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Jason Day’s shoulder: More concerning than it seems?

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If you watched The Players Championship last weekend, you probably saw Jason Day tweak his shoulder on the 16th hole on Sunday. He addressed the injury in his post-round press conference and it caught my attention. Check out this video of the press conference to hear the entire clip.

A few things about what he said stuck out to me:

  • “Every now and then it happens where my shoulder feels like it pops out, but it’s like more of a sting”
  • Feeling a “pop” and “sting” in his lead (left) shoulder
  • Pain is usually during the transition from the top of the backswing to the downswing
  • He’s been doing shoulder exercises to “stay loose”

Just by watching Jason Day’s swing, it seems pretty evident that he is a hypermobile athlete. This simply means that his joints tend to be naturally looser, enabling him to achieve the tremendous positions he does in his swing. This can become problematic, however, when hypermobility becomes instability. Instability of the shoulder can lead to recurrent and frequent subluxations and/or dislocations of the glenohumeral (shoulder) joint.

Shoulder Injuries in Golfers

Photo Credit: Arrow PT

Shoulder injuries account for 8-18 percent of all golf-related injuries. The most common shoulder injuries to the lead shoulder are posterior instability and acromioclavicual (AC) joint injury. Both of these injuries tend to be painful at the top of the backswing when the lead arm is in near-maximal horizontal adduction (reaching across your body). This position creates a compressive force through the AC Joint, which may cause pain.

Maximal horizontal adduction also places stress on the posterior capsule of the shoulder. During the transition from the top of the backswing to the downswing, the hips and trunk begin to rotate towards the target. In elite golfers, the arms tend to lag behind, creating a tremendous amount of torque. This can lead to something termed the “adduction stretch” in the swing when the arm bone contacts the rib cage and the humeral head exerts a posterior force. Repeated over thousands of times, this can lead to posterior instability of the shoulder (especially in a naturally hypermobile person).

 

Notice that Day’s hips have fired towards the target, but his shoulders are lagging behind. This is a move that creates tremendous torque and clubhead speed but also stresses the shoulder joint and capsule.

Golfers with posterior instability may suffer from posterior subluxations. A subluxation is when the shoulder slides out of the joint and immediately slides back in. This is different from a dislocation, where the joint remains separated until it is physically put back into place.

Photo Credit: Back And Body Clinic

Symptoms of a subluxation include:

  • A feeling of the shoulder moving out and in of the joint
  • A feeling of looseness in the shoulder
  • Pain, weakness, or numbness of the arm

Should Jason Day Be Concerned?

I’m not here to diagnose Jason Day with any medical condition. I have not evaluated his shoulder, and I do not have enough information to make any kind of an informed diagnosis. But, if it barks like a dog…

Is Day’s shoulder injury something that could negatively impact him in the foreseeable future? I would argue yes. If he does indeed have posterior instability of his lead shoulder with recurrent subluxations during his golf swing, this may be a problem that nags him for a while to come.

Conservative treatment for posterior instability typically features physical therapy focusing on improving rotator strength and stability. The rotator cuff can help stabilize the shoulder during the golf swing and prevent excessive motion of the humeral head within the socket when it is functioning properly. Medical research shows that conservative treatment of posterior instability is often successful, but not for every person. One study reports only 25 percent that golfers with posterior instability were able to return to golf after undergoing physical therapy. This study is old and has a few issues, but still, this is a pretty low percentage.

Surgical treatment of posterior instability is an option. The surgery includes tightening the capsule to prevent further subluxations. One of the major drawbacks of this surgery is that it may be tough to get full cross-body range of motion back after the capsule is tightened. This can make it difficult for golfers to get back to their old swing style after surgery.

Surgical repair of the capsule showing the tightening of the capsule.

 

Overall, shoulder injuries, particularly to the lead shoulder, can be problematic for golfers of all ability levels. I sincerely hope that Jason Day is able to overcome his shoulder pain and continue to play at his current level.

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Mike Scaduto is a physical therapist who is passionate about educating educating golfers of all skill levels about performance enhancement and injury prevention. He currently works as a PT at Champion Physical Therapy and Performance in Waltham, MA, where he supports high-level and youth athletes on a daily basis.

11 Comments

11 Comments

  1. Kevin

    May 20, 2018 at 5:26 pm

    What jason experiences is actually the anterior impingement which means soft tissues (primarily tendons) get pinched in the frontal compartment. It is likely to be caused by the posterior instability given jason is such a gym nerd. It wont be surprising if he suffers shoulder pain from doing excessive (compared to what a golfer actually need) weight training. Treatment for the antierior impingement requires addessing the posterior laxity too.
    When we look at jason and aaron wise, plus other young fella who drives the ball long and accurately utilising a traditional swing with modern tweak, what is the point of heavy weight training.

