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Jonas Blixt Case Study: From Back Pain to PGA Tour Win

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This is a case study on professional golfer Jonas Blixt and his eight-month journey from severe and persistent back pain to a PGA Tour win. It was written to offer insight into the work that a dedicated professional put into his body and his game after a setback due to a significant injury. The case study also serves to highlight the importance of training for posture, spinal strength, and shoulder girdle stability: three areas of training that are often misunderstood and under-appreciated.

The majority of Jonas’ rehab and progression forward was performed using GravityFit exercise techniques and products. GravityFit is an Australian-based company that specializes in a science-based approach to training the body for spinal strength, injury prevention, posture, and golf movement patterns.

Background: Jonas, 32, and is in his sixth season on the PGA Tour. He’s won three times in his career (2012 Frys.com Open, 2013 Greenbrier Classic, 2017 Zurich Classic), and his best finish in a major came in 2012 when he finished T2 at the Masters.

Strengths: Putting, Around the Green. Career-average rank of 33rd in Strokes Gained Putting. Career-average rank of 36th in Strokes Gained Around the Green.

Weaknesses: Off the Tee, Iron Play. Career-average rank of 143rd Strokes Gained Off the Tee. Career-average rank of 158th in Strokes Gained Approach the Green.

Physical Training History: College program at Florida State University. Exposure to various different methods of training stability, mobility, strength, and power since turning professional.

First Contact

Jonas came to see me with after having received two cortisone shots for back pain resulting from herniated discs leading to nerve compression in his lower back. He also received another shot for pain referring into his left glute/hip, suspected at the time to be caused by facet joint inflammation. His desire was initially to return to a pain-free state, and then to improve his long game by hitting more fairways and greens, thereby gaining strokes on the field in the Strokes Gained Off the Tee and Strokes Gained Approach the Green categories. If that outcome could be accompanied by an increase in distance, then that would be a bonus.

After conducting the initial screening and assessment, I highlighted the following areas as priorities for improvement:

  • Lumbar and cervical spine posture (lower back and neck).
  • Core awareness, stability, and control.
  • Arm and body connection movement pattern in rotation.
  • Quality of rotation movement pattern from thoracic spine (mid and upper back).
  • Mobility in right shoulder (external rotation), thoracic spine (rotation and extension), ankle (dorsi flexion), and quad tightness.

I believed that improving these areas would not only help Jonas move better in his golf swing, but more importantly at that stage, help take strain away from his lower back.

Of particular interest was how Jonas performed in a series of tests for awareness control and stability of the lumbar core (think core muscles and lower back). This seven-stage series of tests is called the Core Body Benchmark. It was developed by GravityFit to provide a more objective measure of core control that could be easily administered in any setting.

Jonas failed the last four tests in the series:

  • Hinge Forward
  • Hinge Forward with Rotation
  • Single Leg Hinge Forward
  • Single Leg Rotation

Despite a history of core training, Jonas was unable to use his core muscles effectively in the movements that he repeated up to a thousand times per week: hinging forward, balancing, and rotating (the key components of the golf swing). Click through for more info on the Core Body Benchmark testing protocol.

Initial Program: These assessment findings, combined with the recent back injury, immediately lead me to write Jonas’ first program using predominantly GravityFit tools and techniques, which are specifically designed for strengthening the spine and improving posture. Luckily, we had a few weeks before the first tournament of the 2017 season, so it was time to go work. Below is a snapshot of the initial program, including a few photos of Jonas and myself demonstrating the exercises.

Program 1

A very basic daily program that focused on establishing good posture, as well as training basic spinal stability and quality of rotation. This program also included a 20-minute walk in the soft sand (Jonas lives near the beach) and a range of self-massage and stretching exercises. The exercises are below and were performed using the Gravity Cap and GravityFit TPro.

Movement Patterns

  • 1A: Gravity Cap Walk
  • 1B: Gravity Cap Knee Lifts
  • 1C: Stomp and Pulse
  • 1D: Split-Stance Backswing
  • 1E: Split-Stance Follow Through

Conditioning

  • 1: Beach Walk
Program 1.1

Figure 1

Gravity Cap Knee Lifts (Figure 1): This exercise establishes a solid upright posture, stretching tall against the resistance provided by the Gravity Cap.

Program 1.2

Figure 2

Stomp and Pulse (Figure 2): Here I’m training golf posture using the TPro for postural feedback and scapula/shoulder stability and control.

