If you’re an Ontario golfer, you know that we recently got some pretty exciting news: golf courses are amongst the first COVID-19 reopenings this summer! So as it turns out, this season may not be a write off after all … at least from a course perspective. With some B-E-A-UTIFUL weather on the horizon, now begs the question, golf season is ready for you, but are you ready for golf season?
The statistics on golf injuries are startling: among recreational golfers (2-3x/week) we see an annual injury rate of 41% - meaning nearly half of all recreational golfers are hurt at some point during their season. Every. Single. Year. The leading areas? Lower back (34% of injuries), elbow (27% of injuries) and shoulder (19% of injuries).
But we have a hunch: in the last two months of lockdown you haven’t been nearly as active as you usually would. If you’re a snowbird, you came back early from golfing down south and that has taken away a major form of exercise. If you’re a working age adult, you’ve lost out on the end of your recreational hockey (or other sports) season, you’ve been home with the kids, and any kind of exercise or strengthening has fallen to the wayside. While none of that is your fault, and everyone is doing the best they can under the circumstances, we know that this decreased level of activity is going to result in an increase in injuries as soon as we eagerly jump onto the links this summer. Injuries mean you start missing rounds, and after a slow start to the season that is EXACTLY what we want to avoid.
Today we’re going to break down the 3 most common golf injuries: when they happen in your swing, and the easiest thing you could do to help prevent each of them. In the next two blog posts we’re going to go over the mobility (or joint movements) and strength you need to golf safely (and well!) and include some downloadable follow-along videos that you can use to get ready for your upcoming season.
If you need a tune up before your season gets into full swing, consider a Personalized Chiropractic Golf Plan with our resident golf expert: Dr Nick Centritto, to make the most out of the weeks leading up to the greens!
The Top 3 Golf Injuries (And How To Treat Them!)
Lower Back Strain/Sprain
When: During your drive, at the very beginning of your round, or the very end
Why: You’re swinging too hard - going for the mile long drive when 150 (straight) yards will do
Setting yourself up with the perfect drive is the best way to find yourself hitting more birdies than bogeys when you’re out walking the links, but every good golfer knows that distance is only half the battle - location is as (or more) important than the number of yards behind that driver. Oftentimes, we see golfers try to muscle through their drive, adding yards, but usually also adding a beautiful, sweeping slice to their final carry. Now, the slice is a problem, but the other problem many rehab professionals see is lower back injuries that result from “overdriving.” What happens is you relax into your backswing in order to increase the distance that the club head has to travel - giving you more time to accelerate the club, and add distance. The result can be effective, but typically not efficient. When you’re “passive” or relaxed in the backswing, you’re essentially going from zero to 100 as you accelerate the club, which causes significant shear force to go through the lower back. What’s the alternative? We know the best golfers are like giant elastic bands - when they’re in the peak of their backswing, they’re not at a zero (or relaxed) state - they are actually at their peak tension, like a slingshot right before you let go. Think about it like the two arms of that slingshot - your legs and hips are one arm, and your shoulders are the other - both of these play supportive roles to allow the elastic to be pulled back as far as you can get it - the elastic represents your core. The core is engaged throughout the backswing and as the hips rotate forwards the core follows, it pulls the stable shoulders through and along with them comes the arms and the club, whipping through space. If the elastic band on your slingshot is stretched out, floppy, or not robust enough, how far is that stone going to go? Not very. And the bonus in the case of humans, is that nonfunctional elastic can predispose them to lower back strains over time.
The Easiest Thing You Can Do:
Practice being active in your backswing - swing into it a few times and pay attention to what you feel through your trunk - do you feel you are slowing your backswing down using your front/lead side core, or does your backswing stop when your back runs out of room (ie - you start to get pinching or compression in your lower back). If you feel compression through your back, slow your swing down and practice staying engaged throughout your swing, and maybe consider adding some rotational core strengthening into your routine.
The SECOND Easiest Thing You Can Do:
Warm up! Getting the joints primed for movement isn't going to fix the elastic band, but it will help the joints become accustomed to the forces they're about to deal with.
Where: Inside of the elbow on your back arm or the outside of your elbow on the front arm
Why: You’re digging holes, swinging your irons too hard, or overgripping your club (or all of the above)
Elbow pain is hard to ignore, and it tends to creep up on you over time. First it’s a little achy in the morning, then it starts showing up late in your round, then earlier, then earlier still until it’s there for every shot. Sometimes, it can peak acutely when you accidentally dig a big hole trying to take a big cut with an iron, which will typically persist as an ache. The thing about elbow pain, is that it typically doesn’t go away on its own. It’ll improve with rest, but as soon as you start swinging a club again, back it comes.