    • Mike Scaduto

      May 20, 2018 at 8:26 pm

      I would agree that there is probably a combination of posterior instability and anterior impingement/subacromial impingement. The two seem to go together in golf shoulder injuries. And I agree that that could be secondary to posterior impingement.

      I wouldn’t necessarily blame that on working out, however. I’m not sure what he does it in the gym and his routine could definitely be contributing, but there are a ton of golfers who lift weights and don’t feel like their shoulders are popping out of the socket during their swing.

      Thanks for the read and the comment, appreciate it!

  2. Hawkeye77

    May 20, 2018 at 11:53 am

    Not going to diagnose, but pretty much did, lol. A good read/reminder for anyone experiencing shoulder issues and author may be proven correct in his non-diagnosis. Something feels odd folks, get it checked out!

    • Mike Scaduto

      May 20, 2018 at 8:30 pm

      Again, I don’t know the complete picture of Jason Day’s shoulder by any means. His recent injury/media coverage provided a good platform to discuss the most common shoulder injuries in golfers. Although how he describes what’s going on does seem to point in the direction outlined in the article.

      Thanks for the comment!

  3. ray

    May 20, 2018 at 9:58 am

    Day is the biggest wimp on tour. If he injured his ankle like Tony Finau did at the Masters, he would be in a full body cast and traction for 6 months.
    Capsulorrhaphy (capsule tightening procedures) are fraught with complications and can often result in poor outcomes and severe arthritis.

    • Mike Scaduto

      May 20, 2018 at 8:33 pm

      He has certainly had a few medical issues, but I wouldn’t call him a wimp. When your greatest asset is your body and health and millions of dollars are on the line, it is probably wise to be cautious.

      Medical literature seems to be saying that capsular shifts/capsulorrhaphy procedures have poor outcomes. They are being done less frequently, especially in relatively young athletes.

  4. Point misser

    May 20, 2018 at 9:24 am

    Smart – swing so hard that you hurt yourself. 0% chance this guy is still able to play when he’s 40

  5. JM

    May 20, 2018 at 7:07 am

    Wow, this hits home because I suffered (I feel) something similar recently. Would golfers with posterior subluxations show up on an xray and/or an MRI? I had something going on for weeks and all of a sudden something felt like it shifted big time in my shoulder and the relief started. I’m sure the cortisone shot shortly after that helped as well. Initial reports on my MRI show nothing abnormal but I couldn’t do things in the gym or play golf for weeks. I found that to be very unusual for someone under 40.

    • Mike Scaduto

      May 20, 2018 at 8:59 pm

      JM– Sorry to hear you’re experiencing shoulder pain.

      Diagnostic imaging can be a helpful tool assisting in the diagnosis of shoulder pain, but it is not 100% reliable by any means. X-rays would be able to detect any fractures in the bones while an MRI would be able to assess whether ligamentous structures are intact. MRI would not be my go to tool to diagnose posterior instability, unless it happened during a traumatic event (ie car crash)

      As a PT, I try to rely more on the subjective history (what the client tells me happened) and actually moving their shoulder around than on MRIs. Research supports this in most cases, the exception being a traumatic injury.

      I would suggest seeing a qualified PT to help reduce pain and promote strength and stability in your shoulder! Thanks for the comment JM.

  6. Butch Harmon

    May 19, 2018 at 9:55 pm

    When i saw this story i guessed 2 things. It was his left shoulder and he let go of the club with his right hand on the followthrough. I found the swing on youtube and it confirmed both of my guesses. Jason, do not let go of the club with your right hand!!

  7. John

    May 19, 2018 at 7:16 pm

    He’s made favorite player… but he’s made of glass

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After an exciting 2022 PGA Championship, the PGA Tour heads back to Texas to play the Charles Schwab Challenge.

Colonial Country Club is a 7,209-yard par 70 and features Bentgrass greens.  The difficulty of the event this week could be influenced by course setup or wind. It can play relatively easy or relatively difficult depending on pin locations and firmness of the greens, but the last three seasons have all produced winners with scores between -13 and -15.

The Charles Schwab Challenge is an invitational that will host 121 golfers this week, and the field is very strong considering despite it being the week after a major championship. Some notable golfers in the field include Scottie Scheffler, Justin Thomas, Collin Morikawa, Viktor Hovland, Xander Schauffele, Jordan Spieth, Abraham Ancer, Will Zalatoris, Sam Burns, and Tony Finau.