Program 1.3

Figure 3

 
Split-Stance Backswing (Figure 3): Training dynamic rotation using the TPro while working on balance and control with the split stance.

Program 2

After two weeks of the initial program, we progressed into more traditional exercises (squat, lunge, push, pull) with the addition of the GravityFit TPro and Core Awareness Belt (CAB) to give audio and kinaesthetic feedback on quality of movement and postural control. We also advanced the specific posture and rotation exercises to add some more complexity and challenge. As you can see in the video below, at this stage even a simple bodyweight squat was a challenge for Jonas.

Strength

  • 1A: Body-Weight Squat
  • 1B: Push Up
  • 1C: BW Backward Lunge
  • 1D: Cable 1-Arm Row
  • 1E: Mini Mountain Climber
  • 1F: Pallof Press

Movement Patterns

  • 1A: Gravity Cap Hurdle Walk
  • 1B: Split-Squat Rotate
  • 1C: Jonas Backswing Drill
Program 2.1

Figure 4

Jonas Backswing Drill (Figure 4): Jonas is using the TPro and the Core Awareness Belt (CAB). Notice the hand position: right palm up, left palm down. This was a custom feel for Jonas that he wanted to train in his backswing.

Video 1

Body-Weight Squat (Video 1): Jonas initially struggled to squat while maintaining his posture. A combination of ankle mobility restriction and lack of core control made it very difficult for him.

About 5 weeks after our initial session, the fall series events came around Jonas decided to play. We continued to gradually increase the complexity of the exercises, each program requiring a little more from the perspective of stability and postural control. The majority was still only using bodyweight and some light band resistance.

Programs 3 and 4

At this point, Jonas was really starting to improve his movement quality and balance.

Program 3.1

Figure 5

Split-Hand, One-Foot Push Up (Figure 5): An advanced version of a push up, again using the TPro and CAB to provide feedback on the quality of posture and movement. This is a fairly typical example of advancing an exercise’s difficulty without adding external load.

Program 3

Strength

  • 1A: Overhead Squat
  • 1B: Split-Hand, One-Foot Push Up
  • 1C: Lateral Lunge with Knee Lift
  • 1D: Single-Arm, Split-Stance Pulldown
  • 1E: Prone Turn Under
  • 1F: Split-Stance Pallof Press
  • 1G: Lying Glute Bridge, Foot Up

Movement Patterns

  • 1A: Gravity Cap Hurdle Walk
  • 1B: Jonas Backswing Drill
  • 1C: Follow Through

Program 4

Stability

  • 1A: Knee Band Crab Walks
  • 1B: Crawling

Strength

  • 1A: Goblet Squat
  • 1B: Resistance Band Push Up
  • 2A: Bulgarian Split Squat
  • 2B: Cable 1-Arm Row
  • 3A: 1-Leg Band Push Out
  • 3B: Pallof Hold

Video 2

Lateral Lunge with Knee Lift (Video 2): This exercise is really quite challenging to perform with balance and control while avoiding the audio feedback that the CAB provides when the core isn’t working properly.

Video 3

Single-Arm, Split-Stance Pulldown (Video 3): Again, a variation on a simple exercise with the aim of introducing a balance and co-ordination challenge.

Return to Playing

Jonas’ transition back to golf wasn’t exactly smooth. Despite showing significant signs of improvements in his movement quality and overall back pain, he was still struggling with occasional flashes of pain into his left glute during play and when getting up and down from a low, seated position. His results and Strokes Gained statistics tell the story of on-course performance.

  • Results: Four events, three missed cuts and a T48
  • Strokes Gained Off The Tee: -1.441
  • Strokes Gained Approach the Green: -0.464

Over the six-week Christmas break, it was decided that a complete rest from golf was a good idea. This would allow Jonas’ back more time to heal and also offered him the opportunity to receive some treatment and advice for the occasional flashes of pain that seemed to be hanging around. Dr. Craig Davies and the Swedish Spine Institute had very effective input into helping resolve the issue, which was eventually identified as a glute med/min tendonitis. Meanwhile, we continued to progress the difficulty of the training programs and added some more significant load.

Program 5

We moved into more traditional strength movements and methods of loading. These were all done still using the GravityFit equipment to provide postural feedback.

Stability

  • 1A: Fall to Wall – 2 Arms
  • 1B: Single Arm Turn Under

Strength

  • 1A: BB Front Squat
  • 1B: DB Bent Over Row
  • 2A: DB Step Up
  • 2B: Torsonator Shoulder Press
  • 3A: Suspended Leg Lift – Bent Knee
  • 3B: Prone Hold 2 Limb Switch
Program 5.1

Figure 6

Barbell Front Squat (Figure 6): This is a classic strength exercise that requires excellent squat mechanics and postural control to be performed safely.

