Last week at our clinic, we had a patient who came in for a visit due to consistent back pain. He was distraught. Because of his back pain, he said he was unable to participate in his favorite sport: golf. This story is not uncommon as young, old, amateur, or expert golf players may experience back pain while participating in 18-holes. During this week’s post, we will address why golf players may experience back pain as well as share tips on how to protect your back to continue participating in the sport.
Why Do I Have Back Pain while Playing Golf?
Low back pain is a very common symptom that affects golfers of all ages and skill levels with 25% of all golf injuries being attributed to low back conditions (Lindsay & Vandervoort, 2014, p.1). Many factors contribute to the occurrence of low back pain, such as biomechanics, golf equipment and methods to transport the equipment, and irritation to pre-existing back conditions (Lindsay & Vandervoort, 2014, p.1).
If you have had the pleasure of taking up the sport of golf, you know how humbling and frustrating it can be to master the perfect swing. As they say, practice makes perfect, and repetitive practicing is required to put these movements into action. As a player tees off, the motion of the swing incorporates trunk, shoulder, and hip movements. The asymmetrical trunk torsion may lead to spinal stress as the trunk slowly rotates away from the target on the backswing and then quickly rotates forwards on the downswing (Lindsay & Vandervoort, 2014, p.3). The high frequency of swing rotations and high velocity may lead to increased or consistent low back pain.
Trunk muscles also make a significant difference when it comes to low back pain. A study that conducted an electromyography (EMG) on golfers showed that trunk muscles were activated differently between healthy golfers and golfers with low back pain (Lindsay & Vandervoort, 2014, p.4). Weakened trunk muscles compromise motor control and may lead to abnormal stress on the tissues of the spine which may lead to a low back injury (Lindsay & Vandervoort, 2014, p.4).
Reference: (Lindsay & Vandervoort, 2014, p. 3)
In addition to trunk torsion, hip movement may also contribute to low back pain. If there is less hip rotation on the backswing, then it may cause an increased range of motion and transference of force to the lumbar spine resulting in low back pain (Lindsay & Vandervoort, 2014, p.4). Studies show that evaluating hip rotation range of motion and assessing the cause of restricted hip motion is important for healthcare providers treating golfers with low back pain.
In addition to biomechanics, equipment transportation is a significant contributor to low back pain due to the increased stress on the spine from the weight carrying the bag, clubs, and other equipment while walking. A study showed that carrying a bag of clubs required about 15% more energy than walking the same distance without the equipment (Lindsay & Vandervoort, 2014, p. 6).
While many factors contribute to low back pain from golf, read below for tips to assist you so that you can comfortably enjoy the game.
Tips for Controlling Low Back Pain while Golfing:
Tip #1: Modify your golf swing to a more “classic” or conservative approach: Changes to your swing technique may be necessary to control your low back pain. Like the great player, Bobby Jones, incorporating a reduced magnitude of hip-shoulder separation angle during your swing decreases the torque and causes less stress on the lumbar spine. Figure 2 below from Lindsay and Vandervoort describes a recommended set-up posture to have a stable and effective golf swing (2014, p.5).
Reference: (Lindsay & Vandervoort, 2014, p. 5)
Tip #2: Make sure your clubs and shoes are properly fitted: Studies show that utilizing a shorter golf club increased spinal flexion and right-side bend velocity, which creates more stress on the back due to poor posture. Getting an accurate fitting is well worth the time and money to ensure you have good posture from properly fitted clubs to promote good posture. In addition to ensuring your clubs are properly fitted, a properly fitted or modified golf shoe, such as a “free-release” or rocker-soled “unstable” shoe, can help with hip motion to rotate further towards the target with a decrease in spinal and hip rotation.
Tip #3: Prioritize exercising and conditioning: A body mass index (BMI) over 25.7 in golfers showed more frequent episodes of moderate to severe low back pain (Lindsay & Vandervoort, 2014, p.4). Prioritizing exercising in between golf rounds to stay fit is imperative to good back health and overall health. Strengthening your core to build solid trunk muscles is also essential. Implementing a conditioning program is crucial due to the importance of trunk rotation during golf. Building trunk muscles will also allow for better motor control during your swing.
Tip #4: Warm up and stretch prior to starting your round. A pre-game warm up can be implemented to help decrease the likelihood of injury. Players who performed 10 minutes or greater warm up experienced less than half the injuries per player than those who warmed up for less than 10 minutes (Lindsay & Vandervoort, 2014, p.6). Arrange to get to the course ahead of your tee time to warm up at least 10 minutes for injury prevention.
Tip #5: Utilize proper transportation for your equipment: To decrease the stress on the lower back, two devices can be utilized to help with this issue, such as a two or three-wheel trolley or motorized golf cart. Unfortunately, a motorized golf cart can put additional stress on the back if utilizing it over uneven terrain and can undo the pre-game warmup benefits. If available, enlist a caddie at the course to help take the load off your back as well.
Tip #6: Do not practice excessively: While you may be attempting to become the next Tiger Woods, do not play or practice excessively when experiencing low back pain. Listen to your body and find a balance between participation and recovery from your low back pain.
Tip #7: Seek our assistance from a golf coach and/or healthcare professional: Finding a golf coach and/or a healthcare professional can be helpful in learning how to modify your swing to help your low back pain by assessing your swing mechanics, assisting with modifications, and monitoring progress and pain symptoms. If you are a beginner, enlisting a golf coach is extremely helpful to learn proper form and build good body mechanic habits to prevent low back pain and injury.
If you are experiencing consistent low back pain during your golf game, give Signe Spine & Rehab a call to schedule your New Patient Appointment for an assessment and individualized treatment plan so we can help you get your life back to the green!
Lindsay, D. M., & Vandervoort, A. A. (2014). Golf-related low back pain: a review of causative factors and prevention strategies. Asian journal of sports medicine, 5(4), e24289. https://doi.org/10.5812/asjsm.24289