A Golfer’s Guide to Low Back Pain

The game of golf has been increasing in popularity in the United States. By the…

A Golfer’s Guide to Low Back Pain

The game of golf has been increasing in popularity in the United States. By the year 2000, there were more than 25 million golfers nationwide, with the number expected to continue to increase. Golf is often thought of as a low-impact sport, but it can be associated with several musculoskeletal injuries due to its repetitive nature.

One of the most common complaints reported by golfers is low back pain. Reported rates vary from 26% to 52%. Low back pain is also a major health issue among adults in the general population. It has been reported that 33% of golfers are age 55 or older; therefore, the degenerative (wear and tear) changes seen in many with age, in addition to the impact of the golf swing, may contribute to the high prevalence of low back pain in golfers.

[See: 11 Ways to Cope With Back Pain.]

Given the high prevalence and high cost of low back pain care, it’s worthwhile to consider how to prevent golf-associated low back pain. The golf swing, at first glance, may seem like a relatively simple task. However, the entire body is used to execute a golf swing in a complex and coordinated motion. When this is repeated frequently, significant stress is placed on the same muscles, joints and tendons, and over time, this may result in injury.

Understanding the mechanics of the golf swing, along with education and training, can help prevent golf injuries. It’s important to use proper posture and proper sequencing, and not to over-swing. Swinging too hard may increase the stress placed on the spine and surrounding structures. Individual golfers tend to have their own unique swing. However, each swing typically falls into one of two styles: the “classic golf swing” or the “modern golf swing.” The classic swing is typically considered a one unit swing where the golfer creates increased hip turn and the torso moves together as one unit with limited separation during the backswing. This swing style is felt to be less stressful on the spine but distance is often sacrificed. The modern golf swing emphasizes less hip turn and a greater torso rotation giving the golfer a much larger degree of separation of the torso from the hips creating the ability to generate more power and distance; however, there is some potential to impart more stress on the spine.

Golfers may be working on their swing with a golf professional, which is beneficial. You may also consider seeing a spine specialist and physical therapist who specialize in golf. There are rehabilitation programs that are golf-specific. Many of these programs offer an analysis of your golf swing combined with a physical assessment of strength and mobility to see where an issue may be present.

[Read: Exercises for Lower Back Pain.]

Organizations like Cleveland Clinic have a golf smart program. This is a golf performance program, and physical therapists with expertise in golf will work with golfers and their team to help them rehab their injuries and make potential swing adjustments. Evaluations can also be performed to customize workouts to help golfers improve their performance. It’s important to also evaluate the golfer as a whole. If one is having pain or experiencing trouble achieving the desired swing, it may be due to specific mobility limitations, which could lead to injury or decreased performance. A common example is golfers with limitations in hip or thoracic (upper back) mobility. These potential limitations may impart more stress on the lumbar spine (lower back), which may contribute to low back pain. These problems can often be discovered by a specific evaluation. Having good control of the proper swing movement pattern is important, and is why golfers with low back pain often need to develop better coordination and strength through specific exercises.

Studying the golf swing biomechanics in relation to the low back (lumbar spine) is helpful in understanding how an injury may occur. In doing so, we’re better able to understand the measures one can take to help with prevention. Strength training with a focus on lumbar stabilization techniques or core, flexibility training, as well as warming up, have all been shown to be beneficial. These therapies and swing modification are reasonable recommendations to consider in one who is experiencing golf-associated low back pain. It is also important to seek medical care and see your physician if you’re experiencing low back pain.

[READ: CBT for Lower Back Pain.]

You should see a health care provider if your pain is persisting or if you’re experiencing these warning signs that require prompt, urgent medical attention:

— You experience fever.

— The pain progressively worsens.

— The pain progressively moves from your back into your leg(s).

— You notice progressive weakness in your legs.

— You experience problems in your balance or walking.

— You notice difficulty controlling your bowels or bladder.

Dr. Tagreed Khalaf is a Clinical Assistant Professor of Medicine at the Cleveland Clinic Lerner College of Medicine. She is a spine specialist at the Center for Spine Health at Cleveland Clinic. Her expertise is non-operative spine care. She has been practicing at the Cleveland Clinic since 2008. Dr. Khalaf also serves as the quality officer for the Center for Spine Health. She enjoys being a mother to her two children and a wife and spending time with her family.