The game of golf may well have been invented by a sadist who wanted to cause harm to the human spine. That being said, over the past decade, golf has become an increasingly popular sport with an exponential increase in golfers of all ages. Not surprisingly, there are now a significant number of chronic injuries owing to overuse and swing biomechanics. Although the press writes volumes about Tiger Woods injury, we all know that golf injuries affect many of us. Why is this? Unlike many sports, golf is not limited to a certain age group, with the average golfer tending to be older than athletes in other sports (approximately 25 percent over the age of 65, with a 50 percent rate of acquired golf-related injuries). Even though they have better swing mechanics and spend more time warming up prior to playing, professional golfers sustain more overuse injuries than amateurs, simply because they spend more time practicing and playing the sport. The golf swing involves an extensive range of motion and is repetitive, especially during practice. Professional golfers over the age of 50 have an 89 percent prevalence of injuries and most professional golfers suffer from more than one injury. Playing habits and golf swing biomechanics explain the location of golfer injuries. Professionals (handicap 1-9) play or practice between 45 and 70 hours per week, while amateurs play about five hours per week. Studies find that repetitive practice swings are the most common cause of injury for men (64 percent) and women (75 percent). Furthermore, the professional golfer performs more than 2,000 swings per week. Hence this repetitive strain on the musculoskeletal system increases the risk of acquiring an injury. The golf swing, combined with the large forces produced in the lower back, may result in an increased risk of medical problems to the lower back such as muscular strains, disc hernias and degeneration of the facet joints of the spine. Lower back pain is the most common complaint among all golf-related injuries. On average, injuries to the lower back cause the golfer to stop participating in his or her sport for 10 weeks a year. Swinging a golf club involves the spine to function repetitively to a great extent. In order to understand the concepts presented in this article, it is important to have a basic understanding of the parts of the body involved in relation to the lower back and golf. Classically, the vertebral column or spine is divided into several distinct parts: cervical, thoracic, lumbar and sacral. The hips and pelvis are the foundation the spine sits on. The spine comprises 33 bones called vertebrae (seven cervical, 12 thoracic, five lumbar, and five sacral) which interact with the arms, legs, shoulders, and head to allow for proper movement. The spine transmits forces and coordinates activities between the upper and lower body. Due to the mechanics of the golf swing, the lower back (lumbar spine) is subject to large ranges of motion and multidirectional forces. Other than the vertebrae, the joints connecting one vertebra to the other in the lower back are the intervertebral or facet joints. The facet joints allow you to bend forward, backward, bend side to side, and rotate while standing in one place. The intervertebral disc bears and distributes loads, restrains excessive movements and allows slight motions. Along with the boney vertebrae and joint structures, the surrounding muscles and ligaments stabilize the spine. It is crucial for a golfer to understand that these forces imposed on the spine can cause damage to the lower back. Repeated stress on the spine of the golf swing can cause muscles to tire easily and lead the golfer to use a preferred muscle over another (compensation) causing a muscular imbalance (strength/flexibility impairments). Lower back pain as a result of a golf swing often arises from two different sources: overuse of muscles in the trunk and poor physical condition of these muscles, both possibly leading to more serious complications such as intervertebral disc and facet joint pathologies. Good physical conditioning permits reasonably prolonged golf practice each week throughout the year without harm, and helps prevent overuse injuries in particular. Golfers of all ages and skill levels must take preventive measures to reduce the risk of potential chronic injury to the lower back. Playing 18 holes or spending hours on the driving range under the burning heat of the sun is not the only way to train for golf. Believe it or not, much can be done in the comfort of a home or office. Scientific literature suggests different types of exercises to prevent golf-related lower back injuries: warm up, strength, flexibility and cardiovascular exercises. Warm up Warming up prepares the body both physiologically and psychologically, while at the same time reducing the risk of injury. Proper warm-up reduces the chance of injury during golf, by increasing body and muscle temperature leading, in turn, to an increase in enzyme activity, blood flow and oxygen availability decreasing contraction and reflex time. Specific warm-up activities include calisthenics such as jumping jacks and running in place for 10 to 15 minutes prior to swinging a golf club. Five to 15 minutes of walking, cycling or easy jogging also increases muscle and core temperature. Cardio-respiratory fitness Fatigue is a major factor that decreases a golfer s performance. Golf requires both a high skill-level and demands a small margin for error with each shot. Even a little fatigue can greatly decrease performance. Concentration, neuromuscular coordination and muscle strength are all influenced by fatigue. Thirty to 40 minutes of cardio-vascular exercises three to four times a week will build up endurance. Flexibility Static flexibility is the range of motion about a joint and its surrounding muscles. Dynamic flexibility refers to the resistance of a joint during movement. Good flexibility is essential to execute a proper golf swing, especially good range of motion of the lumbar spine, flexibility of the trunk and hip muscles, and spinal rotation and shoulder mobility. What exercises should a golfer perform? A description of these exercises appears in the September issue of Golf in Egypt, which you may receive by emailing [email protected], or telephone 3748-3862. We all know that good golf requires concentration and putting everything else out of your mind. So we might sum all this up by saying: A good golfer should have a strong back and a weak mind. Based on a study by Amina Naguib, sports therapist in Amsterdam.
