Golf’s popularity has only continued to grow over the past few decades. In fact, in 2023 over ⅓ of Americans participated in golf in some fashion. Whether that be on course activities (26.6 million people) or off course activities (18.4 million people) such as golf simulators, Top Golf, or driving ranges, people evidently can’t get enough golf.
Evidence of the sport’s growth is apparent due to 3.4 million people reported playing golf for the first time ever in 2023. The median age for participants is 54 years of age; however, the younger generation has become increasingly invested and engaged in the sport due to accessibility and off course golf options.
And as always, as more people of all fitness levels are introduced to a highly addicting and challenging sport (such as Pickleball), golf injuries present and lead to unforeseen challenges of navigating an injury while participating in a sport with complex full body movements - and the need for expert Physical Therapy arises.
Common Injuries Sustained while Playing Golf (In no particular order)
Golfer’s Elbow
Golfer’s Elbow is the street name for Medial Epicondylitis (Yes, I agree, Golfer’s Elbow has a better ring to it).
On the inside of your elbow, there is a common attachment site (you guessed it, the medial epicondyle) where multiple muscles of the forearm attach. This group of muscles plays a role with gripping and swinging activities.
With sports that require forceful swinging and/or gripping (golf, racquet sports, baseball, powerlifting), repetitive stresses to these muscles can lead to inflammation and pain at this common attachment site.
As it pertains to golfer’s elbow, the right elbow will typically be involved with a right-handed golf swing, and conversely, a left elbow will more likely be involved with a left-handed golf swing.
Add into the mix, the valgus stress placed on the inside of the elbow during a golf swing, especially with poor ball contact or inadvertently hitting the ground first, pain at the medial elbow is a common - yet avoidable - injury when playing golf.
Mid Back Pain/Pain between the shoulder blades
What seems mildly obvious, is the rotational component of a golf swing. As one can imagine, in order to properly swing a golf club, you must have the necessary spinal mobility at multiple points throughout the spine.
What may be less obvious, are the postural considerations throughout your golf swing - notably with chipping and putting.
Poor technique with both avid and beginner golfers can lead to rounded shoulders and a spine in a semi-flexed position during both the approach and the actual golf swing. This can lead to excessive stress at the neck and thoracic spine (between the shoulder blades).
Additionally, as we know, injuries originating from the neck can refer pain at a variety of regions in the body, including the shoulders, arms, and mid back.
Knee Injuries (Meniscus Injuries and MCL Sprains)
As you work through the phases of your golf swing, both long drives and short irons, you notice both intentional and necessary weight transfer and shifting from your back leg to front leg.
During this weight transfer between your lower extremities, the torque generated from your swing is absorbed throughout your body - ideally through your club face and to the ball.
But all too often we see increased torque at the front knee, and depending on swing mechanics or your lie/ground environment, the knee may inadvertently be mildly bent. This combination of the force through the front knee, the knee joint position in space, and rotational forces through the knee is a loose recipe for meniscus injuries and MCL sprains.
Lower Back Pain
Although this list is in no particular order, if the order was presented from highest prevalence to lowest prevalence, lower back pain may very well be at the top of the list.
When you account for average age demographic noted above (54 years of age - in case you didn’t want to scroll up), it is of no surprise that lower back pain is common in this demographic regardless of golf.
When you combine long days of repetitive rotational swings, walking on uneven terrain, and bending over, lower back pain is almost synonymous with golf - if one does not take the proper precautions.
Hip Pain
Clocking in nearly as often as lower back pain is hip pain, and this is due to hip movement mechanics being intimately involved in lower back mechanics. Moreover, many times the root cause of dysfunction in the lower back presents as pain at the hip - such as Sciatica.
During your golf swing mechanics, proper weight transfer must occur between your hips, as well as requiring proper hip joint and lower back disassociation.
Because of this, a common mechanism for injury is weakness in hip stabilizing musculature or the inability to generate the range of motion required for your swing due to the lack of hip and lumbar spine disassociation.
So how does both a beginner golfer and an avid golfer avoid the above injuries when people are playing golf for hours at a time.
Tips to Avoid Golf Injuries
Proper warm up
Let’s start with something that could be considered a simple solution - warm up before your tee time.
But how many times has this happened to you:
You find yourself running late to your tee time and arriving at the first tee box so fast that your golf cart turns on “two wheels.”
You head up to the tips (OK, I can dream that I play from the tips, right?), and you take 3, maybe 4, 50% warm up swings…and then let your first drive rip.
This above scenario, although the tips component may be a little far fetched, is extremely common.
So, in order to avoid injuries that can happen during your round, it is paramount that you offer yourself ample time to warm up properly. This ranges from going to the driving range before your round, all the way to a proper functional dynamic rehab warm up - include both hip activation exercises and spinal mobility exercises (see video).
Avoid Playing in Bunches
For many casual golfers, golfing activities tend to come in bunches. Maybe you haven’t been able to get to the driving range in months, and suddenly a local fundraising golf tournament is announced or your college friends are in town for a night at TopGolf. This leads to sudden increased activities involving forceful spinal rotation and full body strenuous activity over a short amount of time - a recipe for injury.
Playing consistently can limit injuries related to a sudden increase in physical activity. Because of this, if you find yourself taking a few months off from golf, then ramping up golf activities in a stepwise progression before jumping back into multiple rounds of golf can decrease the sudden stresses on your body.
Train specifically for Golf movements
I often hear people say, “I don’t know how I got injured just playing golf, I go to the gym all the time. Golf shouldn’t have hurt ME.”
Well the truth is, if you don’t train functionally for the movements required for your sport, then you aren’t training to avoid injury.
If you want to be stronger to lift heavy cases of water around the house - then you lift heavy weights at the gym…
…so if you want to train to avoid an injury during golf, then you need to train functional spinal rotation and strengthening specific to a golf swing.
What if I already have an injury, and a tee time scheduled, What do I do?
If you have a tee time approaching in the next few weeks, and you are already dealing with lower back pain or knee discomfort, then find an Osteopractic Physical Therapist who specializes in both sports-specific training and manual based treatments.
A fellowship-trained Physical Therapist has the tools to assess both your injury and how this affects movement patterns required for golf. Add in an Osteopractic skill set including spinal adjustments, dry needling, cupping, scraping, myofascial work, and therapeutic exercises, then you can still make your tee time - pain free.
If you are in the North Houston area, looking to get your pain-free golf swing kicked into high gear, and have been struggling with pesky golf injuries affecting your performance on the course, then reach out to Flow Physical Therapy and Wellness in The Woodlands, TX where we can address your symptoms and get back on the golf course.
Dr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic, FAAOMPT
Owner of Flow Physical Therapy and Wellness
832.299.5447
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