Golfer’s back pain screening

A 55-year-old gentleman presented for a golf-specific screening to help his assess for any movement issues that could be addressed to help reduce the risk of injury. He explained to me that he played off a handicap of 15 and has experienced some ongoing lower back pain on the left-hand side. He was a right-handed golfer.

The pain was intermittent and would come and go but he was more aware of it after a round of golf and occasionally would get pain on the top of the backswing. He was otherwise generally well with slightly raised blood pressure.

A golf screen assesses all the areas in the body used in the golf swing. It looks at strength, control and flexibility.

On his golf screen, it was evident that he had a very stiff mid-back (thoracic spine) weakness on his left hip and reduced strength around his pelvis and lower back.

This combination of restrictions meant that at the impact on the golf swing, when lots of strength in the left leg is required, the left side was not able to take all the stress. This would then pass stress up into the back. The reduced rotation in the mid back meant he had to extend his lower back to get to a full backswing again overstressing the lower back. This combination meant the lower back was taking more than its fair share. This, repeated over many swings on the course and driving range meant the back was under a lot of stress.

I explained this to him. We arranged a follow up to go through a specific rehab programme that I had put together to help strengthen his left hip, increase his mid-back mobility and also his overall control and strength of his back and pelvis. The research evidence supports this approach, see ref 1.

After working on this for three months he came back to see me. On review, he has much improved his strength and improve mid-back mobility. He reported a significant reduction of symptoms during and after the round of golf with only minimal strain or twinge on occasions but mainly if he played a lot of golf in one go or is away on a golf holiday.

This shows the importance of good flexibility and strength in key areas so that the stress of something like a golf swing is evenly distributed throughout the body without one area taking more load than it needs to or can cope with.

Mark Brennan MCSP MMACP

Ref 1. The research base for golfers back pain.

Ref 2. The conclusions of this study statesthere are many possible factors contributing to LBP from golf including overuse, poor conditioning, inappropriate warm-up and club transportation methods and biomechanical factors creating excessive stress on the spine. In addition to appropriate exercise rehabilitation, it is important for healthcare providers treating injured golfers to investigate factors such as swing technique when determining appropriate rehabilitation strategies. Correction of biomechanical deficiencies in a player’s swing does not rest exclusively on the healthcare provider but will often involve collaboration between the healthcare provider and a certified golf coach.