Golf Injuries: The Power of Education and Teamwork
Injuries are an unfortunate part of golf. The research is out, and the rates of injury are staggering. It has been found that over 50% of recreational golfers will suffer some sort of chronic injury from golf in their lifetimes. The percentage is even higher at the professional level, despite “perfect technique” and expert preparation. Titleist Performance Institute (TPI) has stated that over 90% of tour pros have suffered a severe injury in their career, and over 50% each year will have an injury that sidelines them for an average period of 3-4 weeks. That’s a big deal when the average purse of a PGA Tour event is $11 million. It’s clear that whether you’re a tour pro or an average Joe, injuries in golf are bound to happen.
So what is really going on here? Why do the best in the world still get hurt, despite having perfect swings? Is it the swing itself? Is it the body? Why are injuries so common to us golfers, and what can we do better to understand and deal with them?
What we know now is that injuries are complex and specific to the individual. We are all unique and have equally unique contributing factors to our injuries. Sometimes, it’s our swing mechanics. Other times, it’s our physical body. Or, it’s simply waking up stiffer than usual and hitting one too many golf balls. Two golfers can have the same injury but can become injured by completely different variables. Because there are so many variables to consider, it’s best to use a multi-disciplinary approach and get answers through proper assessment by the experts in your area.
Keep reading to learn the technical and physiological reasons to why injuries happen and how UGP addresses golf injuries through an interdepartmental approach to get you back into the game. We will briefly explain the technical and physiological reasons why injuries happen and how we address golf injury through an interdepartmental approach to get you back in the game.
The Swing
The most common injury in golf is lower back pain. The golf swing produces one of the highest shear forces in the spine across all athletics, specifically in the lower lumbar spine (L4-L5-S1 typically). This especially holds true at the highest level, because the pros move harder and faster than anyone. Injury at the elite level seems to be more correlated to excessive practice and the strain of constant travel. In regular Joes, poor swing mechanics, excessive practice, and poor club fitting have been identified as 3 of the top contributors to injury.
Certain swing characteristics have been correlated to more spine injury, specifically Reverse Spine Angle, Early Extension, and Hanging Back. They are the most common faults in golf, and can come from loading or sequencing issues, mobility problems, strength and stability limitations or even mental errors. The swing itself is already challenging for the spine, but these 3 characteristics all contribute to even more stress and compression in the spine, potentially leading to injury. (Click on the swing faults below for more info)
These faults can be improved with proper instruction, but often there are physical reasons why golfers have these faults. That’s why it’s important for your golf coach to understand the body’s effect on the swing. It is also key to learn and understand how to practice in moderation.
When we learn new tasks, performance tends to be poor. When performance is poor, practice load tends to go up. A new movement practiced at high frequency can irritate new tissues and lead to injury. Productive practice over repetitive practice can be healthier on the body as well as lead to quicker development. This can consist of turning a 2 hour practice session into a quality 45 minute session. Instead of hitting 200 balls at rapid fire, give yourself 30 balls and force yourself to gamify and focus between shots. This can improve the quality of your practice while reducing the stress to your body.
Inadequate/poorly fit golf equipment can also be a contributing factor to a golf injury. Most people take stock sets off the shelf at major golf retailers without understanding the effect it might have on the body, let alone the swing. By going through a proper club fitting analysis, we can determine which specific equipment specifications are right for your swing and more importantly, your body.
The Body
Stuart McGill, a world-renowned expert in spine injury and rehabilitation, does an amazing job simplifying the complexities of tissue injury. Put simply, an injury happens when the “load” to a specific tissue surpasses the specific tolerance of that tissue (Figure 1). You can bend a pencil, but if you bend it too fast or a little too much it will break.
If you gently bend the pencil 1000 times, the pencil eventually will weaken and snap (Figure 2). Our tissues act in a similar manner. Whether it’s spraining an ankle or swinging so much your back starts to hurt, if the “load” to our body is too intense (traumatic) or too repetitive (chronic), our tissues eventually break down and we get hurt. Both types of injuries can happen in golf.