When I see people with golf related elbow pain, it’ll show up in one of two places: laterally (on the thumb-side of the forearm) on the lead arm, and medially (on the pinky side of the forearm) on the back arm. This is because of how each of the two muscle groups work in your grip to keep your hands controlling the club and preventing the grip from getting ahead of the clubhead. Your lead wrist has to resist wrist flexion (or bending forwards) which uses the wrist “extensors” on the outside of the forearm - this is typically called “tennis elbow,” though I always see it more in golfers than tennis players. Your back or trailing wrist has to resist wrist extension (or bending backwards) which uses the wrist “flexors” on the inside of the forearm - this is typically called “golfer’s elbow.” Believe it or not, “tennis elbow” is actually the more common of the two injuries in golfers!
There’s a couple of reasons this could be happening to you - the most significant one is digging holes when you’re overswinging your irons. This is often the same problem as we see in “overdriving” that causes back pain, except you’re more likely to dig holes with your irons when you overswing. Guess what? The solution is the same! Take 20% off your effort, and use that to focus on staying active through the whole backswing - trust me, it’ll pay off in yards, control, and elbow pain.
The other little-known reason that you’re ending up with elbow pain: you’re overgripping your club. Controlling the club is one thing - but strangling it is another. As you get tired, you’ll have a tendency to increase how hard you hold the club to establish control - this will be more pronounced if you’re going into your golf season less strong than your normally would. As you overgrip the club, that translates into inconsistencies in your swing, and overwork by the forearm muscles.
The Easiest Thing You Can Do
If you don’t already - wear a glove! I know many golfers that just can’t get comfortable wearing a glove, but on those hot summer days the sweat from your palm will make getting a proper grip nearly impossible. Let the leather do the work, keep your hands soft, and your grip strong.
You may also consider cleaning, or replacing the grips on your clubs. If they’re a few years old and you’re a regular golfer, things will start to smooth out. To improve your grip without bearing down, making this minor change to the club itself is an easy way to do so.
Finally, if you have elbow pain, get it treated. Often the treatment solutions are simple, and will always involve a look at your swing to see where minor changes can be made. Cortisone injections are worryingly unhelpful for elbow pain, and conservative management will work wonders to keep you playing, while still treating your pain.
The SECOND Easiest Thing You Can Do
Warm up - your body will thank you for it!
Where: The back of your lead shoulder
When: During your drive
Why: you may have dug a hole with your iron, and now every time you get into your backswing it hurts, and you can’t generate power
Shoulder pain is a real bugger, because unlike elbow pain and back pain, when you’re not golfing, you probably don’t notice it so you’re less likely to do something about it. To feel better when you do play, you shorten your backswing and take a lot of power out of it to avoid the jarring impact to the shoulder. You also probably top the ball more - because you’re afraid (consciously or subconsciously) to hit the ground, which sets you back for the rest of the round.
Generally, this kind of shoulder pain almost exclusively happens in the lead shoulder, it’s often something that’s been going on for a while, but is acutely exacerbated by a couple of missed shots. When the body is in full backswing, the shoulder is all the way across the body, and the muscles of the rotator cuff are fully lengthened (or stretched). As the body comes back around to make contact with the ball, the arms may lag behind if you’re not in a completely active position (ie - you whip your arms through like the flailing arm inflatable tube man). If you contact the ground in this position you can jar the shoulder, stretching those already lengthened muscles, and causing a strain in the rotator cuff. For these golfers, chipping, putting, and high irons are generally ok - anywhere where we can take some backswing out, but you start to top the ball more frequently than you would like, and the gas seems to have run out of your drive.
The Easiest Thing You Can Do
Warm. Up. The warmer the shoulders are going into your game, the more likely they are to be able to handle sudden jarring, and full cross-body movement with the rotator cuff muscles fully lengthened.
What's The Moral Of The Story?
There are a couple of minor adjustments that you can make today, but the EASIEST thing you can do to reduce your likelihood of developing one of these common injuries is the game: WARM UP! A proper warm up will raise your resting body temperature, improve muscle and joint flexibility, encourage better muscle activation (ie: you're stronger when you're warmed up!), and have you moving through all of the range of motion you need for your game - before you load it with a club.
Our resident golf-guy - Dr. Nick Centritto, has put together a quick tee block warm up that he uses before each of his games, and often recommends to his patients (injured or not!). Check it out, follow along, and make sure you save it to use before your next golf game!
And remember, if you find yourself in need of a tune up before or during your season, Dr Nick has a Personalized Chiropractic Golf Plan, just for you! These Plans can be carried out virtually, with the transition to in-person care in the near future, and are fully covered by your extended health benefits!