Low Back Pain in Golf

Epidemiology

 28.6 million people aged 6 years and older played golf in the year 2008.[i]  As a form of exercise, benefits are multiple.  Walking the course while carrying a bag requires the same caloric expenditure as walking 3.5-4 mph continuously. [ii] 

The incidence of back pain in those people playing golf has been reported to be 13%.[iii]   In the sporting news we read all the time about professional golfers, such as Jack Nicklaus, Fred Couples or others that struggle with back pain.  If a professional golfer, who theoretically has proper swing mechanics and is physically fit, can have low back problems, then what chances to you and I have.

Studies have shown that measures of core strength (golf swing-specific cable woodchop and bench press) allow the production of greater clubhead velocity and as a result potentially provide a competitive advantage.[iv]  Not only helpful with clubhead speed, core stabilization exercises have been shown to “decrease pain and allow return to play.[v] 

What is more, factors like hip range of motion have been suggested as factors that have some association with low back pain in golfers (A study by Murray et al. demonstrated an association between a deficit in lead leg medial hip rotation in amateur golfers who suffer low back pain).[vi]

So what makes sense as an exercise program for golf?  There are several different levels from which we can approach this question.  For starters, let’s look at the evidence that is out there for a basic warm-up and conditioning program that would be easy to integrate into the schedule of any golfer.  There certainly are more advanced, extensive programs that are out there.  This review, though, will focus on basic but powerful exercises that golfers young and old can employ.

Warm-up Conditioning Program

Using warm-up and stretching has been reported to lead to “an approximate 60% injury reduction in golfers who did so for at least 10 minutes before play.”[vii]

Following is a program studied by Fradkin et al. who looked at improving golf performance with a warm up conditioning program.[viii]  This program was shown to increase club head speeds by 12% after 2 weeks and 24% after just 7 weeks of working with the exercises. [ix]  

 The program was performed prior to starting a consisted of three parts:

• Increasing body temperature
  • Windmills (15 seconds)
  • Trunk twists (15 seconds)
  • Stretches
    • Three for the shoulder
    • One for the lateral trunk/lower torso
    • One for the hamstring/lower back
    • One for the chest
    • Two for the wrist
    • One for the forearm
    • 30 seconds of air swings with a golf club and gradual increase in range of motion and vigor

Functional Training Improves Club head Speed and Fitness in Older Adults

 A study by Thompson et al. looked at the effect of a progressive functional training program on club head speed and functional fitness in older male golfers.  The study involved golfers with an average age of 70.7 year +/- 9.1.[x] 

Results of the study exercise program demonstrated that an increase in club head speed by an average of 3.9 mph after the 8 week conditioning program. [xi]  This degree of improvement in driver swing speed “will result in approximately 10-15 more meters of carry distance off the tee and likely more roll distance as well.”

The study exercise program involved the following four domains: [xii]

• Spinal stabilization
• Balance and proprioception
• Flexibility
• Resistance exercises for functional strength development

The specifics of the exercise program as outlined below. 

As with any exercise program, the specific exercises should be tailored to an individual’s condition and state of health.  Some exercises described in this study may aggravate pain symptoms for some individuals.   I list the exercises to highlight the potential value for working on these issues to ideally decrease back pain symptoms and concomitantly improve golf performance. 

If you do want to try these exercises, a few things should be considered.  Any of the exercises that increase or cause back pain should be avoided.  As always, consult with a physician before beginning any new exercise program.

  Spine stabilization exercises

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[i] Current Sports Medicine Reports. (2010): 9(1): 57-59.

[ii] Current Sports Medicine Reports. (2010): 9(1): 57-59.

[iii] Current Sports Medicine Reports. (2010): 9(1): 57-59.

[iv] J Strength Cond Res. 2009 Sep;23(6):1841-50.

[v] Med Sci Sports Exerc.  2000 (32): 1667-1773.

[vi] Phys Ther Sport. 2009 Nov;10(4):131-5. Epub 2009 Oct 9.

[vii] Am J Sports Med. 2003 (31): 438-443

[viii] Br J Sports Med 2004 (38): 762-765

[ix] Br J Sports Med 2004 (38): 762-765

[x] Journal of Strength and Conditioning Research, 2007, 21 (1): 1331-137

[xi] Journal of Strength and Conditioning Research, 2007, 21 (1): 1331-137

[xii] Journal of Strength and Conditioning Research, 2007, 21 (1): 1331-137