Whether the goal is to relax, network or practice becoming the next Tiger Woods, golf is a sport where strategy, endurance and a little bit of luck converge. Only sometimes, that luck runs out. No matter what age, experience, or ability level, all golfers are susceptible to injury, even on the most leisurely trip to the course. So what’s the good news, when golf goes bad? When properly diagnosed and treated, most golfers can achieve a full recovery from their injuries. The key is being able to recognize the symptoms of an injury and taking the proper steps to recover.
Questions addressed in this article:
- What are the most common golf injuries?
- What are the symptoms?
- What are the available treatments?
- How can you prevent future injury?
While only a physician is qualified to properly diagnose an injury, it is crucial to know the signs and symptoms of injuries and know when it is imperative to receive immediate treatment.
1. Back Pain
Lower back pain is one of the most prevalent orthopaedic conditions. Experts estimate that up to 80% of the general population will experience an episode of back pain at some point in their lives. It should come as no surprise that lower back pain is also the most common injury among golfers. Amateur golfers, in particular, are at high risk for this injury due to the inattention of proper body mechanics. However, even with proper mechanics, an injury can occur among avid golfers of any age or skill level due to too many hours spent hunched over and/or the buildup of rotational forces over time.
Back pain can be acute, often lasting a few days to a few weeks at the most, or a chronic condition that can last indefinitely if not properly treated. It’s important for a golfer to be self-aware, recognize the difference between minor aches and chronic pain, and seek the appropriate treatment in a timely manner. When in doubt, talk with an orthopaedic spine specialist.
The most common symptoms are pain and limited range of motion/stiffness in the lower back, hip, or leg. Some individuals may also experience muscles spasms in the back, pelvis, and hip areas. The symptoms of back pain can range in severity from mild discomfort to sharp, stabbing pain.
Acute lower back pain often comes on suddenly and is caused by a minor strain or sprain of an overstretched muscle or ligament. These injuries can be directly caused by:
- Rotational forces
- Bad posture
- Poor body mechanics
- Repetitive movements
- Inadequate warm-up/stretching
- Improperly carrying a golf bag
- Carrying a bag with excessive weight
Chronic lower back pain may also result from these factors but is more likely to develop gradually over time. Pre-existing orthopaedic conditions, such as degenerative arthritis, can be the cause or contributing factor of a chronic condition.
Acute back pain will typically resolve itself within 7 days. It is generally advisable to rest the first day or two after a minor injury. During this time, apply ice/a cold pack for 15-20 minutes at a time to reduce inflammation, every 3 hours if possible. If inflammation has reduced, heat can be applied via heating pad or warm bath to relax the back muscles.
If there is no significant relief after several weeks, it is likely a more chronic/serious injury. A chronic condition can be caused by a number of factors, including a significant strain or sprain, disc injury, bone fracture, degenerative arthritis or poor body mechanics. It’s imperative to meet with an orthopaedic spine specialist to identify the exact source of the problem and to receive the proper treatment.
Keep in mind that, while the back may be the area in discomfort, it is not always the cause. More often than not, symptoms are the result of back muscles compensating for poor body mechanics and inadequate condition. Participating in a golf-specific sports program that emphasizes both proper technique and fitness will reduce the risk of back pain/injury significantly. In addition to improving a golfer’s swing and strengthening their core, it’s also imperative to properly stretch before starting rounds.
2. Rotator Cuff Injuries
When a golfer’s swing hurts, shoulder muscles may be to blame.
The rotator cuff tendon and bursa are two of the main structures in the shoulder that help lift and rotate the arms. A healthy rotator cuff is cushioned beneath the fluid-filled bursa with enough space to move as it needs to. Repetitive and excessive movements can cause these structures to become irritated and inflamed. This inflammation limits the space the rotator cuff has to move. When inflammation is severe enough, the tendon can impinge – or become pinched – beneath the bursa. If left untreated, this can result in a more serious condition such as a rotator cuff tear.
The primary symptoms of a rotator cuff injury are arm pain, arm weakness, and a limited range of motion in the shoulder. These symptoms can range in severity and can make simple tasks, such as holding the arm straight out in front, or raising the hand of an injured arm above your head, difficult.
