10 Tips to Improve Your Game and Eliminate Back Pain (Cont)
4. Ensure That You Have Sufficiently Mobile Hips:
If you lack hip mobility, which is common in the modern population, maintaining a well-aligned golf posture and rotating efficiently through your swing is more difficult. One way to determine if your hips are tight is to lie on your back, firmly bring one knee to your chest, and then let the opposite leg relax towards the floor.
If your knee has difficulty reaching close to your chest and /or your thigh has difficulty resting on the floor, this frequently indicates the need for more hip mobility.
Here are links from our video library to two of our favorite methods of addressing hip mobility deficits. 3D-Hip-Lumbar Posterolateral Chain Stretch (Warning: do not attempt if you have had a hip replacement): https://www.youtube.com/edit?o=U&video_id=WO5mjzewazs .
Supine Hip Flexor Stretch: https://www.youtube.com/watch?v=eR3wXKyxeDY
5. Ensure that you have Reasonable Core/Trunk Stability – Control:
This is a bit more difficult to determine without professional advice. There are many factors that will contribute to core function as well as its effective training. There are multiple ways to determine an individual’s needs with this. However, a simple bridge with a foot lift is one of TPI’s screen components.
Step one, lie supine on your back with your knees bend and feet on the floor.
Step two, while keeping your back flat, lift your hips up approximately 4 inches from the floor to assume a bridge position (here is a link that will help to understand the starting position https://www.youtube.com/edit?o=U&video_id=0c0jvFk2pWg ).
Step three, while maintaining a completely still body, pick one foot off the floor, straighten the knee, and
hold it for 10 seconds.
If your body is reasonably efficient, you should be able to maintain a straight body, without sagging from the pelvis/lumbar spine. No rotation of the trunk should occur, and you should be able to maintain the position without actively having to brace your abdominals.
Here is a video link to clarify what I am describing https://www.youtube.com/edit?o=U&video_id=NsJjO4bfOag. If you are able to do this easily, then you have at least somewhat adequate core and hip strength. If you sag or have to perform a large abdominal brace to accomplish the movement, then this is an area that could likely use additional work.
Here is a link to beginning level trunk stabilization exercises that can be helpful as well as the video mentioned above from our library. We commonly teach this to our golfers:https://www.youtube.com/watch?v=ikunORdr2wM\
6. Ensure That You Have Good Hip Strength:
The hips are, essentially, the motor that produces the power for your drive, along with your core/trunk musculature. The core and hips work together functionally and are mutually dependent on each other. If you have a weak core, you likely have weak/suboptimal hips and vice versa, which will rob you of power and increase stress to your spine when driving the ball. With weak hips (and core), a common substitute in standing is to use excessive lower back muscle activity and have poor ability to maintain an efficient swing plane.
This can contribute to pain (See picture below for a common example). A good test for this is to sit at the edge of the chair, cross your arms across your chest, hinge from the hips placing her nose over the toes. Practice standing up and sitting down by pushing down through your heels.
Essentially, you are performing a standing squat with the use of your hips. If you are able to accomplish this 30 times with good technique while feeling the effort in your rear end (not your quads) with good balance, then your hip stability is at least somewhat functional.
Here is are links to a sit-to-stand maneuver, as well as one of my favorite beginning level hip exercises, both of which are good ways to evaluate and train for hip strength.
Functional Squat: https://www.youtube.com/watch?v=SsB941ix8TA,
Resisted Lateral Stepping: https://www.youtube.com/edit?o=U&video_id=60y2HcxO6Gk
7. Ensure that you have Sufficient Thoracic Rotation:
If you lack thoracic mobility and have an increased thoracic curve, then the lumbar spine will typically make up for this deficit during your golf swing (particularly if there is insufficient core/abdominal control to prevent this compensation).
See pictures above for examples of C-curve and S-curve postures, which typically indicate poor thoracic mobility in most golfers. There are more formal methods of determining if you have adequate thoracic rotation, and we would be happy to instruct you on them, if you have further interest.
