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by Paul J. Tsahakis, MD and Mark B. Hartman, MD
In recent surveys of professional and amateur golfers, low back pain due to disc injuries was the most commonly cited obstacle to achieving peak performance. The discs of the spine serve as cushions between the vertebra or bones. Flexion, bending and rotation of the back are critical to generating power in the golf swing; however, they also place significant stress on the discs in the lumbar spine. This repetitive flexion and rotation can aggravate or cause injuries such as a disc herniation or annular tear.
Not surprisingly, in both men and women, older golfers report more low back injuries than their younger competitors. Low-handicap golfers tend to experience higher rates of injury than high handicappers, perhaps due to more frequent play and practice. Realistically, all golfers have some risk, although the factors contributing to this risk can be modified.
Swing biomechanics is a critical factor. Maintaining a straight upper back with appropriate hip and knee bend are important fundamentals that also reduce the stress on the spine. Replacing the “Reverse C”— popular in the classic swing that emphasized backward bending in the follow-through—with the more modern upright finish posture, minimizes stress on the low back. “Overswinging” a reverse-pivot at the top of the backswing, or a lack of flexibility in the hips, may also lead to added stress on the back.
If you cannot easily cross your legs to put on your shoes or touch the floor with your knees straight, your infl exibility may affect your performance and increase your risk of injury. The hamstring muscles and the muscles that rotate the hips are among the most important to stretch. Maintaining abdominal strength is also extremely important. The abdominal muscles both stabilize and support the spine as well as control rotation and twisting.It is important to progress through the various clubs while striking balls on the range to adquately warm up. Prior to teeing off, the major muscle groups of the arms and legs should be strengthened, also. Remember that warm muscles are more effectively stretched than cool ones. The most crucial method of reducing injury is maintaining a balance of strength and flexibility—even off the course.
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