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Golf and Back Pain

Unfortunately I learned first-hand that golf can be a painful game when you are injured. Shortly after the birth of my second son, I hurt my back from carrying my kids around too much. This was the first time I had ever had a back injury, and I quickly found that my golf swing was only making it worse. Fortunately for me it was just a muscle strain/ligament sprain, and through my rehab and my work with the Titleist Performance Institute (TPI), I was able to find the proper training and rehab program that helped me restore my health and strength. That made me one of the lucky ones.

The experts at TPI quote that 28% of golfers have some sort of pain in their lower back after every single round. Unfortunately, many of these golfers will have to take extended breaks from the game because of their injury. To some it may sound simple. The lower back is injured; therefore the all-too-common thought is that you need to strengthen your lower back. But it’s important to note that the low back is almost always an “innocent bystander” in the injury cycle, and although it is where the pain shows up, it is rarely the root cause of the problem. Far more often a faulty movement pattern forces the lower back to compensate and bear more of the load than it was meant to do. That’s why it is crucial not to just look at the injured body part, but rather do a full body assessment to find all the potential contributing factors.

The assessment and treatment of low back pain and golf injuries is practically a dissertation unto itself. However I do want to give you one little picture of our thought process at Boundless Health, and our approach to diagnosing and treating the problem.

One of the most common swing characteristics that we look for someone with low back pain is “Reverse Spine Angle.” This is where there is excess backward bending of the upper body during the back swing. This makes it almost impossible to initiate the downswing with the lower body and forces the upper body to dominate the downswing, which causes multiple swing faults and inconsistency with ball contact. However more importantly, it also puts excessive tension on the lower back at the top of the back swing, and since the abdominal muscles are inhibited in this posture, it forces the lower back to carry a heavier load on the downswing with excess flexion and right side bending.

When we see the reverse spine angle, we know that it can frequently be caused by lack of mobility in the hips and thoracic spine, and by too much anterior pelvic tilt at address. Therefore we screen the client with that in mind, and perform a full 16-point assessment to see what other physical characteristics they have which may predispose to these problematic movement patterns. The initial treatment is of course treating the acute injury, reducing inflammation and scar tissue build up, and helping the tissue recover back to its baseline. After that, we frequently emphasize pelvic strength and stability, and helping the client learn to maintain a neutral pelvis at address and maintain it throughout the golf swing. Once the strengthening and motor control is accomplished, then we can work on hip and thoracic spine mobility, thus relieving the pressure on the lower back and allowing for a much more efficient swing with a dramatically decreased risk of injury. However, each phase is dependent on the previous phase. Therefore trying to do too much at once, or doing things out of sequence can be a setup for failure and future injury. Only by a thorough screening, and then the systematic approach to strengthening and improving movements, do you give yourself the best chance of recovering completely and preventing further injuries.

This barely scratches the surface of the topic of golf injuries and back pain. Please contact us to learn more and find out how we can help you on your path to optimal health, fitness and performance.

Bret Scher, MD FACC

TPI Level 1 Certified

NASM Certified Personal trainer

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