Important Tips for Having an Injury Free Golf Season 

With an early spring upon us and golf season for us northerners fast approaching it is tempting to get the clubs out and just start playing. However, before you do that and risk a season ending injury take a few weeks and get started when you have conditioned yourself for the sport you love.

You may think that because golf is a low impact sport that your chance of injury is low. Recent studies showed 60% of professional and 40% of amateur golfers suffered from an injury each season. Among golf related injuries, the low back is the most common area injured in amateur golfers (~26-52 % of all complaints). The golf swing generates considerable mechanical forces including compressive, shear and rotational.

Consider the following when it comes to forces on the spine with the golf swing:

  • Golf is deceptive in terms of physical demand on the spine and musculoskeletal system
  • The swing generates tremendous compressive and shear forces on the lumbar spine
  • McGill: co-activation of spinal muscles occurs in twisting which can increase compressive penalty on the lumbar spine (Transverse Plane (rotational force = 4-5X load)
  • Compression Loads of up to 8 times body weight have been recorded in the swing 
  • These forces were only slightly less than occurred in Division 1A college linemen who were hitting a blocking sled

So before you get out there to hit some balls consider the following recommendation:

Take a lesson with a golf pro to learn the Classic Swing vs Modern Swing

  • 4 parts of the golf swing:
    o backswing
    o forward swing
    o acceleration with ball strike
    o follow through                         

Modern Swing

  • Large shoulder turn with a restricted hip turn 
    (Restricted hip lead foot is kept flat throughout all phases of swing)
  • This increases the hip shoulder separation angle or X factor

Pros:

  • accuracy and club head speed
    (store of potential energy in the viscoelastic elements of the spine)

Cons:

  • Lateral bend during forward swing (crunch factor)
  • Reverse C - at follow through (hyperextension) 
  • Crunch factor is product of lateral bending and angular velocity or rotation 
  • Studies have shown in symptomatic golfers increased trailing side vertebral body and facet arthritis on side of crunch
  • Hyper-extension at follow through also increases compression on spine posterior elements leading to micro-trauma

Classic Swing

  • Reduces X-factor by lifting front heel during backswing to allow hip rotation
    (Also may include a shorter backswing or a combination of the two)
  • Hip shoulder separation angle is lessened and decreases
  • Emphasizes a balanced upright form which reduces the crunch factor
  • Start closer to the ball which minimizes flexion and AP shear 

Learning the classic swing will be one of the best things you can do to prevent the most common injury seen in golfers, low back injury.

Authors with Affiliation:

Eugene Y. Roh, MD
Sports Medicine
Department of Physical Medicine and Rehabilitation
Harvard Medical School
Boston, MA

Michael C. Geraci, Jr, MD, PT
MedFirst: Spine/Occupational/Sports
SUNY@Buffalo School of Medicine & Biomedical Sciences
Michigan State University College of Osteopathic Medicine
Buffalo, NY

Matthew Smuck, MD
Stanford University Spine Center
Department of Orthopaedic Surgery
Stanford University
Redwood City, CA