Course Instructor (P6)

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Back Injury

Biomechanics

Golfers are required to generate violent lumbar rotation. Unlike the baseball swing, where the batter can step to translate force through the pelvis and hips, the golfer’s feet are fixed and the only pivoting action occurs in the lower extremities. Of course, as we will see, this will contribute to lower extremityinjuries; it will also increase the potential for back insult and pain development. In a review done by Calloway and Jobe in the 1985-1986 PGA Season, 77% of golfers were injured, with 43.8% of those injuries attributable to the spine and 42.4% to the lumbosacral spine, specifically. If we were to speculate that the PGA represents the best athletes in the sport, then we would expect that they have a higher level of technique, consistency, fundamentals and fitness than the average amateur golfer. We can further speculate that the recreational golfer’s potential for injury can be even higher if they participate frequently in the sport.

The pain arising from the swing motion can often be localized to poor fundamentals. Ideally, the golfer wants to spread out the rotational stresses over several structures, including the shoulder, hips, pelvis and the entire spine, as opposed to just the lumbosacral spine. Potentially, this would minimize over-stress in a single area during the power phase of the swing.

Course Instructor (P6)Like the baseball swing, the golf swing is dependant upon maintaining a parallel plane between the shoulders and the pelvis, not just at impact, but through most of the swing. For control of the trunk, the abdominal musculature must remain tense. This is aided by slight knee flexion, so knee flexion and trunk control will aid in keeping the shoulders and hips and pelvis in a parallel relationship. It has been said that a powerful swing relies on the ability of the golfer to retain tight muscle control as he or she goes from the maximum backswing to the power portion of the swing. Additionally, one can opine that this would also decrease the potential for repetitive injury in one focal area of the spine. This control over parallel position should limit the tendency of the golfer to laterally bend to the front leg side (left side for a right handed golfer) creating an off-balance asymmetrical loading of the spine.

Anatomy

Because the vertebral column is a chain of intervertebral joints, the neuromotion segment is comprised of the intervertebral disc, its facet joints, concomitant ligaments, vessels and nerves. The basic unit of spinal anatomy and function is the neuromotion segment. The ligaments provide resistance to injurious forces, further supported by the trunk musculature and the lumbodorsal fascia. It is muscle control of the fascial structures that decreases bending and loading stress along with the cushioning effect of the disc. Loads are managed through two basic components; an anterior compartment, consisting of the disc, the body of the vertebra and the longitudinal ligaments. The posterior compartment is comprised of the facet joints, lamina, spinous process, ligamentum flavum and pars interarticularis. For our purposes, it should be pointed out that the intervertebral disc, i.e., the annulus, nucleus, and the accompanying end-plates resist compressive forces well, but torsional forces less efficiently.

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