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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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Clement: Why your practice swing never sucks

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You hear that one all the time; I wish I could put my practice swing on the ball! We explain the huge importance of what to focus on to allow the ball to be perfectly in the way of your practice swing. Enjoy!

 

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Clement: This is when you should release the driver

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The golf teaching industry is slowly coming around to understand how the human machine is a reaction and adaptation machine that responds to weight and momentum and gravity; so this video will help you understand why we say that the club does the work; i.e. the weight of the club releases your anatomy into the direction of the ball flight.

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Kelley: Focus on what you can control

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(Part One) Changing The Swing

The address position is the easiest part to change in the golf swing. If an adjustment can be made that will influence the rest of the swing, it should be made here. The set-up is a static position, so you have full control over it. If concepts are understood with feedback given (a mirror or video) it can easily be corrected and monitored. Once the club is in motion, a change becomes much more difficult.

Most faults in the swing originate in the set-up. All to often players go directly to the part they want to change in the middle of their swing, not understating their is an origin to what they do. When the origin isn’t fixed, trying to directly change the part in the middle is difficult and will often leave the player frustrated. Even worse, the part they are looking to fix may actually be a “match-up” move by the brain and body. These match-up moves actually counter -balance a previous move to try and make the swing work.

An example of not fixing the origin and understanding the importance of the set-up is when players are trying to shallow the club on the downswing (a common theme on social media). They see the steep shaft from down-the-line and directly try and fix this with different shallowing motions. More times then not, the origin to this is actually in the set-up and/or direction the body turns back in the backswing. If the body is out of position to start and turns back “tilty”, a more difficult match-up is required to shallow the shaft.

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The golf swing is hard to change, so work on the things that are simple and what you have control over. You may not be able to swing it like a world class player, but with proper training you can at least the address the ball like one. When making a swing change, look to fix the origin first to facilitate the change.

*Part two of this article will be focusing on what you can control on the golf course, a key to better performance

http://www.kelleygolf.com

Twitter: KKelley_golf

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