Shoulder injuries can result from a number of golf-related factors, including:
- Repetitive use of the shoulder
- Poor posture and form
- Inadequate muscle strength
- Excessive swinging force
Similar to back pain, there are many factors independent from physical activity that can contribute to shoulder pain. These include degenerative arthritis, calcification that thickens the bursa, and bone spurs that narrow the space within the shoulder.
Acute shoulder pain will typically resolve itself within a few days with conservative methods. Similar to treating back pain, patients are advised to rest for a few days apply ice/a cold pack early on for 15-20 minutes at a time, and participate in physical therapy. If pain does not improve with these methods, or if shoulder problems become frequent, it’s time to have a discussion with an orthopedic specialist about other treatment options.
Golfers should always warm up before playing a round or even just hitting the range. To stretch the front of the shoulder, extend one arm straight out in front, use the opposite hand and pull the extended arm across your chest until you feel a gentle tension. To stretch the front of the shoulders, hold a golf club horizontally with both hands, hip widths apart and slowly raise the club overhead. Shortening a golf swing and slowing the speed of a swing will also help better maintain proper mechanics and reduce the stress put on the shoulders during play.
Strengthening the upper body will also help prevent shoulder injuries. Participating in a golf-specific physical therapy will not only help build up strength, but will also improve golf game.
3. Knee Pain
The knee was not designed to handle the rotational forces and side-to-side movements involved in a typical golf swing. In fact, on average, a golf swing exerts a force that is about four times the golfer’s weight onto the front knee of the swing. To make matters worse, a golfer may force more turn in their swing, placing additional stress on their knees.
It should come as no surprise that golfers are at great risk of knee pain, whether it’s due to trauma, mechanical problems, or inflammation. ACL injuries, fractures, torn meniscus, knee bursitis, tendinitis, are just a few of the conditions a player can develop.
Swelling, stiffness, redness, weakness, and instability are the most common symptoms of a knee problem. In severe cases, an individual may not be able to bear weight on their knee, fully extend their knee, or will feel as if their knee will “give out”. Some individuals may also experience a clicking, popping, or grinding sensation within the joint.
Trauma-related injuries can result from:
- Quick rotation of the knee through a swing
- Sudden change in direction
- Accidents handling equipment
Wear-related injuries can result from:
- Repetitive use of the knees
- Poor posture and form
- Inadequate muscle strength
- Carrying a bag with excessive weight
Inflammation-related injuries can result from:
- Overuse of the knees
- Insufficient rest between games
- Misalignment of the hips, legs, feet and knees while swinging
Again, underlying orthopedic conditions such as arthritis can also cause or contribute to knee pain. This is why it’s important to see an orthopaedic specialist to diagnosis the exact cause of your problem.
As previously mentioned, the keys to preventing golf injuries are proper conditioning, adequate stretching, and proper form throughout the course of a swing. Focus on strengthening the core – the abdominal muscles, back muscles, and the muscles around the pelvis – and improving hip range of motion. Exercise also has the added benefit of helping reduce or maintain weight, which reduces force on the knee joints.
Talk to an Orthopaedic Specialist
Back pain, rotator cuff injuries, and knee pain are the most common orthopaedic problems among golfers. Golfers can also sustain injuries to their neck, hands, wrists, hip, feet, ankles, and other regions of the body.
When looking at these various forms of injury as a whole, it becomes apparent that they share many similar causes. Namely, golfers need to avoid repetitive movements, poor posture, and – ultimately – unnecessary stress and wear on their body. Ask any avid golfer, however, and you’ll quickly hear that avoiding these factors is easier said than done.
The truth of the matter is, everyone has has room to improve their golf game in one way or another. Like all sports, golf is centered on the pursuit of perfection: making a perfect shot, playing a perfect round, and ideally playing a perfect game. For many, this is exactly golfs appeal. A golfer’s physical fitness is a key factor to improving one’s golf game and preventing injuries.
If any of the conditions discussed here are interfering with your performance, you can turn to Beacon Orthopaedics and Sports Medicine’s Golf Performance and Rehabilitation Program to help patients improve their golf game and recover from any golf related injury. Our team of specialty-trained physicians can also assist professional and casual golfers just looking to improve their game.