on the body.

I hope you have learned a little something about golfer's back and agree that staying fit can be difficult if pain inhibits your participation in sports. Therefore it would be wise to take care of your body so that you can keep playing more rounds for years to come.

References:

1. Lyndsay, D. Golfer's Back : Technique Factors. Fit fore Golf Course Manual. 2003
2. Lyndsay, D. Golfer's Back: Five Stage Back Care Program. Fit fore Golf Course Manual. 2003