Program 5.2

Figure 7

Torsonator Shoulder Press (Figure 7): Using a uni-lateral (one-sided) external loading technique requires more from the core and postural stabilizers. It was a big step forward when Jonas was able to comfortably perform these exercises. 

2017

With the New Year came a return to practice and first start in the Sony Open. All traces of pain by this time had been eliminated, and Jonas’ elusive long game seemed to be showing significant signs improvement through his first few events of the year.

  • Strokes Gained Approach Green: -0.217 (his career average was -0.44)
  • Strokes Gained Off the Tee: +0.242 (his career average was -0.24)
  • Club Head Speed: Increased to 112.5 mph from (108.5 mph at first event of 2017 fall season)

Building to a Win

As we moved forward into the spring tournaments, I progressed Jonas on to much more traditional strength-and-conditioning training sessions while still using the GravityFit equipment to provide feedback on posture and technique. We also continued to retain the daily exercises that focus on postural control with spinal strength and stability.

Program 6

Strength

  • 1: Barbell Squat to Box
  • 2: Dumbell Reverse Lunge
  • 3: Barbell Hip Thrust
  • 4A: Underhand Pull Up
  • 4B: Plate-Weighted Push Up
  • 4C: Dumbell High Row

Core

  • 1A: V Sit
  • 1B: Split-Stance Pallof Press
  • 1C: Back Hyperextensions – Arms Up
Program 6.2

Figure 8

 

Plate-Weighted Push Up (Figure 8): We moved to standard variations of exercises like this and adding more external load with the aim of eliciting a strength and muscle growth response (as opposed to stability before).

Video 4

Barbell Squat to Box (Video 4): We used the box to avoid the lower-back strain that is most acute at the bottom of a squat. This is a natural progression toward full squats.

Jonas should be applauded for his tenacity, conviction, and work ethic during this tough time. He has used a potentially career-threatening injury as an opportunity to improve his body to new levels. He’s also become more resistant to injury using the GravityFit techniques and equipment to develop superior postural awareness and control, plus strength and stability around his spine, shoulders, and hips. These improvements, combined with better rotational movement patterns, have improved his body for golf and seem to be having a positive transfer to his ball striking.

This all went along way to helping Jonas collect his third PGA Tour win at the Zurich Classic of New Orleans with partner Cameron Smith. Cameron is also a client of mine, and he has been using GravityFit equipment and techniques for years to train his posture and movement patterns.

For more information on the GravityFit exercise tools and techniques I used with Jonas, as well as Cameron Smith, click through to GravityFit’s website. For more information on my online training, service check out my Golf Fit Pro website.

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Nick Randall is a Strength and Conditioning Coach, Presenter, Rehab Expert and Massage Therapist contracted by PGA Tour Players. Nick is also a GravityFit Brand Ambassador. He is working with them to help spread their innovative message throughout the golf world and into other sports.

14 Comments

14 Comments

  1. rosey

    Aug 30, 2017 at 7:25 pm

    great article!
    And in case anyone cares, I’d definitely buy the “swing kit” off gravityfit if were half price. But $111 is crazy expensive!

  2. Gnam

    Aug 30, 2017 at 12:22 pm

    Was Tiger right about his glutes not activating? 🙂

    • EngineerBob

      Aug 30, 2017 at 3:40 pm

      Vertically or horizontally? Now that he’s on all those prescription and recreational drugs he must be totally limpid …. if you know what I mean.

  3. BH

    Aug 30, 2017 at 8:54 am

    Overall, this is an informative article. I appreciate this because I am someone who has back pain and is constantly working to make sure I keep it in control.

    What I don’t appreciate is that the article implies that using GravityFit is THE way to do all of this. I incorporate most of these exercises into my workouts even without your product. So it’s frustrating for me to read this and get the impression that he had to use this product to get back to game shape. Any good fitness instructor could have worked with him and got him back all without that product.

  4. Scott

    Aug 30, 2017 at 8:26 am

    Yes, proper rest after hitting a thousand balls is overlooked, especially by the young. There are always exceptions to the rule, but most will not escape the inevitable physical breakdown

  5. Oppai

    Aug 30, 2017 at 1:55 am

    Geez, with all these exercises he had to do get fit and pain free, you would have thought he was a lazy fat slob of a weekend warrior trying to cut it on tour. Unbelievable that a player has to do all this just to stay with it on tour now.

