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Fix your golf back pain, Step 1: The importance of assessment

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This article is co-written with Marnus Marais. Since 2011, Marnus has worked with some of the world’s best players on both the PGA Tour and European Tour, helping them to maintain optimal health and peak physical performance. His current stable of players includes Dustin Johnson, Patrick Cantlay, and Louis Oosthuizen, amongst others. 

This article is No. 1 in a 4 part series:

Step 1: The Importance of Assessment

Step 2: Early Stage Rehab

Step 3: Functional Strength and Golf Movement Patterns

Step 4: Building global strength for prevention of future injury

Introduction

If your back pain has been bugging you for a while and is starting to annoy and worry you, then your enjoyment of the game and your performance is likely beginning to be affected too. It’s frustrating, and you are ready to take action……..with your new foam roller and exercise bands in hand, you’re ready to knock the back pain on the head finally and forever. 

Please wait a moment before you start!

Back pain and especially back pain in golfers, is a complicated thing. More often than not, it’s the result of many contributing factors, and is vitally important that you identify what those factors are before you start your mission to fix your back pain. We really can’t stress this point enough! We have seen many people start a program to ‘help’ or ‘strengthen’ their backs, but only succeed in making them worse and getting even more frustrated.

As the famous saying goes: “If you’re not assessing, you’re guessing!”

To help successfully address your back pain, we must first identify what the main causes are. In our experience, it’s usually a combination of factors from these three categories:

1 – Physical issues (muscle imbalances, alignment issues, muscle weakness, lack of strength endurance, etc.)

2 – Golf swing mechanics (swing faults such over-swinging and excessive side bend)

3 – Lifestyle factors (sleep, diet, hydration, stress, posture, activity level outside of golf, etc.)

To help identify contributing physical issues, specific physical tests and screening tests are extremely valuable. There is a range of these we like to use, and in this article, we will share 5 of the main ones with you. These are tests we often use with our professional golfers on the road and remotely when we can’t see them in person. They are also go-to tests and screens we use with our online clients who can do them in the comfort of their own homes.

These tests will help give you an indication if an underlying alignment or muscle imbalance issue could be a contributing factor to your stubborn back pain. Please read the instructions carefully! Even though they seem like ‘simple’ tests, they are subtle, and the more careful you are with the execution, the better the results will be.

With all these tests, it can be helpful to take a picture or video with your phone. It is also useful to have them documented for comparison with future test results.

Test 1 – Leg Length Test

  • Start by lying on your back relaxed.
  • Rest your arms at your sides on the floor. Take a normal breath in through your nose. Exhale fully through your mouth to bring the ribcage downward and to feel your lower back make contact on the floor.
  • Ask a friend or family member to have a look at the bones on the insides of your ankles (medial malleolus).
  • Are they the same level, or is one higher/lower compared to the other one?

Test 2 – Seated Ankle Mobility Test

  • In bare feet, sit with both heels on the floor and your back resting comfortably against the back of the chair.
  • Hips and knees should be bent approximately 90 degrees each.
  • Keeping your heels on the ground, feet flat, and toes pointing straight ahead.
  • Slide your foot straight back until your heel starts lifting up off the floor. Stop as soon as the heel starts lifting up.
  • Note the distance. Keep that foot there.
  • Now repeat on the other side.
  • Note if there is any difference in range of motion between the two sides.

Test 3 – Seated Rotation Test

  • In bare feet, sit on the front half of a chair with both heels on the floor.
  • You should feel your “sit bones” in contact with the chair.
  • Find the center of both heels and maintain the position throughout the test.
  • Place a foam roller, small ball or equivalent object of about 4-6” in diameter between your knees.
  • Place a broomstick, golf club or the equivalent across the front of the shoulders with your arms crossed.
  • Keeping your heels centered at all times and holding the stick stable across the front of your shoulders, turn the shoulders as far as you can to the right.
  • Note how far and how easily you can turn to your right side.
  • Return to the starting position.
  • Again, keeping your heels centered at all times and holding the stick stable across the front of your shoulders, turn the shoulders as far as you can to the left.
  • Note how far and how easily you can turn to your left side.
  • Repeat the test a few times to ensure an accurate measurement.
  • Take note of any difference in range of motion between the two sides, and areas of restriction and discomfort.

