By Dr. Jordan Ganther, PT, DPT
Golf in Wisconsin is something that we only get to do for about six months out of the year. It has been one of my biggest hobbies over the past few years. Even though it is a low impact sport, we can experience a multitude of different injuries.
I have experienced golf injuries myself, especially during the first few rounds of the year where my back stiffens up and the inside of my elbow hurts. While these only last a small amount of time, I have seen countless patients where the post round aches and pains turn into a diagnosed condition. Since we can only play a few months out of the year, most of us do not play nearly as often during the winter as we do during the summer. Because of this, I see a lot of overuse injuries at the beginning of the summer. The mechanics of the golf swing require significant rotational forces being directed to various parts of our bodies. If we do not have proper mechanical alignment in our joints and the strength to take an average of a hundred swings in a day, we can create significant strain into our body as a whole.
What are common golf injuries?
It is really challenging to have a complete tear or rupture of something while golfing. It doesn’t involve running, jumping, cutting, or lifting heavy weights. I primarily see the “overuse” injury where faulty mechanics and poor strength lead to too much stress on our bodies.
The most common areas that I see injured in golfers are:
Low back (lumbosacral strains and sprains)
Medial elbow (golfer’s elbow)
Hip (trochanteric bursitis, impingement)
What causes golf injuries?
The motion of the golf swing is repetitive and cyclic. Throughout the swing, we see a slow rotation backwards with a violent rotation in the opposite direction as we attempt to hit the golf ball. It is very similar to running in that if there are impairments in our body, they are magnified with the countless repetitions of the specific movement.
Low back and hip range of motion is vital to the golf swing. The lead hip goes through the entire available range of motion during a golf swing. If we do not have adequate hip range of motion during the golf swing, we either put too much strain on the hip or we compensate with our low back. This then puts strain on the low back.
Torso kinematics are also an important part of golf performance and injury prevention. It can be observed that when people have limited rotational range of motion of their mid and low back, performance suffers. We simply cannot generate enough force directed at the ball if we are not able to rotate through our spine. Lack of core strength is another big component of low back injuries, in general, but it is amplified with golf. Our lumbar stabilizers need to be strong so they can be resilient when violently attacking the golf ball.
If we couple tight hips, a tight low back, and weak core muscles; we end up with substantial strain going into the facet joints and discs of the spine. This will frequently lead to injury.
Now most golfer’s have heard of “golfer’s elbow”. It is truly named medial epicondylitis. This is a condition of pain and swelling over the inside portion of the elbow, otherwise known as the medial epicondyle. The causes of this injury are repetitive strain into the medial elbow over time, weakness, and muscle tightness. Most of the time, this is not a one time injury. I see it happen at the beginning of the season where swing mechanics are poor and forearm strength is lacking.
How do we treat common golf injuries?
The first step in addressing common golf injuries is doing what we do with every patient. Identify the impairments that are leading to strain being put on different areas of the body. Improving hip range of motion and low back range of motion will assist with a more mobile golf swing. After proper hip range of motion is achieved, we can begin to start strengthening these areas.
Physical therapy can help these impairments. At Wisconsin Orthopedic Physical Therapy, we all utilize a tool called dry needling. By dry needling certain muscles of the hip and low back, we can reach new ranges of motion. This coupled with a proper stretching routine will allow these changes to last.
Rotational strength allows for greater club head speed, which in turns makes the golf ball go farther. Hip stretching, thoracic rotation, and core strengthening are a part of my workouts in order to be better at golf. These will also help prevent injury.
Golfer’s elbow can be treated with the same approach to care as the low back and hips. The most common impairments are wrist range of motion and lack of strength in our wrist flexors. By stretching and strengthening the appropriate muscles, we can make our elbow resilient to the strains that can occur when hitting a shot too thin or too fat.
References:
Kiel J, Kaiser K. Golfers Elbow. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519000/
Bourgain M, Rouch P, Rouillon O, Thoreux P, Sauret C. Golf Swing Biomechanics: A Systematic Review and Methodological Recommendations for Kinematics. Sports (Basel). 2022 Jun 9;10(6):91. doi: 10.3390/sports10060091. PMID: 35736831; PMCID: PMC9227529.
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