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Preventing Low Back Pain: A Golfer’s Guide

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Whether you’re a once-a-month golfer or one who hits balls every day, there is a good chance you’ve experienced some kind of discomfort in your low back as a result of swinging a club.

A host of tour players including Brandt Snedeker, Rickie Fowler and Tiger Woods have complained of back pain this season, even missing tournament play because of it. Indeed, research has consistently identified low back injuries as the most common injury affecting golfers. The exact cause of this pain is a hotly debated topic, however, most seem to agree that the rapid and intense shear, rotational and lateral forces placed on the lumbar spine (low back) as a result of the golf swing are in some way responsible.

My personal experience (backed by research I would like to add. After all, proper academic study results are much better than just taking my word for it!) points to several likely causes of lower back pain in golfers, and that appropriate intervention can successfully prevent and alleviate lower back pain. With that said let’s crack on to the bit you probably skipped to and look at some strategies and interventions to prevent low back pain:

Address Swing Faults and Characteristics

Studies seem to agree that faulty movement patterns and type of swing utilised have a great affect on the propensity to experience low back pain. Any swing fault involves excessive flexion, lateral flexion (a fancy way of saying side bending), or extension of the lumbar spine will increase the likelihood of low back pain. A “reverse C” address posture or follow through (think Monty’s swing for a pretty good dictionary definition of this) or reverse spine angle are the biggest candidates in my experience. Reverse spine angles in particular have been associated with low back pain associated with low back pain by researchers.

Interestingly, the “classic” swing (think Jack Nicklaus or Sam Snead where the lead heel comes off the floor in the backswing and hip turn is much more pronounced) has been demonstrated to be easier in terms of forces on the low back than the modern golf swing in which the lead heel stays flat and a big “x factor” is developed with a small hip turn and a huge shoulder turn.

Develop a Strong Core

Glute and ab strength helps stabilize the body and alleviate some of the pressure on the low back. The same study mentioned above showed that pro golfers not reporting low back pain demonstrated significantly greater abdominal muscle activation than those that did. Essentially, if you have weak abs and glutes, the low back is called upon to support the upper torso and supply stability in the golf swing. That’s not good.

The other issue concerning glute and ab strength is that of unilateral imbalances, with one side being stronger than the other. Several studies have identified muscle imbalances and asymmetry in glute strength as a probable cause of low back pain. A simple way to test unilateral glute strength is to complete a supine single leg bridge test.

Lying with your back on the floor, bend your knees so you can place your feet flat on the floor and fire your glutes and hamstrings to lift your butt off the floor, locking your hips out, so your body forms a straight line in a glute bridge position. From here the left leg off the floor. Hold this position for 10 seconds.

  1. Notice if the pelvis starts to drop, or the right leg starts to shake on either side.
  2. Do the hamstrings or lower back start to cramp?

If these things happen, you likely have a strength issue with your glutes or they are inhibited. If the results are significantly different when you repeat the test holding your right leg in the air then you likely have a unilateral strength imbalance.

single-leg supine bridge

Strive for Neutral Posture

Studies have reported that golfers exhibiting low back pain tended to flex their spines more when addressing the ball. However, it’s not just your golf posture you need to watch. In your daily postural habits too, you should strive to keep neutral pelvic alignment. Anterior pelvic tilt (forward tilting pelvic position) in particular has been associated with low back pain, as the tilt of the pelvis lengthens the hamstrings, affecting hamstring and glute function and requiring the low back to do much more work in providing strength and stability to make up for these inhibited muscles. Essentially you’re forcing your low back to do more work under more load, a recipe for pain and injury sooner or later.

Improve T-spine Mobility

Your lumbar spine can withstand some degree of extension and rotation, but not nearly as much as the thoracic spine is designed to achieve. Unfortunately, the fact is most people significantly lack adequate T-spine mobility to achieve proper rotation in the golf swing and therefore must make up for this by finding mobility elsewhere – i.e the lumbar spine which is, as I said, not designed to achieve a great deal of rotation. Not conducive to low back health!

