Golf-Related Injuries In Australian Amateur Golfers (P3)
One thousand six hundred and thirty-four amateur golf players returned their survey forms from 10 clubs in Australia (7 813 sent, response rate 21%). The average age of the 1 634 golfers was 55.2 ± 14.6 years. There were 318 females (19.5%) with an average age of 59.2 ± 12.2 years, and 1 316 males (80.5%) with an average age of 54.3 ± 15.3 years. The average handicap of female respondents was 26.3 ± 9.5, and of male respondents 18.1 ± 7.0. Respondents reported that golf scored 7.4 out of 10 (± 1.9) in importance on a visual analogue scale (VAS) (1 being not important, 10 being very important). A total of 288 golfers reported sustaining at least 1 injury in the past year. Results analysing the 288 primary injuries were reported. The injury rates of men and women were the same (17.6%).
In total, 73 golfers reported having sustained an injury to the lower back region (25.3%). In this cohort, the lower back was the most common injury site followed by the elbow (15.3%) and the shoulder (9.4%) (Fig. 1). The most common mechanism of injury reported by golfers was a self-reported incorrect golf swing (44.8%), followed by overuse (25.3%) (Fig. 2).
Regarding where in the golf swing the respondent felt that the injury occurred (Fig. 3), 30.2% said the follow-through and 17.7% the downswing. Those golfers who indicated ‘other’ in response to the question reported that more than 1 swing phase or specified impact and/or hitting the ground caused their injury, with impact-based injury accounting for 20% of all responses in the ‘other’ category and 6% of the overall injured golfers. A total of 57.3% of golfers who sustained an injury reported that the injury occurred over a period of time, while 46.9% of those who sustained injury reported having had a previous injury at the same injury site. Golf was reported to have aggravated the injury in 72.2% of cases, while the injury was not aggravated by any activity in 14.9% of cases.
Almost 75% (74.7%) of those injured reported having sought treatment for their injury. Of the practitioners sought, physiotherapists were sought most often (47.4%), followed by general practitioners (47.0%) and chiropractors (27.9%) (Fig. 4).
Of the injured golfers, 4.9% reported to have stopped practising, 5.2% reported to have stopped playing, and 55.2% reported to have stopped both play and practice (Table I). The most common length of time off practice was 2 – 3 weeks, followed by 1 – 2 weeks, while 14.5% reported having spent more than 12 weeks off practice following the injury (Fig. 5).
The most common length of time off from golf play was 1 – 2 weeks, followed by 2 – 3 weeks, while 12.1% reported having spent more than 12 weeks off practice following the injury (Fig. 5).
Those variables that appeared significant in univariate analysis are presented in Table II. Results showed that age, other sports / activities, golf club shafts used, glove use, golf shoe use, warm-up and conditioning habits and game / practice habits appeared significant. Using multivariate analysis, these factors were further examined in relation to the risk of golf injury.
The results including odds ratios and the corresponding 95% confidence intervals obtained from the multivariate analysis are presented in Table III. It was found that age remained significant after adjusting for all other factors in the multivariate analysis. Golfers aged above 40 years had the highest risk: 40 – 59 years (OR 5.7, 95% CI: 2.0 – 16.0), 60 – 69 years (OR 5.4, 95% CI: 1.9 – 15.6), and 70+ years (OR 4.4, 95% CI: 1.4 – 13.1), followed by those aged between 20 and 39 (OR 3.8, 95% CI: 1.1 – 13.6), while the youngest group (under 20) had the lowest risk of injury. Golfers who reported sustaining an injury in other sports or activity in the previous 12 months were more likely to have reported a golfrelated injury in the same period (OR 2.2, 95% CI: 1.6 – 3.1).
After adjusting for the other 2 warm-up variables (air swings, hitting balls), only range of motion exercises remained significant, showing a positive association with the risk of injury (OR 1.6, 95% CI: 1.2 – 2.2). For conditioning activities, only golf-related strength work significantly increased risk of injury (OR 2.7, 95% CI: 1.6 – 4.6). Golf-specific stretching during the week was no longer significant after adjusting for golf practice activities, and general stretching and strength work were no longer significant after adjusting for golfspecific stretching and strength work in the same model. After adjusting for other golf practices, golf practices including chip-putt (p = 0.2), full shot (p = 0.4) and game play (p = 0.1) were no longer significant. The type of club shafts used by golfers was not significantly associated with injury (p = 0.05), although using steel irons / graphite woods or all graphite exhibited a greater risk of injury than all-steel shafts (OR 1.8, 95% CI: 1.2 – 2.6 and OR 1.6, 95% CI: 1.0 – 2.4 respectively). Wearing golf gloves was associated with increased risk of injury compared with using no glove (left hand p = 0.02, 95% CI: 1.2 – 2.5, both hands p = 0.00. 95% CI: 2.3 – 11.7). In contrast, those who wore golf shoes with rubber ripples had significantly lower risk of injury compared with those wearing no golf shoes (p = 0.02, 95% CI: 0.2 – 0.9).