Swinging Into Shape
Injury Prevention for Golfers
There are approximately 5.1 million junior golfers in the United States, and while it is a relatively safe activity compared to other sports, the game of golf, specifically the golf swing, stresses the body in unique ways that can lead to injuries.
Because it is a non-contact sport, golfers are at a greater risk of overuse or chronic injuries than acute injuries like a broken bone. The majority of these injuries affect the upper extremity like the shoulder, elbow and wrist; however, the most common complaint of golfers is low back pain. The leading side of the body is more commonly injured than the trailing side of the body.
Factors in Injury
The prevalence and type of injury depends upon certain factors:
Amateur golfers have a higher percentage of low back complaints, whereas professional golfers more often report injuries to their hands and wrists.
Injuries in amateur golfers are most often related to poor swing mechanics, over-swinging, poor warm-up, changes in grip or swing, or hitting a “fat shot”(striking the ground with the club). Injuries in professional golfers are secondary to overuse from playing many hours of golf a day most days of the week.
Golfers with a lower handicap (0–9) are more likely to develop an injury than those with a higher handicap (greater than 18).
Most avid golfers strive to develop a rhythmic, consistent, refined golf swing that is the same every time. This type of swing is termed a “grooved swing” and is characteristic of professional golfers, resulting from countless repetitions, swing refinement and patterned coordinated muscle firing. Amateur golfers, however, have not developed the organized muscle firing patterns characteristic of professional golfers, which is why most of their overuse injuries relate to problems with swing biomechanics.
Amateur golfers tend to compensate for poor swing mechanics by applying larger muscle forces in an attempt to overpower the ball. The use of more muscle strength to compensate for technique increases the risk of injuries. Also, as a golfer tires, muscles fatigue and poor mechanics become more pronounced, further increasing the risk of muscle soreness and injuries.
Breaking Down the Swing
The golf swing is a complex coordinated movement of the legs, trunk, shoulders, arms, wrists and hands, and making the appropriate adjustments in your swing can compensate for injuries or prevent them from occurring.
The golf swing is broken down into four phases: backswing, downswing, acceleration and ball strike, and follow-through. Understanding each phase will help the golfer identify specific problems in his swing mechanics that may lead to poor performances or injuries.
Preventing the Most Common Injuries
Making small adjustments to the golf swing can help prevent some of the most common injuries golfers face:
a. Low Back Pain
There are two ways to adjust a golfer’s swing to reduce the strain on the lumbar spine. At the end of the follow-through, the spine should be straight and perpendicular to the ground, rather than the “reverse-C” position, to minimize the load placed on the lumbar spine. Second, during the backswing, minimize the difference between hip rotation and shoulder rotation to decrease the forces placed across the back.
b. Shoulder Pain Shoulder pain is usually caused by overuse rather than poor swing mechanics. Too much, too soon, too often are the usual causes, as well as an inadequate warm-up and poor conditioning of the shoulder muscles. Warming up prior to each round of golf as well as a conditioning program to strengthen shoulder and back muscles can prevent injuries. Adjusting the backswing can also help; ending the club at the 1 or 2 o’clock position, rather than 3 o’clock, can reduce stress on the shoulder and the acromioclavicular joint without sacrificing club head speed in the downswing and acceleration phases.
c. Golfer’s Elbow Excessive grip tension can cause an injury to the elbow called epicondylitis, better known as “golfer’s elbow.” Medial epicondylitis occurs in the trailing arm, and lateral epicondylitis occurs in the leading arm. One way to combat the problem is with a medial counterforce elbow brace (similar to a tennis elbow strap). A change of equipment may also help: Try using clubs with a larger grip, cavity-backed irons with larger heads and “sweet spots” to decrease the amount of vibrations, and/or more flexible graphite shafts.
Each round of golf should begin with a proper warm-up to prepare your body and muscles for the stresses that you will encounter during your game. Focus on flexibility and stretching in the neck, shoulders, forearms, trunks, low back and calves.
Dr. Troy Smurawa
Board-certified in both pediatrics and sports medicine, Dr. Troy Smurawa is the director of pediatric sports medicine at the Children’s Health Andrews Institute for Orthopaedics & Sports Medicine in Plano, Texas. Dr. Smurawa earned his medical degree from The University of Texas Health Science Center and did his residency in pediatrics at the University of Wisconsin. He completed a sports medicine fellowship at Children’s Hospital Medical Center in Akron, Ohio.