Back in the Swing: Learn how to help your patients avoid injuries while golfing

By Kym Burke

(This article was published in the July 2009 edition of the American Chiropractic Association News.)

Golfing is a common summer-time activity that those of us who live in the northern parts of the country don’t participate in year-round. The physical demands of golf are much different from what most of your patients experience in their daily lives. Therefore, it makes sense that at least a portion of their fitness training should be spent preparing the body for the specific physical stresses, so they can enjoy the time spent golfing and participate as much as they would like. Below you will find specific training that can be done to prepare the outdoor enthusiasts for playing golf, while avoiding any acute or overuse injuries.

Endurance Training
The game of golf is usually played over a three- to five-hour time period. Therefore, there is certainly an element of endurance involved. Being able to maintain a neutral spine while repeatedly standing in the address position, for instance, requires quite considerable muscular endurance on the posterior muscular chain, specifically, the hamstrings, gluteals, erector spinae, as well as the deep spinal stabilizers. Deadlifts and anterior reaches are both excellent movement patterns to train.

Joint Mobility and Stability
Unique to the game of golf is the highly ballistic 1.5-second explosive golf swing. This complex movement requires a high level of execution, coordination and power. Mobility and stability of the different joints are key.

Starting with the foot and ankle, having the ability to move freely in the frontal plane (i.e., side to side) will not only decrease the stress on the knees, but also allow the legs to remain “quiet” throughout the swing. The supro-dance addresses the mobility of the foot and ankle exactly as is necessary in the golf swing. This is not a typical movement pattern for activities of daily living; therefore, it is very important to include this in a golfer’s training regime.

Rotation Training
Internal rotation of the hip is another common limiting factor with the recreational golfer. If golfers lack the ability to internally rotate their pelvis in relation to their femur, they will “slide” through both their back swing and follow-though. Using two-leg and single-leg hip rotation exercises will train the golfer to move freely through this range of motion.

Training Pelvic Tilt
Another common problem with recreational golfers is their inability to move their pelvis in the sagittal plane through an anterior pelvic tilt and posterior pelvic tilt. Having the neuromuscular control to maneuver in a coordinated fashion through these positions, as well as the endurance to hold the anterior pelvic tilt in the address position on the back nine, presents quite a challenge. If the golfers are not conditioned properly, they will begin flexing their spine in order to address the ball, as opposed to hinging at their hip. Throw in a dynamic rotation pattern on a flexed spine, and you’ve got a perfect recipe for injury. A quadruped anterior-posterior pelvic tilt as well as a standing anterior-posterior pelvic tilt will teach the golfer the necessary neuro-muscular control.

Working on the Trunk and Shoulders
The golfers’ ability to turn their shoulders will be determined by the “smartness” (i.e., coordinated strength) of their core in neutral spine, as well as their ability to rotate their thoracic spine. Remember, it is the thoracic spine that drives the scapula and the scapula that drives the humerus. So for the humerus to have the mobility to get the club face back, for instance, the player must have the mobility in the thoracic spine. A stable lumbo-pelvic unit will provide the platform for good shoulder turn. Various chopping and lifting exercises will train your golfer patients to “own” the appropriate length-tension relationship on the core musculature, giving them an opportunity to move the upper back and shoulders as is necessary in the golf swing.

Kym Burke, a certified personal trainer and health and fitness instructor, is the co-owner of One on One, Fitness Consultants Inc. (www.fitnessconsultantsinc.com). Established in 1985, One on One provides customized fitness training programs, from post-rehabilitation to enhanced sport performance.

View this article on the ACA website.