Golfers are pretty hard core and committed. They invest thousands of dollars and time into improving their golf swing and their score. As a Level 3 Medical Golf Fitness Professional certified by the Titleist Performance Institute, Dr. Tyler Hamel says the biggest void in golfers today is that they are not looking after their bodies. They are not putting much, if any time, into golf fitness.
The statistics are a bit alarming, but they are real as over 1/2 of active golfers are dealing with varying degrees of back pain, some so severe that they are unable to play a full round without stopping. That is 50% of both men and women golfers who are experiencing some kind of back pain, so why is this such an epidemic? In a nutshell, the golf swing puts significant stress on the lower back, for the average golfer this means taking 40-60 full swings of a golf club per 18 holes of golf. How many golfers out there, besides PGA and LPGA tour players, have a perfect swing that does not overly stress their back, hips, shoulders and neck? The answer is a very low percentage.
Most golfers have swing faults that are caused by their body’s inability to physically swing the golf club efficiently. Swing faults such as S-Posture, Reverse Spine Angle and Early Extension cause significant wear and tear on the spine of the low back, the hip joints, and the musculature that surrounds the mid back, low back and hips. The body is very resilient says Dr. Hamel, it can handle quite a bit of abuse, but over time it gets to the point where it is so broken down it starts to cause aches and pains.
Due to the twisting and compressive forces of the golf swing, the most common low back injuries we see are disc bulges/herniations, facet syndrome, misalignments/subluxations, and muscle spasms. What a lot of golfers don’t understand about low back pain is that it’s not the cause of the pain, it is usually the source of the pain. This means that common restrictions or lack of movement in the hips and mid back (thoracic spine), are causing the low back to compensate and to move much more than it should during the golf swing.
Dr. Hamel points out that the golf swing will always put stress on the low back, however, an optimized golf body that has the right combination of stability and mobility will be much better off. What this Kingwood chiropractor strives to do is to keep golfers golfing by helping to keep them healthy so they don’t have to quit the game.
We all know how enjoyable golf can be; it becomes a routine where lots of golfers are out there 3-5 times a week having fun with their friends and seeking out a lower handicap. Now, can you imagine how they feel when they can no longer get out there?
It is very important to work with your golf pro or instructor as well as a golf fitness professional like Dr. Hamel as there are always golf mechanics to be worked on, as well as improving your golf fitness body. What needs to be addressed is the ability of the golfer to swing properly. Is it a mechanics issue or is their body unable to physically do what it needs to do? As you can see, there are two major components to look at with the golf swing, and they are both related. Some golfers just don’t have the coordination or have not practiced enough to know how to swing the golf club, this is where a local golf pro or instructor can help. If after a few weeks of instruction the golfer sees how to swing the club properly but just isn’t able to physically do it, then a certified TPI golf fitness professional is what they need.
So, with the physical side of golf and the golf fitness body, what are the common restrictions that Dr. Hamel often sees which is not allowing them to swing the golf club with the proper mechanics? After 20 years of experience evaluating golfers and other rotational athletes, this is what Dr. Hamel primarily sees with these low back pain patients:
- Very tight and restricted movement of the thoracic spine (mid back area), rounded shoulders and anterior head carriage. This restriction is so common because of all the postural stress we have. We are sitting at computers and working on screens more now than ever before. Just think of how we start to slouch when working on a computer for 4-8 hours per day. Once our head moves even an inch forward it causes 2X as much pressure on the neck and midback, which equates to about 25 pounds of pressure. This is not just a problem for golfers, as Dr. Hamel has seen hundreds of new patients since COVID-19 because so many people are working from home at a home office that is not very ergonomically friendly. Postural stress is a major problem and is the most common cause of issues like headaches, chronic neck pain, chronic back pain and Sciatica.