Acute events (i.e. chunking a wedge and tweaking your wrist) typically resolve with rest, but the chronic, slow onset injuries that return over and over again are what force golfers to take time off or quit the game all together. When you throw in all the variables (poor swing mechanics, poor mobility, prior injuries, nutrition, overall health and fitness, etc.), it can be hard to pinpoint when the whole injury process started and even more difficult to fix.
To recover from a severe chronic injury, it’s vital to understand the relationship between your unique swing, your physical abilities, and how they tie into your injury. That’s why we recommend finding a local physio, chiropractor or healer who understands the demands of golf and can relate it back to your injury. When done properly and in coordination with your swing coach, they can develop a plan to address some of the issues causing pain and get you back in the game. If you are dealing with a golf injury, our advice is to give your body time to rest and get properly assessed so you don’t continue to deal with it in the future.
The Body’s Capacity
Another known risk factor for why golfers get injured is the lack of an individualized exercise routine. Having a routine designed specifically to your needs will help your body become resilient and capable enough to handle the constant stress of the swing.
An individualized exercise program allows you to take full advantage of your body’s inherent capacity to heal itself and prevent injury. Strength training specifically allows you to improve weak or pain-affected areas to ensure proper future use, which in turn prevents re-injury and future injuries. Through repetitions of strength exercises, the tissues are placed under stress because they are forced to work against an external load that they are not accustomed to (the downward sloping portion of the line in Figure 3). This causes micro-trauma in the system that quickly repairs when the tissues are given proper rest, allowing them to recover and adapt, and become more capable of tolerating stress (the upward sloping portion of the line in Figure 3). This recovery period should also include proper sleep and nutritional habits, giving your tissues all the resources they need to properly and completely heal. When these same tissues are then placed under stress again, they will be stronger and more capable of handling the external load (or stress) placed on them.
For example, let’s say you are trying to get better at push-ups. You start off by doing 5 push-ups each day. At first, this is difficult because your body is not used to this activity, as you are recruiting muscles you normally don’t use. When doing the 5 push-ups eventually becomes easy, you move to 10 push-ups per day, then 15, 20, 25, and so on. The body gradually adapts to this new activity and becomes stronger and able to tolerate more load/stress, until eventually you can perform the push-ups very quickly with minimal fatigue and little to no soreness after. In the same way your body and specifically your tissues performing the movement adapt to performing push-ups, they adapt to strength training exercises to become stronger and more resilient, helping to prevent injury.
Training specific movements in the gym also helps to solidify swing modifications made during coaching sessions. Once your body is able to naturally perform movements in the gym, these same movements are transferred to the golf swing without much thought, eliminating the interference of swing thoughts. Because old movement patterns are often deeply ingrained in the way you move, training those new movements in the gym can accelerate the process of replacing old habits with newer and stronger movement habits. The gym can be essential to establish and reinforce proper movement patterns to prevent injury or pain in the golf swing.
It is important to understand the benefits of working with a fitness professional who really knows your body and its physical limitations, and can work in coordination with your golf coach. Together, they can design a specific exercise program for you to address these limitations and strengthen the weaker areas that may be causing issues in your golf swing. A trainer who knows what proper body movement looks like and how to gain the most from the exercises will be most helpful to your recovery and success in golf.
Takeaways
Coming back from an injury is a puzzle. It is hard, confusing, and takes time. But if you're patient, take a step back to gain perspective, and get some help along the way, you can recover. Client education and professional coordination are two of the most important tools we use when dealing with injured players.
At UGP, we take a holistic, team-based approach to understanding every facet of your performance. Having all resources under one roof with intense communication amongst a team allows for proper healing and faster development. Each UGP team member has their own knowledge and experience, and by working together in an integrated fashion, we can provide the client with everything they need to be successful, recover from injuries, and get back to playing the game we all love.