Improving mid back (t-spine) mobility can alleviate any unnecessary torque on the low back. A 2002 study of professional golfers found that those presenting low back pain exhibited significantly more lateral bending and less trunk rotation in the backswing, while those who did not exhibit pain demonstrated more than twice as much trunk rotation. Give mobility drills such as the one below a go to improve yours:

[youtube id=”a3nPgxJKMPE” width=”620″ height=”360″]

Improve Hip Mobility

A case study of a pro golfer with low back pain has demonstrated an increase in hip turn in the swing resulted in a reduction of low back pain. Another study found correlation between decreased lead hip rotation and low back pain.

Simply put, just as with improving t-spine mobility, greater hip mobility can help reduce forces on the low back during the swing.  Why not give this hip mobility drill a try to improve yours? Just remember to keep the low back flat to the floor to stop it becoming a low back stretch (you’ll find out why very shortly):

[youtube id=”40_I_69Gvl0″ width=”620″ height=”360″]

Stop Stretching!

For years golfers in particular have been recommended exercises like hip crossovers and scorpions to “warm-up” the low back, when in reality, as I said, the lumbar spine is not designed for much movement at all. I would argue that most golfers should be avoiding exercises that excessively rotate the lumbar spine as this is really just feeding into the problems causing low back pain. Instead, they should focus on developing motion at the hips and thoracic spine. Don’t just take my word for it, check out this article by legendary athletic coach Mike Boyle, then do another set or two of the hip mobility and t-spine mobility exercises in the videos above.

The truth is that good motion in golf comes from turning the hips and shoulders, not from rotating the lumbar spine. The bottom line is bad, injured, golfers turn at the low back, good golfers turn at the hips and shoulders.

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Nick is a TPI certified strength coach with a passion for getting golfers stronger and moving better. Through Stronger Golf he uses unique, research based training methods to create stronger, faster, more athletic golfers. Golfers who are more coachable, achieve higher levels of skill mastery, play injury free, and for longer as a result of improved physical fitness.

14 Comments

14 Comments

  1. Pingback: Preventing Low Back Pain: A Golfer’s Guide - Spinesurgery-Pain-Usa

  2. Pingback: A Golfers Guide to Preventing Low Back Pain | Stronger Golf

  3. Bob Jones

    Jul 21, 2014 at 1:11 pm

    Nick, very good article. I had two spine surgeries in 2012, causing me to change everything about how I play golf. Here are a few thoughts, based on physical therapy and extensive research in the medical literature on the issue of lower back pain and golf.

    To save your lower back, you must minimize the angle between your hips and shoulders on your backswing. Maximizing the “X factor” is very hard on the lower back. Let the left heel come off the ground, like you said, and let the hips turn.

    The most damaging combination of movement in golf is lateral bending (side to side leaning) combined with compression (gravity pulling down along the spinal column). You can’t play golf and avoid this combination, but a swing with a high X factor accentuates it.

    I now swing the golf club with my hands. The body responds to what the hands do. The result is a shorter backswing, and less of a power move through the ball with my body. Those two things take a lot of stress off the lower back. I don’t hit the ball as far as I used to, so I moved up one set of tees. This swing provides much more accuracy, so I’m shooting lower scores.

    I have also slowed down my swing by quite a bit, which decreases distance, but which leads to centered contact, getting that lost yardage right back.

    The reason why, in the two videos, the demonstrator performs the two exercises with his spine in a horizontal position, is that the spine can thus be rotated without being compressed at the same time. Very important.

    Back strengthening exercises are important, too. One I do, and see everywhere, is to get on all fours. Stick your left arm straight out in front of you, parallel to the ground, and do the same with your right leg straight behind you. Hold for five seconds, and switch to right arm/left leg. Repeat ten times. You might thave to do fewer reps starting out.

