Golf and lower back pain

Spear Physiotherapy and Sports Injury Clinic work with a number of athletes (elite, professionals and everyone in between) and whilst we treat people from all sporting backgrounds, our own hobbies and experience in the the field can often drive our areas of expertise.

David Fanthorpe, a chartered physiotherapist with SPEAR is a keen golfer and works alongside Karen Young treating clients with golf-related injuries.  David and Karen also recently delivered a presentation in association with the Kings Links Golf Centre to golfers on related-injuries, recovery and prevention from a physiotherapy perspective.  We’ll be following up this presentation with a series of blog posts over the coming months.  This month David addresses concerns regarding growing trends of golfers incorporating weight training into their routines and some myths surrounding lower back pain. 

Golf has evolved over the last decade and we are seeing a shift in attitudes with the game being referred to as a sport.  The Professionals within the game are fast becoming on par with elite athletes and most are quite up front with the degree of training they incorporate into their schedules.  I guess a fair question would be…. is this in a bid to look good in tight fitting clothes or….. are golfers gaining physical attributes necessary to compete in the modern game?

This phenomenon of weight training for golf, comes with some pitfalls as some perceive this to link to Lower back Pain in the game (LBP).  How many of us have heard the comment “he’s lifting too much weights, he’ll damage his back”…. let’s reserve judgement before jumping to this conclusion.  At SPEAR we challenge you to break things down a little first and look at some evidence which may inform that opinion.

Firstly, LBP is common whether we lift weights or not.  The World Health Organisation suggests that the likelihood of developing LBP at some point in our lifetime is 60-70%.  A further study investigating the prevalence of injuries in golf reported that, of 283 players 72% reported injuries that caused them to miss a tournament or match, 55% of which were due to LBP.

This being so, it’s fair to say that LBP is relatively common in all walks of life – be it a professional golfer or an office worker and in clinic we treat all!  Like anything in life, there are loads being applied to our bodies structures whether you are static, or moving and we do not need to lift weights to directly load the spine.

It is easy to blame the gym for lower back pain in professional golfers, however a recent study investigating LBP specific to golf explains “…that while a golf swing creates sufficient stress to cause damage if not biomechanically optimal, it is usually more so from the accumulative load of poor technique versus one distinct swing that causes an injury.”  For example, a stiff mid back will cause more stress on the lower back.  If this is the case, one swing may cause no issue but the cumulative strain of hitting 200 balls on a range may be a different matter.

As physiotherapists we often see that if pain is elicited either in the gym or playing golf it is due to poor technique and abnormal loading, rather than the amount of weight being the issue.

So how can we reduce this??

For all you golfers out there who are keen to minimise the risk of LBP on the course, I have highlighted some of the key points taken from a the recent study* as a quick point of reference on further reducing the risk of developing LBP and get the most out of the Aberdeen golfing season!

• Warm-up for more than 10 minutes prior to playing and practicing.  This ensures we get the stiff areas moving so we don’t strain other area’s.
• Don’t practice for prolonged periods if you’re not used to it! Obviously playing and practicing can improve performance (a goal of many golfers) but you need to understand that your body’s tolerance for this needs to be increased over time.
• Improve upper body rotation and flexibility to help control your turn.  As mentioned earlier if the mid back is stiff we strain other area’s.  For all you big guns….increased mid back rotation has a correlation with increased drive distances.
• Maintain good hip rotation flexibility especially on the lead side to ensure you can get over the ball at impact.
• Practice hitting shots the other way (left handed if your right handed) for fun, by doing so you will be preventing developing an overpowering dominant side.
• Improve the strength and especially the endurance of the muscle that stabilise the spine. The incredible vitality and longevity of professional golfer, Gary Player, through six decades of competition is an example of the value of habitual, life-long exercise.
• Seek assistance if you are concerned about your swing from a Professional golf coach or physiotherapist to assess your swing mechanics and determine if there is a need to address biomechanical aspects which may be limiting your swing.
• Lastly, seek professional assistance from a physiotherapist or qualified strength and conditioning coach if you need to assess if your gym programme is at the appropriate level for your body’s capabilities

Going back to the original question as to why we are seeing a change in attitudes in professional golfers towards gym training? What we are seeing is a progressive increase in challenging the bodies in a variety of manners whether it is flexibility training or weight lifting, to better protect the body from the adverse effects of golf.  To put it plainly…….Golfers are implementing strategies to help maximise their physical threshold and reducing the cumulative load placed on their bodies through the sport of golf and extensive practice in the pursuit of excellence.

I suggest that the next time you hear those words “he’s lifting too much…” remember that the gym isn’t the enemy here and consider how common LBP is in life.  Learn from the best in the game and understand why they do what they do from a scientific mindset.

If you are concerned about the nature of your LBP in relation to your game or would like to be assessed regarding the matters discussed, please feel free to contact us at the SPEAR clinic.

*Lindsay. D, Vandervoort. A 2014.  Golf Related Low Back Pain: A review of causative factors and Preventative Strategies.  *Sugaya H, Tschiya A, Moriya H, et al. Low-back injury in elite and professional golfers an epidemiologic and radiographic study. In: Farrally MR, Cochran AJ, editor. Science and Golf, sun- III: Proceedings of the World Scientific Congress of Golf; 1998 Jul 20-24; St Andrews. Champaign (IL): Human Kinetics, 1998: 83-91