According to the National Golf Foundation, ” 36.9 Million Americans age 6+ played golf–both on and off the course– in 2020.”
Golf is one of the most frequently played sports in the United States. It recently became more popular as COVID-19 restrictions have forced some of us to stay locked down and practice social distancing.
Low back pain is the biggest complaint among professional and recreational golfers.
Research shows that 15-35% of amateur golfers and 55% of professional golfers have suffered from low back pain during or after playing golf.
Golf is a repetitive and one-sided sport. The golf swing produces high loads in the spine, causing strain to the muscles and spinal structures over time. Fatigue and stress have a way of compromising the integrity of these structures and lead us to muscular imbalances and pain that plague the amateur golfer.
For right handed golfer’s, the right low back is the most commonly injured body part. This is because the right external obliques, abdomen and low back muscles produce the greatest force on the downswing. Doing this over and over for 18 holes creates muscular imbalances and increases the likelihood for an overuse injury.
The right external obliques, abdominals and low back muscles in this case, end up overworked and tight; while the stabilizing hip and abdominal muscles like the glutes and the transversus abdominus muscles end up weak and prone to microtears.
Everyone that follows golf remembers the Tiger Woods 2015-2018 comeback story and how low back pain continuously knocked him out of tournaments. In one interview, he is quoted blaming “deactivated glutes that he could not keep activated” for his low back pain. This later becomes the reason for withdrawing in 2015 and later again in attempts to return after several procedures. The story here is that with some “glute activation”, whatever that meant, Woods came back stronger than ever after 16 months off and won the PGA TOUR championship in 2018 for his 80th PGA win.
Well, it turns out that he might have been onto something…
The glute complex (Gluteus Maximus, Gluteus Medius, and Gluteus Minimus) form the largest muscle group in the body. They are eloquently designed for speed and power, two incredibly important features for a successful and powerful downswing.
The glute complex however, plays a large role in a less sexy function that is equally if not more important, stabilization. Without this function we are unable to truly coordinate and generate the speed and power necessary through the hips to drive the ball.
So how does your butt relate to your back pain? Like in TW’s case, if your glutes are not firing there is a big chance that you are using your lower back and hamstring muscles to compensate and provide stability. This compensation is what allows you to increase your power output to drive the ball 200 yds. The problem is that as we age and with repetitive motions, the body can no longer take the toll for the muscular imbalances and uneven loads forced through the body and we create overuse injuries.
If you have back pain before, during or after playing golf here are tips to improve your golf fitness and decrease the chance for an overuse injury.
Golfing is a repetitive activity. Each swing needs to be precise, in form, and with the right mount of power. Going directly to the tee box at 8 a.m., pulling out the driver, and trying to smash one as hard as you can is the easiest way to “pull your back out.” In a previous blog post I discuss the importance of the warm up and how it can help improve your game. Glute activation is key here. If your glutes are not active during your swing, you will end up using your low back or hamstrings.
Taking the time to go through a proper warm up and getting some practice swings in is one key to take the stress of your low back and prevent injuries.
Above I mentioned how a proper warm up is ONE key to prevent low back injuries in golf. Here’s another major key. Focus on staying active between golf rounds.
One way to accomplish this is to walk 30-45 minutes per day 2-3x per week to boost your cardiovascular and muscular endurance to be able to perform without pain for all 18 holes.
This is an intentional walk to get the blood flow moving and break a light sweat. This should be considered a minimal exercise routine.
If you are feeling spicy, adding weight training to your routine can take you to the next level. Weight training could be beneficial in maintaining muscle mass and strengthening the glutes in order to improve the power output of your swing. It is beneficial for both young and elderly players looking to improve their fitness.
If you are not able to manage your pain or need more guidance on following a proper fitness routine on your own, it may be prudent to seek out professional help from a Physical Therapist.
Let’s talk ergonomics. How you carry a golf bag, transfer it from the car to the bag drop, and how you carry it across the course matters. A typical set of clubs can weigh close to 30 lbs. Most of us casual players only have to move it from the trunk to the bag drop or down to the golf carts. We talked about how back pain in golf is common due to its repetitive nature and repeatedly picking up 30lbs clubs with bad form adds up and is taxing on your back.
Using your back and bending at the waist to pull clubs out of the trunk can set you up for failure and ramp up your back pain before you even take the first swing.
The way we move matters. And the way we move while we carry “loads” matters even more. For some, a dual backpack strap for your golf bag would distribute the weight of the clubs more evenly across both shoulders and can prevent exacerbation of pain on the injured side vs using a single strap bag. If buying a new bag is not an option for you, consider what Peter Opsvik, the father of ergonomic furniture design would say,
“The best posture is the next posture.”
Movement is more important than trying to perfect one position or buying a new bag. Try changing the shoulder you carry your bag on often or use a golf cart or trolley to ease the burden on your low back and shoulders.
For those concerned about their lifting mechanics, consider keeping the spine lengthened and straight, chest lifted and knees bent. When lifting clubs out of the car, allow the knees to rest gently against the bumper to brace your body. Hinge at the hips instead of rounding the back to reach into the trunk. Lift the bag with both hands and avoid twisting at your spine/waist, instead pivot your whole body and carefully lower the bag to the ground.
Movement is medicine, if you are unsure of how to get started or have questions about how to prevent injuries send me a message on Facebook or schedule a consultation with me!