    • Nick Buchan

      Jul 22, 2014 at 12:54 pm

      Thanks Bob. Completely agree that a swing with a higher x factor is often more demanding on the lower back, however it has not been my experience that a loss of turn must be the result, simply that that turn most come from other places. Additionally as I said in the article it has been my experience that working on t-spine and hip mobility should allow the amount of turn to be maintained without the pain and shoulder turn should not need to be reduced as has been suggested by many comments on this article. I also agree that back strengthening exercises are important, birdogs however, the exercise you are describing, is more of a movement patterning and core exercise with an element of scapular control and stability. A great exercise for those with back pain definitely, although some true strengthening exercises for the back such as face pulls, cable rows and chest supported rows should also be included too.

  4. joro

    Jul 21, 2014 at 11:14 am

    The quest for distance is the culprit, whether you are Tiger or Joe Hacker, or anything in between. Every as tells you to buy my club and be longer, so we swing harder. This puts tremendous pressure on the back. I broke my back in 2 places in an accident several years ago and as an avid Golfer played for a while in pain, until I broke it down to find out why it hurt so much.

    Simple, I was swinging at the Ball rather than through it. It w as then I realized the answer was to turn with the club, drop the club, and hit through the ball. I was a PGA Teacher and started getting my students with bad backs to do the same, turn back, drop the club and turn through and the speed will happen with a good turn through finish. It is not Rocket Science.

    You will get good distance, a better contact, and be more accurate. Sure, we hit hard at it and every once in a while but most of the time we flub it. But, as we are, we only remember the good one and not the rest of them. I am selling nothing, just saying what the real cause of back pain is, take it or leave it, but you will hit it better by turn back, swing with arms and never the hips, and hit through the ball to a good finish and by slowing it down from a flash to a roar you will have plenty of speed and make a solid hit.

    Swing hard and hurt. swing smooth and enjoy.

  5. joro

    Jul 21, 2014 at 11:03 am

    This is too simple. The problem with Golfers is because we are told it is all about distance we swing way too hard at the ball and not through the ball. I am both a teacher and have a bad back, the result of a Motorcycle crash. I lived and played in pain for a short time until I figured out it is the downswing that is the culprit. I started turning with the club and not pulling the club down but letting it drop and hitting through the ball.

    I teach that to Golfers with bad backs and when they realize they can do it without pain they are shocked. These Pros are no different with their high speed swings. They are the ones with the real bad backs while the slower, shorter hitters are going along with no back pain. Sure, excercise helps also, but the fast swing is the real culprit.

    Slow it down, you will hit it more solid, probably be longer and without pain. Turn back, turn through, and swing the arms, not the hips. This jamming the hips is wrong and puts more pressure on the body.

    • RD Thompson

      Jul 21, 2014 at 2:21 pm

      Joro.. I am in same condition as you and searching for a more relaxed swing that doesn’t impact the spine. When you mention turn back.. just about how far back? I, as you know the further back the longer the shot [supposedly] so I glean you are just back swinging to the point the arms are extended? How do you measure the back swing limit?

      • Bob Jones

        Jul 22, 2014 at 12:01 am

        RD: When you swing a hammer, you only go back so far, or you will not be able to deliver the hammer to the nail accurately. Let that feeling between the clubhead and the ball guide how far back you take the club.

  6. Frank McChrystal

    Jul 21, 2014 at 11:01 am

    See “Know your golf machine” on you tube. I can’t believe it has been posted for six years already.

  7. Nigel

    Jul 21, 2014 at 6:25 am

    Great write Nick, more of these types of Articles!

  8. Nick Buchan

    Jul 19, 2014 at 6:37 pm

    Thanks Nick. Appreciate it!

  9. Pingback: Preventing Low Back Pain: A Golfers Guide | Spacetimeandi.com

  10. Nick Randall

    Jul 18, 2014 at 10:42 pm

    Nice article Nick.

    I really enjoyed the recommendations, great to see some golf fitness advice that is relevant to every level of player and is easy to apply.

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What should your hips do in the golf swing?

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If you want to become more consistent, a better ball striker and hit longer golf shots then this is the video for you. This video will show you exactly what your hips pelvis should be doing during your backswing, downswing and through impact. Having great control of your pelvis and it’s movement will help you have greater control over your golf swing.

