Physical Therapy for Golfers with Low Back Pain

The most common type of injury associated with golf is low back pain (LBP), which may prevent you from playing golf and even performing everyday activities. The low back is most frequently injured part of a golfer’s body due to considerable mechanical forces, including compressive forces, shear forces and rotational forces to the lumbar spine, that are created while swinging a golf club. These forces on the lumbar spine, along with improper swing mechanics and decreased strength, flexibility, coordination or balance, place golfers at a higher risk of LBP creating injuries.

Types of Back Injuries Associated With Golf

There are a number of different types of back injuries associated with golf, including:

Mechanical Pain. The most common type of back injury is mechanical pain. Mechanical pain is often caused by a strain and will result in spasms. This type of pain is generally localized to the low back area.

Sacroiliac Joint Dysfunction. Sacroiliac joint dysfunction or SI dysfunction is an increasing recognized cause of back pain. SI dysfunction mimics LBP and may be located in the buttock and posterior thigh.

Herniated Disc. Disc herniation may occur during a golf swing. Disc herniation may be associated with a "snap" or "pop" in low back. Pain with disc herniation usually radiate down lower extremities. Pain may increase with sitting, coughing and bearing down

Compression Fractures. In the older population compression fractures may be considered due to high compression forces during swing.

Other Back Injuries. During golf swing hyperextension of the lumbar spine may cause injuries such as spondylolysis and facet joint pain. Spondylolysis is a defect in the connection between vertebrae, the bones that make up the spinal column. This type of injury is usually seen in adolescent athletes. Facet joint pain is most associated with osteoarthritis of the lumbar spine. Facet joint pain is usually increased with sleeping or resting as well as trunk side bending.

Golfers With LBP vs. Golfer Without LBP

Individuals need many physical attributes to properly perform a golf swing. To complete a swing, golfers need proper range of motion in the trunk, shoulder, torso and hips. Other needs include strength, postural stability and balance.

A recent study in the Journal of Orthopaedic & Sports Physical Therapy matched 16 male golfers with LBP and 16 male golfers without LBP. Each individual underwent biomechanical swing analysis, trunk and hip strength and flexibility assessment, spinal proprioception testing and postural stability testing. These assessments and tests results were analyzed and significant differences were noted between the two groups in trunk extension strength and lead hip adduction strength as well as limited trunk rotation toward the lead side. It was concluded that physical deficits in these areas, which may cause LBP, could be improved with exercises from physical therapy.

Another recent case study examined a golfer with decreased hip internal rotation and lumbar instability who suffered from LBP. The golfer was treated using manual physical therapy to improve hip range of motion and therapeutic exercises for lumbar stabilization. After physical therapy the golfer was able to return to golf pain-free and improved his handicap by three strokes.

Physical Therapy For Golfers With LBP

Physical therapy is a great conservative method to return to golf pain-free. LBP may cause strength deficits in trunk and lower extremities, flexibility issues in hamstrings and hips and decreased range of motion of the lumbar spine. These deficits will limit function and may cause you to play golf with pain and below your true abilities. Physical therapists are trained professionals that can examine and assess impairments and motion deficits that may impede your golf game and everyday activities. A physical therapist will be able to individualize a treatment plan to address impairments and deficits to help you return to golf pain-free as quickly as possible.

To find out if physical therapy will help with your needs call Rehab Connection at 856-547-4422 to set up a free screening for your injury.

Rehab Connection is a facility with Doctors of Physical Therapy that can address your needs to facilitate your return to golf.

Sources

Tsai, Y. P., Sell, T. C., Smoliga, J. M., Myers, J. B., Learman, K. E., & Lephart, S. M. (2010). A Comparison of Physical Characteristics and Swing Mechanics Between Golfers With and Without a History of Low Back Pain. Journal of Orthopaedic & Sports Physical Therapy, 40, 430-438.

Reed, J., & Wadsworth, L. T. (2010). Lower Back Pain in Golf: A Review. American College of Sports Medicine, 9, 57-59. Reinhardt, PT, MSPT. (2013). The Role of Decreased Hip IR as a Cause of Low back Pain in a golfer: a Case Report. HHSS Journal, 9, 278-183.