This is a post by Dr. Dustin Lee PT, DPT
It is now springtime in Georgia. For some of you, this means it is time to get out and pound that pavement, spin those wheels or even enjoy splashing in the water (for me, otherwise known as trying to swim with good form). For others, it is a time to dust off those irons, regrip your clubs and start to use that high-tech yardage gear you received over the winter holidays. With the change of seasons, I figured this would be a great time to pass on some injury prevention knowledge to help you enjoy this beautiful weather by playing a round at your favorite course.
The golf swing is as simple or as complex as you can make. Tom Watson once said, “My golf swing is a bit like ironing a shirt. You get one side smoothed out, turn it over, and there is a big wrinkle on the other side. Then you iron that one out, turn it over, and there is yet another wrinkle.” I am not here to critique your swing, change your lag angle or help you close the club face on the down swing. However, I am here to explain how amazing the human body is at performing the golf swing motion. The result of your swing is a product of the club, which acts as an extension from your body to carry that ball toward the hole. First and foremost, you need to take care of your body because no matter how expensive your clubs are, you only get one body with which to use those clubs to their advantage.
The golf swing requires a complex interaction between joint mobility, muscular strength and stabilization and appropriate tissue length. This article is intended to highlight areas of major importance without overwhelming you with detail. Out of all the body motions needed for the golf swing, hip and spine rotation deserve the most attention. Lacking these motions places increased stress on surrounding joints and soft tissues, which can lead to injury. First and FOREmost (all credit given to my wife for coming up with this pun), the spine is made up of 33 vertebrae. Twenty-four of these bones are not fused, while the remainder have a degree of fusion (namely the sacrum and coccyx). Joints between the vertebra allow for movement to occur. Each of these vertebra therefore has the ability to move through small ranges of motion before influencing the movements of the vertebra above and below. When you combine small amounts of motion from each vertebra, your sum equals total spine movement for the purposes of daily function. At times – depending on a variety of factors, including age, activity, disease, etc. – vertebral movements can become reduced or significantly increased. Both alterations in movement can contribute to, but do not cause, pain and dysfunction. Reduced movement is more common for many individuals and can cause increased motion of surrounding vertebra to attempt to make up for the range of motion loss. This can lead to joint stress, muscular contraction to protect from injury and alterations in movement to reduce stress at the area of increased movement.
Now, let’s consider the impact that reduced hip range of motion can have on the spine. The hip joint is made up of the pelvis and upper leg bones (femurs). The spine connects to the pelvis via the joints between the sacrum and pelvis. During the golf swing, the hips each go through internal and external rotation (turning in and turning out). The pelvis rotates on top of fixed legs, and the spine then rotates on top of the pelvis once hip motion is completely utilized. So, what if I asked you at this point what would happen if hip rotation motion was limited – especially on your trail limb? Using what you learned from above, you may have been able to come up with the following answer: the spine needs to try and make up for the rotation motion loss during the swing. I will stress again that this can lead to joint stress, muscular contraction to protect from injury and alterations in movement to reduce stress at the area of increased movement.
Lastly, let’s consider the effect that limited motion of the spine has on the shoulders by starting you off with a fun fact: Did you know that the shoulder’s primary connection to the skeletal system is through the clavicle? The clavicle connects the shoulder blade to the sternum. The sternum connects the ribs to the spine (specifically the thoracic spine or middle back). I guess you may see where I am going with this now, but for repetitive purposes and to drive the point home, let’s go through it again together. So far, we have covered how limited motion of the spine may cause excessive motion elsewhere. In this case, if there is limited motion of the spine (especially the thoracic spine), it can lead to limited motion of the shoulder as well. The shoulder is a very dynamic joint that requires a lot of harmonized motions to simply get your arm above your head – and the spine is a crucial component of that motion. It should be no surprise now when I report to you that the leading injury sites for professional and amateur golfers include the shoulder and lower back, as stated by a literature review performed by McHardy et. al. in 2006.1
Good job on sticking with me this far. We just made it to the par 3, 17h tee box at TPC Sawgrass. Let’s drive this home for an ace and cover some ways you can be proactive and help your body perform at its best!
“What people find in poetry or art museums, I find in the flight of a good drive” – Arnold Palmer
Mchardy, A., Pollard, H., & Luo, K. (2006). Golf Injuries. Sports Medicine,36(2), 171-187. doi:10.2165/00007256-200636020-00006