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Preventing Low Back Pain during Golf Season

For many golfers, low back pain is a significant issue during and after play.

Low back pain is a common condition that affects athletes and non-athletes alike. Symptomatic low back pain in golf can affect golfers’ level of enjoyment or, worse, can result in significant pain and disability.

It is important to understand the reasons for low back pain and take necessary measures to prevent it.

What Causes Low Back Pain in a Golfer?

Golf is a sport that requires a player to generate significant rotation force and propel an object, the ball, down a narrow fairway. Distance and accuracy are premium.

During the swing, the golfer will rotate in the backswing at 85 degrees per second and return on the downswing at 200 degrees per second. The lumbar discs will encounter shearing forces of eight times body weight during this action. The high loads on the lumbar discs are attributed to the switch from the classic swing to a modern swing that requires more spine rotation (a combination of the thoracic and lumbar sections of the spine) and less pelvic rotation during the backswing.

The biomechanics for the lumbar spine are not well suited to the change. The lumbar spine only rotates 2-3 degrees at each of its five levels. Most of the rotation will come from the thoracic spine throughout the swing, and from the hips on the downswing and follow through. Studies show that golfers with low back pain have a tendency to have more lumbar flexion at the initiation of the swing, and decreased rotational endurance of the spine.

How to Prevent Low Back Pain During Golf Season

A good way to address these issues is to have a pre-season training schedule to prepare the spine for golf.

Realizing the importance of spine rotation is critical, as is working on motion and strength of the thoracic spine. Multiple repetitions at a lower speed and with a light club should help to reduce the risk of injury, improve endurance, and help improve range of motion. A similar approach can be taken for the hips. In addition, improving overall endurance will help to maintain strength and form during the later holes in the round.

In regards to the lumbar spine, a good core strengthening program can help; the core is comprised of the abdominal, pelvic, trunk, and low back muscles. The lumbar spine acts to store the energy of the swing and provide limited rotation. Having good strength and ability to maintain a neutral spine position should help to avoid lumbar flexion at the beginning of the swing. Coordinating lumbar stability with hip strength can help maintain balance; an important component of accuracy.

Finally, here are a few other pointers:

  • Walk more and avoid the cart in early season. This will help with endurance and avoid high pressure in the lumbar discs associated with sitting.
  • Warm up with active stretching and hitting shorter irons.
  • Never hit using full strength, as 60-70 percent will give similar distance with less errant shots.

With a good pre-season workout program, you will hopefully have a productive and pain-free season.

Authors

Peter J. Moley, MD
Associate Attending Physiatrist, Hospital for Special Surgery
Associate Professor of Rehabilitation Medicine, Weill Cornell Medical College

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