    • Chris

      Aug 30, 2017 at 7:46 am

      It’s only in this particular case. Not every tour player need to go through all this.

  6. SH

    Aug 29, 2017 at 3:04 pm

    Great article.. we hear that these guys train, but rarely get a glimpse into their regiment. Very cool!

    • Brad

      Aug 29, 2017 at 3:36 pm

      Visualize the training regimen and you too will be great in your mind.

      • SH

        Aug 29, 2017 at 4:07 pm

        I don’t think being great in our mind is an issue for any of us

  7. Brad M.

    Aug 29, 2017 at 1:57 pm

    I’ve been a fan of bodyweight work for a long time. Adding resistance bands and the occasional extra load of weight (like in the standard pushup) is great after strength/stamina and fixing general fitness deficiencies have been accomplished. For the non-pro who may play/practice 2-10 times a month, are free weights and intensive weight training advised? Especially if we can’t afford (or simply won’t use) an expert for ongoing technical assistance?

    • Brad

      Aug 29, 2017 at 3:34 pm

      The average recreational play will never make a commitment to conditioning and training because they ‘don’t have the time’. They simply play for fun with their equally decrepit buddies and yukking their way painfully slowly down the course.
      Of course a new set of SGI clubs ($1395), latest driver and fairways ($795) and a studio putter ($395) should make a significant improvement in their game. Oh, and ProV1s($50) for total tour quality WITB weapons. It’s a shame the clubs will get scratched up.
      Instructors. trainers? Forget it, better to buy a rangefinder and great shoes and nifty clothes.

  8. Boss

    Aug 29, 2017 at 10:56 am

    So, what you’re saying is, he wasn’t very fit before. LOL
    Now he’s a bit more fitter, stronger.
    But why not also change his swing and have him lift his left heel and swing with a more classic swing and let go of the finish and not strike a pose with feet down and torque twist that caused his problem like all modern swingers with the same problem?

  9. Brad

    Aug 29, 2017 at 10:53 am

    Pro golfers injure their spine because they practice in an insane obsessive-compulsive manner. It’s all due to overuse, overstress and breakdown injury which is not given enough time to heal. IOW, they are oblivious to their injurious mental state and just continue on a downward spiral. These guys just fail and fade away. Blixt is an exception, but his chronic injury will haunt him forever.

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Let’s Retire Old Man Par: A Modest Proposal

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In 1729, Jonathan Swift wrote a satirical essay entitled “A modest proposal,” in which he suggested that the Irish eat their own children. As might be expected, the piece drew a great deal of discussion and controversy. He was of course not serious, but simply attempting to make a point. As you will read this piece contains “A Modest Proposal” as well, but it is not intended to be satirical. I am for the record dead serious.

The golf industry is wringing its hands, trying to find a way to bring new players into the game, while at the same time keeping those that are in the game from leaving. They have initiated any number of programs designed for this purpose. How successful have they been? I would venture that they have barely moved the needle.

Barriers to the game

What we do know is that today there are three major barriers that confront the industry. They are first, the time required to play the game; second the costs associated with playing the game; and third the difficulty of the game.

There are among those adults that start the game, three distinct different groups:

  1. Those who would like to start playing golf but for any number of reasons decided not to take up the game.
  2. Those who once played more frequently but have reduced the number of rounds that they play.
  3. Those who started to play the game but then after a short period decided to leave it.

Those who leave the game

Those in the golf industry, the hand-wringers, have developed any number of programs to bring new players to the game. I would ask the question, “What is the point, when almost an equal number of players that start playing the game each year, decide to give it up within a span of a few months.

Does it make any sense to continue to put water into a bucket when there is a hole in the bottom? Of course not, but that is effectively what is being done. The first question to be ask, why do these new players quit the playing after a short time? In my opinion, the number No. 1 reason is the method of scoring being used.

Were an exit poll to be conducted asking these people why they quit playing, I seriously doubt they would answer truthfully. Who would want to admit that they were discouraged by their inability to succeed at any endeavor? The two answers that would be given the most often would be 1) that golf is too expensive to play; or 2) that they simply didn’t have time.  In this case both answers serve to preserve the individual’s dignity. And who could blame them?

The concept of par

Why did these individuals find the game difficult? The short answer is that while golf is a hard game to learn, there  is a more compelling reason.  I would venture, that the underlying reason they quit the game is that it ceased to be fun because of how they viewed their performance. And for one central reason… the concept of par. The idea that an amateur golfer, especially a beginner, should measure their level of success against an imaginary set of numbers that represents what an expert player would score on each hole is on the surface ridiculous.

