As spring gives way to summer, many people find recreation in playing certain sports. One of the fastest growing and most popular of these warm weather sports is golf. There are many reasons golf’s current rise to prominence around the world. Increased exposure of golf in the media, increased availability of golf courses, and an overall increase in its popularity are a few of these reasons. Most importantly though, the game of golf transcends gender, age, and physical ability so that any person can play the game. Therefore, thousands of amateur golfers flock to the links every year to try their hand at this great game. As with many sports however, there is always a risk of injury.
There are many injuries that can result from the modern golf swing. The excessive repetitive swinging of the golf club during play or practice causes most of these injuries. Commonly injured sites can include the wrist, elbow, and shoulder. However, Jobe and Yocum (1988) found that the area most prone to injury in amateur golfers was the lower back. Low back pain has also been identified as a common complaint among members of the PGA and LPGA professional golf tours. In fact, 80% of people in Western countries will experience low back pain at some time during their lives. This does not bode well for the “weekend warrior” looking to take a few hacks at the driving range or on the course. In fact, because of the golf swing’s series of rapid and complex movements, it can place undo stress on various body segments.
There are a couple of reasons why amateurs are more susceptible to back pain than a professional golfer. One, recreational golfers are drawn from a wide range of ages and recreational levels who often play sporadically and without proper warm-up. For the most part, the amateur’s conditioning level does not approach that of a professional. Second, the amateur golfer often has poor swing mechanics. Because these varied swings and unorthodox methods place increased loads on the spine, the amateur golfer is definitely more susceptible to injuring their back. To address these issues and avoid back trouble, the amateur golfer should first concentrate on proper flexibility.
The amateur golfer should look at adopting a warm-up/flexibility program before teeing off. Maintaining proper flexibility is the cornerstone of the modern golf swing. In general, the muscles and tendons of the body are engaged during each phase of the golf swing. More specifically, the end of the swing phase and impact zones engage these soft tissues more than some of the other phases, as they are under the most stress. The force of these movements can transmit unnecessary torsion and compression of the thoracic and lumbar spines if there are restrictions in the soft tissues (Ferrante). Described below are 10 warm-up and flexibility exercises designed to allow greater range of motion from the swing phase through impact.
1. The golfer should attempt to walk for five minutes prior to stretching for a warm-up. This may involve parking in the far corner of the lot or walking to the driving range. This will increase the golfer’s heart rate and allow the tissues of the body to become warm.
2. Standing Rotation Swing - In this exercise, the golfer assumes an address position with their arms crossed over their chest. The golfer then generates a slow full shoulder turn to the right (approx. 80-90 degrees) with only slight (approx. 30-40 degrees) hip rotation. Once end range is met, the golfer releases as in a normal follow through. The golfer should repeat this 5 to 6 times slowly. This will provide the golfer a stretch of several critical tissues that when engaged can limit range of motion. Specifically, a stretch is provided in the right hip, mid-thoracic and lumbar spines, the scapulothoracic junction, IT band, and the costotransverse/facet joints (Ferrante). This stretch also prepares the lumbar spine for the torsional and sidebending forces, which occur at the end of the backswing. (Fig 1)
3. Quad Stretch – Performing this stretch involves flexing the knee and placing the foot on a bench or back of the golf cart. Use a club for balance. This stretch is for general flexibility of the thigh and allows for unrestricted arc of motion during the golf swing.
4. Hamstring stretch - Place the heel of the leg to be stretched on a bench or seat of the cart with the leg straight. Maintain an upright posture and only bend at the waist to obtain more stretch of the hamstrings. (Fig 2) Hold the stretch for 20-30 seconds and repeat 2 times on each leg.
5. Low Back Stretch – Single knee to chest with the foot resting on the fender of the cart or a bench. Again, hold the stretch for 20-30 seconds and repeat 2 times for each leg. This stretch warms and stretches the erector spinae muscles of the low back, which are critical during the golf swing. In an article by Pink et al., electromyographic studies show peak activation of these muscles during the forward swing and acceleration through the ball. Therefore, proper flexibility is needed to avoid injuring these critical muscles at the end range of the swing phase and through the impact zone. (Fig 3)
6. Pectoral stretch – Place the golf club behind the shoulders, holding it at either end. Make a full turn to the right slowly and then turn to the left all the way to the end of the follow-through. Repeat five times slowly, then increase the tempo of the turn for an additional five times. (Fig 4)
7. Arm/Shoulder stretch – Assume the address position and place one end of the club in each hand. Begin the backswing position and stretch the right arm while maintaining the right rotation of the backswing. Repeat to the left side. Repeat 5 times slowly each direction. (Fig 5a, 5b)
8. Lateral Shoulder/Posterior Glenohumeral capsule stretch – Grab the left arm at the elbow with the right. Gently pull across your body until a stretch is felt. Repeat for the other side 5 times each. This stretch allows the golfer to maintain the club on plane during the backswing and to create a full release during the follow through. (Fig 6)
9. IT Band stretch – In a standing position, cross the right foot over the left. With support from the golf club, slowly sidebend to the right side to feel a stretch in the left hip. Alternate between sides repeating 5 times for each side and holding 20-30 seconds. Restrictions in the IT Band can be the cause of several swing faults, most commonly right leg external rotation during the backswing and excessive sidebending of the trunk to the right during follow through (Ferrante).(Fig 7)
10. Progressive Speed Swing – Now that the tissues of stress have been stretched, swinging of the club can begin. Assume the address position with the club gripped in a normal manner. Begin swinging at ¼ speed of the normal golf swing and make 5 swings. Increase the speed by ¼ each time until full speed is attained (20 swings). At the end, add three swings that are 10% faster than 100%. This will prepare the low back and the critical tissues for the stresses to come during the round.
This pre-round flexibility regimen can offer the amateur golfer improved flexibility and decreased risk of injury if followed correctly and adhered to. However, the amateur golfer must also realize that maintaining proper flexibility alone does not exclude one from injury. There are other factors to be considered which play a significant role in proper management of the golf swing. Strengthening of the primary and secondary muscles of the body that perform the swinging motion and stabilize the golfer during the swing is imperative for reducing injury risk and improving performance (Grimshaw). Proper posture and spine angle also play a critical role (Hosea). It is proper flexibility, which can be easily adopted by amateur golfers to reduce the risk of injury, reduce common swing faults, and improve their game.
Ferrante, H.J. Soft tissue restriction and the critical tissue stress points. Back to Golf: A Sports Medicine Program for Golfers.
Grimshaw, P.N. and A. M. Burden. Case report: reduction of low back pain in a professional golfer. Med. Sci. Sports Exerc., Vol, 32, No. 10, pp. 1667-1673, 2000
Hosea, T.M. et al. Biomechanical analysis of the golfer’s back. Science and Golf: Proceedings of the First World Scientific Congress of Golf, A. J. Cochran(Ed.), London: E & FN Spon, 1990, pp.43-48
Jobe, F and Yocum. The dark side of practice. Golf. 30(3):22 1998
Pink et al. Electromyographic analysis of the trunk in golfers. American Journal of Sports Medicine. Vol 21, No. 3, 1993
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