2022 Charles Schwab Outright Bets

Jordan Spieth (+1500) (FanDuel):

Spieth was my headline bet at the Byron Nelson a few weeks ago, and although he didn’t get it done in the end, he did nothing to dissuade me from believing that a Texas win is imminent.

Course history has proven to be extremely important at Colonial, and there is no one better at the course (or even close) than Spieth. In his past six trips to Fort Worth, he has six Top-10 finishes, including a win and three runners-up. His form overall in the state of Texas is nothing short of immaculate.

Spieth’s performance at the PGA Championship wasn’t his best showing, but statistically, he continued his strong ball striking. He gained 8.6 strokes from tee to green, including a solid 4.7 strokes on approach.

He’s still struggling on the greens, as he lost 3.2 strokes on the field with the putter.

In his past four starts at Colonial Country Club, Spieth has gained 7.1 (2021), 8.6 (2020) and 7.5 (2019). If there were ever a place that the 28-year-old can find his putting stroke, it’s here.

Daniel Berger (+3500) (Bet365):

Berger is as predictable as it gets in regard to which courses fit his skill set. Shorter, Par-70 tracks — where accuracy is at a premium — have always suited the 29-year-old. He’s a fantastic iron player, but tends to struggle on long and difficult courses, which is why it’s no surprise that he didn’t do well in last week’s PGA Championship.

Colonial Country Club is an excellent fit for Berger’s game. The small greens give him an advantage over the field due to his accuracy on approach. He edged out Collin Morikawa — who also is one of the most accurate iron players on TOUR — here in a playoff in 2020.

Despite his poor showing last week, he still ranks in the top-10 in the field in Strokes Gained: Approach. Last week’s statistics may be a bit unfair, as well, as Berger was caught in the difficult AM/PM draw.

It’s certainly arguable whether or not Berger is in the best of form right now, but it feels as though we are getting a discounted price this week, making it worth the risk.

Webb Simpson +4000 (DraftKings):

It’s been a rough year for Simpson. Last week’s 20th-place finish at the PGA Championship was his first Top-20 finish of 2022. He’s missed plenty of events due to injury, but the six starts he had between Top-20 finishes was one of the longest stretches of poor form of his career.

Despite the brutal season, there seems to be some reason for optimism. Simpson gained strokes off the tee, on approach, around the green and putting at Southern Hills. That was the first time the 36-year-old has gained strokes in all four of those categories in an event since February of 2021.

Webb is also a strong course fit for Colonial, and has two Top-5 finishes here in his past four trips.

It was encouraging to see Simpson turn in such a well-rounded performance on a course that would typically be difficult for him due to its length. The fact that he hung around all week tells me he’s finally starting to round into form. His strong play could he attributed to his recent iron switch. He gained 2.6 strokes on approach, which is his best performance of the season thus far. When speaking about the switch, Webb made some encouraging comments.

“ I haven’t been hitting my irons great. Approach to the green is typically a strength for me; this year it’s been a weakness, and I’ve struggled out of the rough. I keep getting told that these the irons I’m playing are better out of the rough, better with distance control, better with mis-hits, and so I guess I was being stubborn but finally listened and I really like them.”

If he’s back, this is a small price to pay for the win equity the seven-time PGA TOUR winner possesses.

Justin Rose +6600 (bet365):

Rose came out of nowhere last week to finish in 13th place at the PGA Championship.

The timing of his game starting to come around couldn’t be at a better spot in the schedule, as Colonial is a course that “Rosie” has been sensational at throughout his career. The Englishman won the event in 2018 and finished in 3rd in 2020.

Rose’s statistics were perhaps even more impressive than his result last week. He gained over five strokes on approach at Southern Hills, which is something he’s done only one other time since August of 2020.

He also gained 4.2 strokes putting and is one of the best Bentgrass putters in the field.

His combination of strong iron play and putting make Colonial an ideal fit.

I believe Rose has another PGA TOUR win in him, and this event is one of the most likely spots for him to get it done.

C.T. Pan +10000 (Bet365):

Before withdrawing from the Byron Nelson a few weeks ago with an illness, C.T. Pan was playing some great golf. He’s gained strokes on approach in his past seven starts and has gained strokes from tee to green in his past eight starts.

The bronze medalist can’t contend on every course on TOUR, but he’s one of the better players if the course is short enough. In his past 24 rounds, he ranks 13th in the field in Strokes Gained: Total on par 70s that are under 7,200 yards.

Pan finished in 3rd place here in 2019 and was the only player in the Top 5 to shoot all four rounds in the 60s (68-67-68-69). His recent run of consistency paired with his quintessential course fit make him an ideal triple-digit target this week.

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