Low back pain is the most common injury in golf and has been shown to account for up to 54 percent of all golf injuries. It also affects over 70 percent of golfers at some point in their sporting career. So why is low back pain so common in golf and what can we do to prevent it?
The golf swing requires high velocity rotational movements at end range of motion. These motions repeated over and over again put a significant demand on the body. The Titleist Performance Institute (TPI) uses the stability/mobility model of movement to describe how our bodies should move appropriately. The body is made up of alternating segments of stable and mobile joints and when this pattern is interrupted, dysfunction occurs.
If we have physical limitations restricting the efficiency of our golf swing, repeated high velocity rotational movements can be a recipe for low back pain during golf. The good news is we can correct these limitations and get back to playing golf without low back pain with the help of a Physical Therapist. Identifying common limitations and learning how to correct them could help get you back on the course in no time!
Common Physical Limitations
Decreased Lead Hip Internal Rotation:
Decreased lead hip internal rotation (IR) has been shown to be commonly associated with low back pain in golfers. As we move throughout the swing we are required to utilize IR of the left hip in a right-handed golfer and if we do not have adequate range of motion our body will usually compensate with increased rotation of the lumbar spine. When I screen golfers, I look for them to achieve 60 degrees of rotation on the TPI Lower Quarter Rotation Test. Decreased hip IR can be caused by several factors such as soft tissue restriction, joint mobility restrictions, or motor control. One easy exercise I like to use for hip mobility is hip drops. See video below for an example.
Decreased Trunk and Shoulder Mobility:
Most commonly, decreased trunk and shoulder mobility limits players as they go into their backswing. Similar to hip mobility, when we have a decrease in trunk and shoulder mobility, our body will tend to compensation from the lumbar spine. This leads to swing characteristics such as reverse spine angle, sway and loss of posture. These swing characteristics make it difficult to produce an efficient swing and commonly leads to an upper body dominate swing. Below are two ways to improve trunk and shoulder mobility.
Decreased Muscular Endurance and Strength:
The Titleist Performance Institute uses the saying “The glutes are the king of the swing”. This could not be more true. As we attempt to produce power in our swing, our hips should be where the power of the swing come from. If you look at the golf swing, tennis serve or even throwing a pitch, all these rotational sports are driven by the pelvis and hips. I use the single limb bridge test to screen proper hip stability. Try it out and see if you need to improve your glute strength.
Additionally, I like to say, if the glutes are the king of the swing, our abdominals are the queen. Our abdominal muscles should be firing throughout the downswing to produce stability throughout our lumbar spine. We talked about our bodies alternating segments of stable and mobile joints, and our abdominals are what create the stability for our body to move around. Here are some great therapeutic exercises to improve glute and abdominal motor control.
To summarize, the high incidence of low back pain in golf makes it likely that you or someone you know is dealing with it. Optimizing our mobility and strength to allow our bodies to move efficiently through the golf swing is an important part of either getting back on the course or trying to prevent low back pain from starting. At Specialized Physical Therapy we have highly qualified therapists who can analyze your personal deficits and help correct your movement patterns to get you back on track for golf. If you are having pain which is limiting you from playing golf (or any other activity) make an appointment today and let us help you get back to doing what you love.