10 Tips to Improve Your Game and Eliminate Back Pain

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The most common ailment suffered by golfers–of all ages and skill levels–is back pain. According to statistics provided by Titleist Performance Institutes from surveying over 31,000 golfers, 28.1% suffer from back pain after playing. In professional golfers, lower back pain is also the most common complaint. Roughly 23% have “ongoing issues and pain” (TPI Course Manual). Tiger Woods is just one well-known example. For the general population and golfers in particular, back pain rarely results from a single event or trauma. But rather accumulates from repeated, inefficient movements and repetitive stress to the spine during daily activities and suboptimal swing mechanics. Let’s break that down further and apply the principles directly to the golf swing.

The easiest way to explain the high prevalence of back pain in golfers is to understand what happens to the lumbar spine, or lower back, with rotation. The golf swing is a complex rotary activity that requires an efficient integration of the trunk, hips, and upper/lower extremities which is beautiful to watch when performed efficiently. But the lumbar spine has difficulty tolerating rotational stress. During the golf swing, a well studied sequence of movements occurs between the pelvis, thoracic spine, and upper/lower extremities. Well-coordinated movements minimize stress to the spine and increase accuracy and consistency. This sequence can only create when the golfer’s body has developed the requisite mobility, strength, control, alignment, and balance.

Lacking or weak in these, things go awry and problems can ensue. One common result is increasing stress to the lumbar spine. For example, if an individual lacks rotation from the thoracic spine, hips, and lower extremities, then he or she commonly compensate by extending and/or rotating excessively from the lumbar spine during the swing. This compensation results in swing faults such as an early extension of the hips during the downswing, altering swing plane, or a reverse spine angle at the top of the backswing (See pictures). The compensations will increase stress to the lumbar spine, potentially leading to back pain. The remedy is to increase mobility in the thoracic spine, hips, and lower extremities to allow an efficient swing to emerge.

The basic philosophy ofTPI, as well as our program at Thrive Physical Therapy, is to improve the body’s efficiency in movement through rehabilitation and appropriate training programs. If the golfer/athlete lacks the key physical attributes, then attempts at correction typically prove futile. But, with therapy and focus training, the athlete can be more efficient, and effective with their swing. Or stated another way, fix the body first and the swing will follow!

With the preceding in mind, we have identified the factors in our golfers that contribute to their back pain. The key is to identify specific issues and to address them effectively. The following information and tips on how to improve your swing and treat back pain have proven effective through years of experience; some are backed by research and practice. These tips are general and not intended to be a substitute for sound medical advice provided by a physical therapist that understands your history, has thoroughly examined you, and has analyzed your swing. Only through a complete history, physical examination and swing analysis can the best course of action for you be accurately ascertained. We use the analogy of a puzzle with our golfers. Their individual problem is likened to puzzle pieces.

Some athletes have more complex puzzles and require more pieces assembled before they feel a big change in their swing mechanics and symptoms, while others have simpler puzzles and their pieces fall together more readily. These patients/athletes respond more quickly. The key, really, is determining what your issues are and addressing them effectively. You can make a significant improvement in your situation by taking the steps provided. We want you to do well and benefit from increased knowledge. Commit to improving by working on what is most relevant to you and staying at it.

1. Use Ice and Heat Correctly:

If you are having new symptoms or have recently exacerbated an old injury, then use ice for 15-20 minutes. Check 3-5 times daily for the first week following an injury or after you play your round. The defining characteristic is the existence of swelling and inflammation, usually present in the preceding situations. Swelling and inflammation respond most
effectively to ice. The exception to this is if you have sensitivity to ice from a medical condition or from prior experience. Ice may not work for you. For best results, the only thing that has to be cold is your back, not you, so, for best results, make sure the rest of your body is warm.

Use Heat: If you feel stiff, or have an old injury, use heat for 15-20 minutes, 1-3 times per day. Heat is a good idea with more chronic injuries, as inflammation is usually less of an issue. It promotes muscle relaxation, connective tissue pliability, and increases circulation which promotes healing; besides, it feels good. Before your round, it is preferable to use an active warm-up; it will wake up your core/hips and more effectively prepare you to play. An effective, active warm-up series is difficult to explain and teach in a written format. If you have interest in learning an effective pre-play routine, we would be happy to help. Call or respond to an email, and we will assist you.

2. Sit Less:

Sitting for prolonged periods (standing can be, as well, but that is for another topic) has been linked with many adverse health events which can be seen in this link for a New York Times . Also, from a mechanics perspective, static sitting tends to be tough on the spine and contributes to restricted hip flexor mobility, not helpful for your spine health or your swing efficiency. From a health perspective, our bodies are active in nature, so do it regularly and often!

3. Critically Evaluate and Improve Your Alignment in Golf-Posture:

In golf posture, the position you start out in determines how your trunk/core will function and, to a large degree, the efficiency of your swing. Initial setup, in optimal golf posture the head, scapula, rib cage, and pelvis, should be aligned vertically, as if directly stacked on top of each other in a slight squat position (See pictures below for ideal and
dysfunctional postures). Please note, if you lack shoulder, thoracic, hip, or ankle mobility, achieving optimal alignment is more difficult to attain and maintain throughout your swing. According to TPI research 
loss of posture (body alignment) or any significant change in body alignment during the swing (64.3%) causes a hook/block, which is commonly caused by inability to squat, mobility issues, core/hip stability deficits, inability to disassociate hips and trunk. Here is a link for correction of golf posture alignment (insert Thrive Correction of Golf Posture)

Tips to Improve Your Game and Eliminate Back Pain

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