You might imagine a beginning player scoring an eight on a par-four hole after hitting six good shots and then two putting for an eight. In the context of their ability, they should be ecstatic — but of course they are not (because as their playing partner reminds them) they were four-over par on that hole. The time has come for Old Man Par to retire. And retire permanently. He is killing the game.

Perceived failure

In another scenario, the beginning player scores sixty for nine holes, which is an excellent score given the short amount of time they might have spent playing the game. And yet their nine-hole score was 24-over par. How would that make you feel? Would you be encouraged or discouraged? You might imagine yourself back in school and regardless of the amount of work that you put into a given class you always receive an “F.” At some point, would you give up?

Why should every golfer be judged by the same standard when there is such inequality in their ability? The equivalent would be placing a high school freshman in a graduate-level college course, expecting that they could perform at the same level as the other graduate students. The disparity in knowledge, based on age and experience, is precisely the reason why there are different grades in school. The same disparity exists among golfers. In this case, the difference being the ability to perform on the golf course as opposed to the classroom.

What about the second group of players that now plays less than they did in the past? Could it be that they are no longer having fun playing the game?And then there is the third group, those that consider playing the game but abandon it for another sport. Could it be that they are intimidated by the scoring system, knowing that as a beginner par is an absolute impossibility?

Old man par 

The legendary Bobby Jones was the first to coin, perhaps with the help of his friend O.B. Keillor, the phrase “Old Man Par.” Jones was, of course, the greatest amateur to have ever played the game. He won the Grand Slam in 1930, retiring then at the age of 28.

The time has come to retire “Old Man Par” and devise a new system for measuring a golfer’s progress in the game. I know that those in the USGA. would reject the concept immediately for fear of, and here is a $10 word used primarily by attorneys, “bifurcate” the game. What that word essentially means in this context in having more than one standard. The USGA is responsible for preserving the nature of the game, but at the same time it should be equally concerned with preserving the future of the game.

Personal par

What I would suggest is a system based on the principle of what might be termed “personal par.” This was essentially the system that was used to groom a young Tiger Woods. As a young child, he was not capable of reaching the longer holes in regulation, making par a virtual impossibility. Consequently, his coach wisely devised a system in which par was adjusted upward based on his ability at a given point in time. This served to keep the young child feeling good about his performance and subsequent progress.

This is the type of system that needs to be devised for the health of the game. The system would begin at a nine-hole level using a par of thirty-six as a basis. The actual numbers are not as important as the basic concept. There would be within the nine-hole and the eighteen-hole groups five different levels as follows with assigned par for each hole and eighteen holes roughly equal with the player’s ability.

As players improved, they would graduate from one level to another based on their total score. The handicap system would work in similar fashion as it does now with a single modification. The strokes give from one player to another would depend on the level in which they fall and the par assigned to that level.

The personal par handicap system would not be as exacting as it is presently used, but it would be sufficient to allow players to be reasonable competitive without any significant sacrifice. There would then be two scoring systems then, allowing players to choose which one they wanted to use. Or a recommendation might be given that until they reach a given scoring threshold that they use the personal par scoring system.

There would, of course, be the usual concern with something new being injected into the system, but the proposed change would be no greater than when the system of equitable scoring was introduced or when courses were first assigned a course rating number.

A few years ago, when life-long teacher and educator Dr. Gary Wiren was inducted into the Golf Teacher’s Hall of Fame, he wanted to pass along a single piece of advice to those teachers in the room. “Gentleman,” he started and then paused for emphasis. “We must find a way to make the game more fun for our students.”

I’m in full agreement with Dr. Wiren. The question is, “What is the best way to accomplish that goal?” I believe that that the first step in that direction is to change the scoring system so that golfers experience more satisfaction and accomplishment. That is what makes learning fun.

And so, I would have you consider “The Modest Proposal” that I have put forward. And rather than attempting to find reasons why a revised scoring system couldn’t never work, for the benefit of the game, look for the same number of reason why it could work. The time has come for Old Man Par, as we know him, to retire. He has served us well, but he has become an anarchism. He is as obsolete as the horse and buggy. Let’s hand him his gold watch and let him enjoy his golden years in peace.

And at the same time, let’s welcome the “new kid on the block” who will pave the way for the next generation of golfers pioneering a scoring system that promises to make the game more “fun.”

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