Here is a beginning exercise from our exercise library that is helpful in improving thoracic rotation as required for an efficient swing:
8. Ensure that You Have Good Single Leg Balance:
In order to have an efficient swing and play golf well, it is imperative that you have good balance. Here is a way to evaluate it: With your weight centered on your feet as mentioned in step one attempt to stand on one foot and remain still without shifting your body or hip.
You should be able to accomplish this for at least 15 seconds without extraneous body movements, or dropping/rotation of the pelvis. If this is difficult work, to retrain it and improve balance, practice standing on one leg while maintaining vertical body alignment and a stable pelvis. According to TPI statistics, tour professionals are able to maintain a single leg stand with eyes closed for16-20 seconds, on average.
9. Ensure You Have Good Ankle Mobility:
In order to achieve an efficient golf posture and to swing efficiently, it is essential to have adequate ankle mobility. Lack of ankle mobility can adversely affect the rotation of the lower extremities and your ability to generate force, robbing you of power and/or adding to lumbar spine stress.
A good way to determine if you have the necessary ankle mobility is to evaluate your ability to perform a full squat as shown in this video https://www.youtube.com/edit?o=U&video_id=SsB941ix8TA.
If you are unable to keep your feet facing straight ahead without turning out at the lower leg, and or you cannot squat without shifting your weight back over your heels and leaning forward at the trunk, it is quite likely you have insufficient ankle motion. Here is one of our favorite corrective ankle exercises from our video library that also develops hip strength: https://www.youtube.com/watch?v=xjZbvkABtgQ
10. Find a Good Physical Therapist/Golf Performance Specialist:
I am obviously biased here, but there is no better action you can take to get rid of pain and improve your golf swing than to work with an appropriately trained physical therapist. I have worked with a large number of golfers–with varying degrees of spine dysfunction–and helped them achieve miraculous improvement and return to play, pain-free and well.
Everyone should work with a physical therapist for prevention as well as treatment for conditions and injuries. Much like you have a dentist for preventive care, you need regular physical therapy for maintenance and prevention as well. To that end, I recommend a few guidelines to find the appropriate professional. Your therapist should have specialty training in hands-on corrective care (manual therapy). Manual therapy has been shown to be more effective than traditional physical therapy and is golf specific in its techniques. Manual therapy is hands-on work to mobilize and
manipulate stiff joints, increase muscle relaxation, improve connective tissue pliability, and facilitate proper movement or muscle activation.
The ultimate goal is to improve how your body functions as well as your golf swing. Also, your therapist should provide
some degree of one-on-one care without heavy reliance on aids/technicians. Your sessions should not feel like a group exercise class or a trip to the gym. Your training should facilitate an active approach, focused on improving your overall movement efficiency. Your therapist/specialist should be a good educator and should provide an
understanding of corrective exercise, posture, and golf specific movement training should empower you to self-manage and to improve your condition/game. If you are in need of a good physical therapy group, please consider us. My team and I are highly effective at helping people eliminate pain and get back to thriving in life. I am confident
your experience will be exceptional if you should need our help.
So there you have it: 10 tips that you can work on to improve your swing, reduce back pain, and improve how you feel on a daily basis. Commit and work on them regularly! Small things can make a large difference, but it takes dedication, positive belief you will improve, and consistently working to improve. These suggestions are only a beginning. Much more can be done to get you feeling better and back to playing the game you love! In the coming weeks, we will be sending you more advice on how to improve your general health and get back to an active lifestyle, including the role physical therapy plays in that
I hope you enjoy the information and will use it to achieve your goals. In addition, may this be the beginning of a long-term relationship with us at Thrive Physical Therapy. We hope to provide you with the information you need to achieve a healthy lifestyle and great golf game!
In good health,
C. Clarke Tanner PT, MPT, COMT, ATC, CSCS, FMSC, TPI
Physical Therapist Specializing in Spine Care and TPI Certified Golf Specialist