How Playing Golf Can Hurt You

In our last blog on this topic, I explained how playing golf can actually hurt you. Today, I will go more in depth into the injury mechanisms in a golf swing that are responsible.

Once again, studies have shown that low-back pain accounts for anywhere from 18-54% of golf injuries. Injuries of the knees, hips, elbows, and wrists are also prevalent. Perhaps the biggest injury mechanism in golf is rotational movement, as all the swing types that are utilized in golf have a rotational component.

The human body is capable of doing many things, from hitting drives of 200+ yards to nailing precise putts. However, pain and injury can occur in rotational movements when joints that aren’t meant to rotate do exactly that. The joint-by-joint approach shows how the body’s joints alternate between mobility and stability for optimal movement. We can see here that the lower back is meant to be stable, and that both the upper back and the hips are meant to be mobile. These two areas are the primary drivers of rotational movement.

However, when either of these two areas are stiff for whatever reason, the body will find adjacent joints to produce rotational movement. Now, the lower back and the knees have to rotate, but neither of these areas were meant for that. This is how injuries occur in sports.

How many of you have “tight” hips or shoulders? How many of you can’t squat deep or move your shoulders through their full range of three-dimensional movement? These are common issues, and I’m not surprised that low-back pain is so prevalent in people who golf.

Pain and injury in golf generally occur as a result of overuse. Rotation, even if it occurs in the lower back, isn’t necessarily injurious right away. At a certain point though, these problems come to a threshold and injury finally occurs.

The silver lining though is that these injuries are preventable. Adequate rest and recovery, proper movement (especially in rotation), and strength can all mitigate injury risk. This all sounds obvious, but these three things make an enormous difference when it comes to staying healthy for golf.

Injury Mechanisms in the Golf Swing

Let’s cut right to the chase here. In a golf swing, there is a large magnitude of shoulder, torso, and hip movement. This is especially true of tee shots; without this magnitude of movement, golfers wouldn’t be able to drive the ball 200+ yards.

When you combine these large magnitude forces–especially on the spine–with a high number of swing reps, this cumulative load can result in LBP. It is hard to avoid either of these; you need high forces to drive far and perform better on the course, and you must practice this in order to be competitive.

Interestingly, it has been found that these forces differ between amateurs and pros. Amateur golfers have been shown to have higher peak shear loads on the spine, while pros averaged higher compressive loads on the spine.

Shear stress occurs when parts of the spine rub and slide against each other. This is problematic for amateurs, as shear stress isn’t well tolerated at all. It is buffered by the strength of the discs themselves, rather than bones and muscles. Compression is easier to handle, and it seems like professional golfers are better able to control their rotation in favor of higher compressive loads, which the spine can tolerate much better.

Think of a skyscraper. You can have people occupying every floor of the building, but the skyscraper won’t go anywhere–it remains completely intact. This is compressive stress.

Now think of the same skyscraper, and imagine that each individual floor slid left and right against each other. Skyscrapers weren’t meant to do that, and this one would promptly crumble to the ground.

– from Tiger Woods Golf Secrets

In order to make the most out of rotation, it is important to maximize something called the”X-factor,” or hip-shoulder separation. Better separation means better distance when it comes to the golf swing. In simple terms, hip-shoulder separation is when the shoulders are rotated as far away from the tee as possible, while the hips remain stationary and square to the target in the backswing. Then, the hips rotate forward towards the tee in the downswing, before the shoulders rotate forward. This creates a stretch in the trunk muscles (the abs) that preloads them for a bigger contraction and better club head speed, which in turn hits the ball harder and farther.

Think of the trunk as a rubber band. The more you stretch one, the harder it snaps back.  Likewise, better hip-shoulder separation stretches the trunk more. It has been found that experienced golfers do this better than beginners, but separation does put more stress on the spine and increases injury risk.

Let’s not also forget that golf is an asymmetrical sport, that likewise results in asymmetrical adaptations. Even between the backswing and downswing, there is asymmetry. Trunk rotation velocity is slower on the backswing and faster on the downswing. This makes sense, since the backswing is a “wind-up” for your downswing.

Furthermore, in a right-handed golf swing, there is left side-bend on the backswing, and right side-bend on the downswing. This is known as torqueing.

This combination of rotation and side-bending can be hard on the spine. In the right-handed downswing, left axial rotation velocity and right side-bending angles reached peak values at the time right after ball impact in LBP subjects. You can see this in the third picture of the series seen here.

 

This can be damaging to the lumbar spine, as it creates excessive intervertebral lateral shear. Furthermore, LBP predominantly occurs on the trail side (right side for right handed swingers).

Wrapping Up

As you can see, the golf swing can push the limits of the body’s functional integrity and result in injury, particularly of the lower back. In fact, the same injury mechanisms for the lower back that are mentioned above apply elsewhere in the human body too; the golf swing is a full-body movement, after all. As with other athletic motions, like sprinting and throwing, the combination of high movement amplitude and high speed in the golf swing is paramount for performance, but this also creates a higher risk of injury. It’s just the nature of the game.

But you can still mitigate injury risk with adequate rest and recovery, proper movement (especially in rotation), and strength. The last part of this series will go over strategies to help you do this.

References:

Lindsay, D. M., & Vandervoort, A. A. (2014). Golf-Related Low Back Pain: A Review of Causative Factors and Prevention Strategies. Asian Journal of Sports Medicine5(4), e24289. http://doi.org/10.5812/asjsm.24289

by Jeremy Lau

Jeremy Lau is a Senior Staff Coach and Metabolic Lab Manager at Halevy Life.

Jeremy graduated cum laude from Rensselaer Polytechnic Institute with a BSc. in Biomedical Engineering and received his Master’s in Exercise Physiology at Columbia University. In addition to his academic accolades, Jeremy is a Certified Strength & Conditioning Specialist (CSCS).

Prior to joining the team at Halevy Life, Jeremy completed a coaching internship at Cressey Sports Performance, where he coached both amateur and professional athletes, among whom were many professional MLB baseball players.

As an athlete, Jeremy has played baseball competitively for most of his life.