Test 4 – Supine Hip Internal Rotation Range Test

  • Start by lying on your back relaxed.
  • Rest your arms at your sides on the floor. Take a normal breath in through your nose. Exhale fully through your mouth to bring the ribcage downward and to feel your lower back make contact with the floor (as discussed above).
  • Lightly squeeze either your fists, foam roller, or a small ball between your knees.
  • Rotate your feet outwards while maintaining 90 degrees at your hips and knees.
  • This will measure your hip internal rotation range of movement.
  • Go as far as comfortably possible. Don’t force it.
  • Take note of the range of motion and any difference between the two sides.


Test 5 – Seated Hip External Range Test

  • Sit with both heels on the floor and your back resting comfortably against the back of the chair.
  • Bring the outside of your ankle and place it on the top of the opposite knee.
  • Go as far as comfortably possible. Don’t force it.
  • Relax in this position.
  • This will measure your hip external rotation range of movement in the seated position.
  • Repeat on the other side.
  • Take note of any difference in range of motion between the two sides, and areas of restriction and discomfort.

If there is an imbalance or difference between the left and the right sides in any of the above tests, it could be an indication that you might have an alignment or muscle imbalance issue that needs to be addressed first before you start any strengthening program. You wouldn’t want to throw a bigger, more powerful engine in a car with poor alignment and bad suspension!

In the next article; Step 2: Early Stage Rehab, we will provide you with exercises that can help improve mobility / flexibility, muscle imbalances and posture issues.

If you would like to see how Marnus can help with your golfing back pain, then check out the resources below:

Marnus Marais – marnusmarais.com

If you would like to access training programs designed for elite and recreational players, then check out the following resources and services from Nick at Golf Fit Pro:

Articles
Golf Fit Pro App (iOS)
Online Training
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Nick Randall is a Strength and Conditioning Coach, Presenter and Rehab Expert contracted by PGA Tour Players, Division 1 colleges and national teams to deliver golf fitness services. Via his Golf Fit Pro website, app, articles and online training services, Nick offers the opportunity to the golfing world to access his unique knowledge and service offerings. www.golffitpro.net

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Club Junkie

Club Junkie: Srixon ZX and TaylorMade SIM2 Max fairways and My top 3 drivers!

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Masters hangover week is here! I have had the new Srixon ZX fairway out on the course and it is underrated as you would imagine. Reshafted the SIM2 Max 3w and it has been super consistent and comfortable. Talking about the top 3 drivers I have been hitting this year.

 

 

 

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Opinion & Analysis

The Wedge Guy: The importance of a pre-shot routine

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I believe one of the big differences between good amateurs and those who are not-so-good—and between the top professionals and those that can’t quite “get there”—lies in the consistency of their pre-shot routine. I read an interesting account on this subject after the final round of the 1990 Masters when Nick Faldo passed a collapsing Greg Norman. I know that was 30 years ago, but the lesson is just as relevant today.

This particular analyst timed the pre-shot routines of both players during the first three rounds and found that on the final day that Norman got quicker and quicker through his round, while Faldo maintained his same, methodical approach to every shot, not varying by more than a second or so. I think that is pretty insightful stuff.

Anytime you watch professional golf—or the better players at your club—you’ll see precision and consistency in the way they approach all of their shots. There is a lesson there for all of us—so, here are my ideas of how the pre-shot routine should work.

The first thing is to get a good feel for the shot, and by that, I mean a very clear picture in your mind of how it will fly, land, and roll. It is certainly realistic to have a different routine for full shots, chips and pitches, and putts, as they are all very different challenges. As you get closer to the hole, your focus needs to be more on the feel of the shot than the mechanics of the swing, in my opinion.

On any shot, I believe the best starting point is from behind the ball, seeing in your “mind’s eye” the film clip of the shot you are about to hit. See the flight path it will take, and on greenside shots, just how it will roll out. As you do this, you might waggle the club back and forth to get a feel of the club in your hands and take as many practice swings as it takes to “feel” the swing that will produce that visualized shot path for you.

Your actual pre-shot routine can start when you see that shot clearly and begin your approach the ball to set up. From that “trigger point,” you should work hard to do the exact same things, at the exact same pace, each and every time.