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Playing in your mind vs. playing out of your mind

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Comparing the recreational beginner to the elite player

As a player, I know there are rounds of golf where I feel like I worked extremely hard to achieve the results and there are also rounds that are effortless and just plain easy. Why do we go through these peaks and valleys in golf?

As an instructor and player, I want to explore a deeper understanding of what it means to be playing out of your mind vs. playing in your mind.

I want to address both beginners and elite players on their quest for better play. All beginners and elite players must understand that, as players, we are all experiencing ups and downs. The bottom line is that some handle them better than others.

Why is this a feeling golfers have: “playing out of your mind”?

Well, it is pure relaxation. It is fluid, seamless, continuous motion. No hang-ups. No hiccups.

The next big question, how do we achieve this regularly?

We get to this without forcing it, by believing in our makeup. It is locked in our subconscious. It is a controllable, uncontrollable. Subconsciously, your nervous system is in the green light. You are just doing. This is peak performance. This is the zone. This is playing autonomously, out of your mind.

I believe that over time, a golfer’s game is compiled in his/her built-up expectations of the player they truly believe they are. Expecting to make a putt vs. just so happening to make it feeds two different minds. When you place an expectation on an action tension is created. Tension creeps into our nervous system and our brains either respond or they don’t. This is called pressure. This is what I call playing in your mind. You are in your head, your thoughts are far too many and there is just a whole lot floating around up there.

The more players play/practice, the more they will expect out of themselves, and in result, create that pressure. (ie. Why progress is difficult to achieve the closer you get to shooting par or better). The best players are better at responding to that pressure. Their systems are auto-immune to pressure. (ie. Think of practice like medicine and think of a pre-shot routine like the Advil to help calm the spiking nerves.)

  • Playing in your mind = high tension golf… you might need an Advil.
  • Playing out of your mind = low tension golf… you are in a good headspace and are doing all the right things before your round even started.

The key to understanding here is that we can play in both minds and achieve success in either situation. It is all about managing yourself and your re-act game.

Subconscious playing is beyond enjoyable. It is more recreational in style. I believe beginners are playing more subconsciously, more recreationally. I believe elite players can learn from the beginner because they are achieving superior moments and sensations more subconsciously, more often. All players at all levels have off days. It is important to remember we all have this in common.

The goal is always to play your best. When I play my best, there are no preconceived thoughts of action. It’s simply action. Playing out of your mind is an unwritten script, unrehearsed, and unrepeatable on a day to day basis, you’re living it.

Say you have that one round, that out of your mind, crazy good day. The next few days, what do you do? Do you try to mimic everything you did to achieve that low number? As good players, we take these great days and try to piece it together into a script of playing. We know we can get it down to almost damn near perfect. The more a player rehearses the better they get. Edits are made…knowing that things are always shifting. Visualization is key.

No doubt, it’s a huge cycle. Players are in a continuous race to achieve results in numbers. Players looking to reach great success should generate a journal/log and compile a record and playback method and revisit it repeatedly.

There is no secret or magic…it takes mastering the minds to achieve the best results more often. Most important, as players, we must recognize that during our amazing rounds…

  1. We are relaxed
  2. We are having fun
  3. We are just doing

In this game, the deeper we go, the more we propose to be there. It will always bring us back to the basics. One complete full circle, back to the beginner in all of us. So, the next time an experienced player sees a beginner on the first tee…take a moment and appreciate that player!

Remember to enjoy the walk and believe that hard work always works!

Please reach out to me at dmfiscel1482@gmail.com to learn more about the zone and how to become accustomed to playing autonomously.

 

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Equipment improvements are even better for women! Now they are getting over 300 yards!

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We had a sweet driver shaft fitting at Club Champion in January. We picked up the shaft in their store in Phoenix and that afternoon, and Savannah hit two benchmark drives at 305 and another at 317 yards! Kinda makes you a bit of a believer, huh!? We are looking forward to seeing the numbers on our GC Quad back home this week to check out the difference. Stay tuned for next week!

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