- Hip restriction and anterior pelvis. This is another case for postural stress. when we sit for 8 hours a day it really locks down our pelvis and causes our hip flexors to be very tight. Tight hip flexors always lead to our pelvis rotating forward. Not only does this put extra stress on the hips and the musculature of the hips but also the low back. Over time, our hips get stuck. A big part of an efficient golf swing is internal and external hip rotation and the ability to clear the hips in the latter part of the golf swing. An anterior rotated pelvis definitely causes an S-Posture swing fault, meaning that the golfers butt is sticking out during the entire golf swing.
The simplest way to think about this is that a restricted thoracic spine and hips will make the low back have to move much more than it is supposed to move. Chronic low back pain for golfers will never go away unless they address the lack of movement in the mid back and hips. The cause of the problem has to be addressed, and that is what we do here, says this Kingwood chiropractor.
OK, so most golfers have learned something new about the thoracic spine, hips and low back pain, and with that being said it is really important to know what kind of swing faults are created because of these physical restrictions.
Most Common Swing Faults Causing Low Back Pain And The Reasons Why
1. S-Posture: The golfer is creating too much arch in their low back because they are sticking their butt out during the set up position. If you look at the lower back it appears to look like an “S” shape. Automatically this puts a severe stress on the joints and musculature of the lower back. This anterior pelvic posture caused by the S-Posture causes a core stability problem because it deactivates the ab muscles. A common cause of this can be lower crossed syndrome, meaning the patient has overly tight lumbar muscles and hip flexors and overly weak gluteal muscles and abdominal muscles. Lower crossed syndrome is almost 100% caused by two things; chronic sitting postural stress and lack of movement or exercise. Often times this swing fault will go along with the Reverse Spine Angle swing fault, which will be discussed next.
2. Reverse Spine Angle: This is when the upper body extends and bends backwards during the back swing. In this scenario your head is actually moving towards the target or golf ball when in reality it should be moving slightly away from the ball. This swing fault, the Reverse Spine Angle, is the most common cause for low back injury in golfers. Not only does this swing fault put excessive stress on the golfers left lower back, (for right hand golfers), but it puts even more wear and tear on the right low back through the downward swing. This is why the most common low back injury for right handed golfers is in their right lower back, caused by excessive right lateral bending and rotation of the lumbar spine. So, what causes this swing fault is coordination of moving the upper body on the lower body, tight mid back and latissimus dorsi muscles, weak core muscles, and decreased internal hip rotation on the back leg.
3. Early Extension: This is where your hips and spine straighten up during the downswing of the club. You can see this on a side view because the golfer appears to be lunging towards the golf ball. A golfer would notice early extension the most because it will not allow their arms to swing down and through as it’s like their pelvis is in the way. This swing fault is commonly caused by stiffness in the joints of the lumbar spine and hips and also decreased internal rotation of the left hip during the downswing and follow through. Some other mechanical things leading to early extension are excess weight on the heels during set up, standing too far away from the ball, inactive core/ab muscles and a steep swing plane.
As one can see, all of these swing faults have a physical restriction or component involved; the lack of a good, physical golf body is not allowing their body to do what it needs to do to swing the golf club effectively. If you are a golfer and are in pain or you notice that you just can’t hit the ball as far anymore, seeking out a golf fitness professional may be just what you need. If you believe you might have some of these swing faults causing unhappiness to your back or your golf score, a golf fitness evaluation is recommended. Golfers want to keep on golfing. They don’t want to be at home nursing their injuries and watching the golf channel. In a way, it’s all about being able to perform when you get out and play 18 holes, hitting the fairway, making some pars, birdies, hitting your clubs to the right distance and being pain free at the end of the round. This is what golf is all about.
About the Author:
Dr. Tyler Hamel is a Chiropractor, Nutritionist and Titleist Performance Institute (TPI) Certified Level 3 Medical Professional who has been in practice for over 20 years. He is a member of Kingwood Country Club and is an avid tennis player and golfer who is always in the gym working on his golf and tennis fitness.