This is something that you can and should work on at the range. When you are out there “banging balls,” don’t just practice your swing, but how you approach each shot.

So, guys and ladies, there’s my $.02 on the pre shot routine. What do you have to add?

 

 

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Opinion & Analysis

Ways to Win: Hideki Matsuyama from Low Am to low man at the Masters

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They say the Masters does not start until the back nine on Sunday, but by that time, this year’s iteration was all but wrapped up. Hideki Matsuyama stepped onto the 10th tee with a five-stroke lead and the volatile back nine in front of him. The Augusta pines would be void of roars, though, as Matsuyama’s pursuers near the top of the leaderboard struggled to mount a significant charge. The closest challenger was a late-charging Xander Schauffele, who made four straight birdies to get to within two of the lead heading to the 16th tee. His hopes were then quickly dashed when he dunked his tee shot in the water and eventually made a triple-bogey. Augusta National Golf Club played difficult this spring. Contrary to the record-setting November version, the greens were more brown and firm than typical and required precision. Luckily for Matsuyama, precision has made him one of the elite golfers in the world. He earned this green jacket. He just happened to earn it on Saturday where his 65 was three strokes better than the next-best round. Using V1 Game to analyze his Strokes Gained performance shows Matsuyama gained 6.7 strokes on the average PGA Tour field on Saturday and 4.2 of those were from his iron game.

Matsuyama has always been a premier ball striker and, if anything, poor putting has held him back from winning more. Augusta National is no place for a balky putter and Matsuyama has made some significant strides in that category. While he did not gain strokes on the field in putting this week, he managed to get to average and, with his elite ballstriking, that was enough. Augusta National’s lightning-quick, undulated greens reward a properly-struck shot and punish even the slightest mishit. Matsuyama made 96 feet of putts Saturday (the PGA TOUR average is around 70 feet), including birdie putts of five, 19, 10, four and 10 feet. He also made a six-foot eagle putt on 15. You don’t have to be an elite putter when you have opportunities that close. Good for Matsuyama, because while he filled it up on Saturday, for the week, his putting was sub-standard.

V1 Game breaks down putting performance by distance from the hole, where we can see that Matsuyama lost strokes to the field in all but four distance buckets. He gave significant strokes back to the field from 4-6 feet, 11-15 ft, and 31-50 feet. Matsuyama had four 3-putts on the week, including one on Saturday and one Sunday. That’s progressing in the right direction, but still with room for improvement for the 29-year-old Matsuyama.

If you are going to win the Masters, it always starts with the par 5s and Matsuyama took advantage, playing them in 11-under for the week. He played the par 3s in +1 and the par 4s in even par for the week. Clearly, the par 5s were vital to him being able to get to the required -10 to win the tournament by just a single stroke. Augusta National has arguably the finest set of par fives in golf, each of them scorable and each of them dangerous. With V1 Game’s Hole History, Hideki played the 13th the best at -4 and the 8th the next-best at -3. Hideki made three eagles on the par 5s and averaged 4.3 strokes on the par 5s. That even includes the near-disaster on 15 on Sunday. Matsuyama was consistently in play off the tee and able to challenge the greens with his approach shots throughout the week.

All of the above added up to a healthy lead and afforded Matsuyama some cushion coming down the stretch, cushion that he needed as he got closer to earning his first green jacket. The golf tournament could have turned out significantly differently if young Will Zalatoris could have found a way to play better around Amen Corner, but instead Matsuyama was able to stumble a bit down the stretch and still maintain a two-stroke cushion until the final putt was holed. The Strokes Gained Heatmap from V1 Game for his final round scorecard shows exactly which part of his game became unsteady. Matsuyama overshot the 15th green into the lake and made bogey (Approach). Then three-putted the 16th green and missed a short putt on 18 (putting), knowing bogey was enough to win the golf tournament.

Still, a well-earned victory for Matsuyama. He struck the ball better than anyone else this week and did enough to claim the victory. Augusta National showed its teeth with firmer, faster greens and challenged the field to be precise. Matsuyama has made a career out of being precise. The same strength that brought Hideki Low Amateur honors more than 10 years ago brought him the green jacket as low man in the 2021 Masters.

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