SURVIVING THE SEASON
Finally the snow has melted off the greens and you are eager to get golfing,
squeezing in as many rounds before the snow flies again. We would like to help
you make it through the golf season without an injury. After all, it’s dangerous
out there; you risk being hit by a golf ball or even a flying club, being in a
motor vehicle accident with a golf cart, there’s always the possibility of
twisting an ankle, or falling in the water hazard and drowning.
Apart from these abusive traumatic injuries, golfers may suffer from overuse,
misuse and disuse. These factors may be the result of, or result in poor golf
technique. Several regions of the golfer are susceptible, including the wrist,
elbow, shoulder and neck. However, low back injury is the most common
amongst both amateur and professional golfers.
In amateurs, poor swing technique, overuse, failure to warm up and ill-fitting
equipment have all been suggested as potential causes of low back injury. In all
you professional golfers, overuse in relation to the repetitive and asymmetrical
nature of the golf swing is thought to be the most common cause of low back
injury.
A number of studies have investigated factors believed pertinent to the health
of golfers. Several authors have found that trunk muscle strength and
endurance, proprioceptive awareness and the general fitness of the golfer
influence occurrence of low back injury (Stover and Stoltz 1996, Pink et al
1996).
However, few studies involving golfers have been undertaken and none have
established a clear link between physical factors and the occurrence of low
back pain.
Kerrie Evans, principle of Golf Medicine Gold Coast and an educator for the
Professional Golfers Association (PGA), is currently doing her PhD on the issue
of low back pain (LBP) in golfers. As part of her research, Evans has been
investigating the relationship between some common tests of flexibility,
strength and trunk muscle endurance and low back pain in golfers.
Here is what she has found so far:
1. None of the flexibility tests looked at have correlated with future episodes
of low back pain.
2. One of the strength measurements used in the study required the golfers to
perform a maximal voluntary contraction in a position similar to that of the
seated row exercise. Poor performance on this test was moderately correlated
with future episodes of moderate or severe low back pain.
3. For trunk muscle endurance, the Side Bridge test (McGill et al 1999) was
investigated. It was found that asymmetrical holding time on this test (where a
golfer scored less on his dominant side than non-dominant), predicted future
episodes of moderate or severe low back pain.
4. In previous studies, the Biering-Sorensen trunk extensor endurance test has
been found to predict future episodes of low back pain in non-golfers. In
Kerrie’s study poor performance on the Biering-Sorensen test, was not at all
related to low back pain in their groups of golfers.
This suggests that seated row and the side plank are important exercises to
include as strengthening exercises for golfers to minimize the risk of injury in
the low back.
However, the most interesting finding was that a golfer with a low body mass
index was more likely to suffer future episodes of moderate/severe low back
pain. Is this because golfers with a larger body mass index (BMI) have an injury
buffer i.e. their bulk? Does this mean golfers need to be bulky to be healthy?
Future research is obviously required but it does beg the question “Does being
overweight protect golfers from low back pain?” OR, is this the scientific
evidence we have all searching for to rationalize the BEER CART?????
Another common golf injury which occurs at the elbow, lateral epicondylitis, or
tennis elbow. This commonly results from using exercise force to grip the golf
club, or improper technique.
Like many sports injuries, most golf injuries are due to overuse, especially the
use of muscles that are untrained for the great stresses of that sport. Typically,
the golf clubs are put away for the winter, and then dusted off in the spring for
a round of 18 before the golfer's muscles and joints are ready.
It is possible to avoid or reduce the severity of elbow and wrist injuries by
doing simple wrist and forearm strengthening exercises prior to and during the
golf season. Working with golf professionals and trained sports medicine
professionals to correct poor grip or swing mechanics. Embarking on a preseason strengthening and stretching golf- specific program to prepare the
muscles and joints and continuing the program throughout the season will
minimize your injury risk.
We want to help golfers to recognize injuries early and to prevent them. Early
recognition of golf-related injury symptoms could speed rehabilitation and the
return to the links. Tennis elbow starts out slowly with pain on the outside of
the elbow only when gripping or lifting. If treated early, the golfer will likely
miss only a few weeks. Without rest and subsequent strengthening of the
forearm muscles, the pain progressively gets worse so that even minimal
activity hurts, and eventually weakness occurs. The same is true with wrist and
back injuries. Unless you rest and allow the injury to heal, and then learn to
change the mechanics or weaknesses that caused the injuries, you will not get
better.
Rest, ice and pain medication will help elbow pain, but the condition at the
elbow is not inflammation but rather tendon micro-tearing or degeneration.
Therefore these will help you feel better, but will not correct what caused the
tendon injury in the first place. If you go back to repeating your bad habits, the
injury will likely come back again.
Returning to sport successfully after elbow epicondylitis requires gradual
flexibility and strengthening of the forearm muscles, sport-specific
rehabilitation is essential. The entire recovery process can take four to five
months, so patience is important.
Over sixty percent of golfers will experience an injury directly related to the
sport. Some golfers will suffer from severe, acute episodes of low back pain,
while others will suffer from constant, unrelenting symptoms. However, if
golfers adopt a lifestyle of healthy habits, including, but not limited to a safe
stretching program, aerobic exercise, resistance training and proper nutrition,
they may be well inclined to avert such a fate.
If you would like assistance with a golf related injury or a specific stretching
and strengthening program please contact a health care professional to ensure
you have a pain free and most enjoyable golf season.