Golfing and Low Back Pain
There are two main reasons why almost 40% of amateur golfers experience chronic low back discomfort and/or acute injury: The first is technical in nature, and the second has to do with muscular deficiencies.
From a technique perspective, there are several very common swing faults that can bring on low back issues. First and foremost is reverse spine, or a leaning of the upper body back toward the target during the back-swing. Not only does this fault not place the golfer in a good hitting position to initiate the downswing in the proper hitting sequence, therefore causing the upper body to dominate the swing, but it also often times leads to low back issues.
A close second is early extension, or a moving of the hips toward the ball, usually during the downswing. As this occurs, it traps or blocks the golfer's hands and arms behind him, usually causing him to push or hook the shots. Increased upper back curvature and head lift generally accompany this fault. Stress is usually to the right lower back.
Finally, the S-posture, or swaying (arching) of the lower back while at address over the ball, places excessive stress to the lower back muscles. This position also will cause the abdominal to relax, which can lead up to reverse spine or loss of spine, consequently impacting the swing sequence. This fault is typically seen more often in women and younger golfers.
Anatomically, regardless of swing faults, tight hamstrings in the back of the thigh or tight hip flexors in the front of the hip are major factors that contribute to low back discomfort.
Can you touch your toes without bending your knees?
Tight hamstrings, which are seen mainly in men, may rotate the hip posteriorly toward the back, causing the low back muscles to stretch and become taut. Early signs and symptoms include tightness in the lower back after sitting for a prolonged period of time, and/or stiffness the day or two after a round of golf or other physical activity such as raking leaves. More serious consequences cause the discs in the back to wear out quicker, leading up to a nerve impingement from a slipped or bulging disc, and/or a narrowing of the space between two vertebrae. The result can be sciatica, buttock and/or leg pain, or numbness in the lower extremity.
Tight hip flexors, seen mainly in women, causes the hip to rotate anteriorly toward the front, causing an arching or swaying of the lower back. That, as discussed above with S-posture, places excessive stress to the lower back anatomy. More serious consequences are the same as those for tight hamstrings.
Weak glutes, or butt muscles, can also play a factor in low back discomfort. Often times the low back muscles will try to compensate for weak glutes by placing additional stress on the lower back. Of note, older male golfers I've evaluated for back pain have poor glute strength.
Awareness plays an essential role in alleviating and/or eliminating low back discomfort and injury among golfers, especially the older golfer. Identifying the particular swing faults and muscle deficiencies allows for the development of a personalized exercise program that will isolate and correct the mechanism(s) causing the pain. This, without a doubt, is the key to pain-free golf, regardless of how chronic or acute the condition has been.
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Case in point is Bill from College Station. An avid golfer, Bill had stopped playing due to pain in his lower back. Upon assessment, among other deficiencies, it was discovered that Bill's left lower back muscles and glutes were weak; he shifted his left hip early on extension swing due to a hypermobile hip joint; his hamstrings were extremely tight; and he showed a marked imbalance in his follow through swing strength. A corrective program to isolate these areas has brought Bill relief and he is now back on the golf course. Here's what he had to say: "I had been experiencing lower right side back pain for a couple of months that was so bad that I was not able to play golf and experienced constant pain. During that period I saw my primary care provider, had a spinal injection (my back and leg pain came back) and I was told I might need spinal surgery. I had an evaluation with Dr. Bradway and he sat me down and explained to me exactly why I was having my lower back pain. He developed a program for me and told me that if I followed his therapy program and corrected some of the deficiencies he noted during my evaluation it would solve my back problem. Guess what? My back pain problem is solved! I'm back to playing 18 holes of golf and my back doesn't hurt anymore. What a great feeling!"
If you are in search of treating your pain and want a pain-free life, contact my clinic at 979-776-2225 to set up an appointment. I promise you that physical therapy can change your life for the better.
