Whether you're a gym-goer who enjoys golf on the side, like Dwayne Johnson, or have more serious dreams of winning the PGA championship, you'll realize that golf is far more physical than it is may appear at first. Swinging a club requires multiple bodily processes, which is why golf injuries are common on the course. So M&F spoke to Dr. Andrew Creighton, a resident of physiology at the Hospital of Specialty Surgery and an assistant professor of clinical rehabilitation medicine at Weill Cornel Medical College, to master the biomechanics of golf and get some top tips on injury prevention and recovery.
What are some of the most common golf injuries?
Golf may seem like a fairly gentle affair, but poor technique and a poor understanding of the mental and physical demands of the game will throw you off course at any age. "The lower back, the lumbar spine, is the first area of injury," says Dr. Creighton. "For young golfers, particularly skeletally immature golfers, the concern is injury to the bone, particularly the pars bone." The pars bone is located between the joints within the spine and is often prone to injury in younger athletes.
“As the golfer ages, the lumbar disc is a common injury. Often times the golfer will injure themselves bending, lifting, or turning, especially when weight is added," says Dr. Creighton. “As the golfer ages, it can develop arthritis of the facet joints of the lumbar spine, which in turn typically causes pain on twisting and distension of the painful area. Most often, lower back injuries occur as a result of mobility problems in the thoracic spine (behind the chest), mid-back, or mobility problems in the hip. Problems with mobility in the thoracic spine and hip cause more torque and shear forces to occur in the lumbar spine, resulting in injuries to the bones, discs and joints.”
dr Creighton, a former collegiate golfer and current amateur golfer, says upper extremity injuries are also very common, particularly in the elbow and wrist. "The most common injuries to the elbow are medial and lateral elbow tendinopathies, also known as medial and lateral epicondylitis," he says. “The tendon changes and sometimes tears partly due to overuse and poor technique. The golfer usually feels pain at the prominent bone on the inside or outside of the elbow and from those areas directly down the arm. When looking at the wrist, injuries often occur on the inside or outside of the wrist, or the ulnar and radial sides.”
What are the most common causes of golf injuries?
“Wrist injuries are most common when the racquet is used to hit an object, such as a stick. a tree root or tall grass, causing a sudden decrease in movement of the accelerating hands and wrists,” says Dr. Creighton. “In addition to accidentally hitting the racquet, overuse and poor technique injuries can also occur, similar to an elbow injury. Common causes of golf injuries include overuse or poor swing mechanics and hitting an object during your swing. All of these problems can affect golfers of all ages. As with any activity, there is likely to come a point when the golfer overplays. However, this point of excessive golfing is likely to be different for everyone. The golfer has probably reached this point by the time the pain and injury occurs. Therefore, it is recommended that the golfer address these pains and injuries and consider taking time off to recover. It is important to investigate if there is anything that can be changed about their golf swing or golf routine before they play again.”
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Should golfers be aware of outside weather conditions?
"The cold can slow down your nervous system's ability to produce a muscle contraction," says Dr. Creighton. “Overall mobility is important in the golf swing and when you're cold it can affect mobility. Limited flexibility can lead to joint and soft tissue stress and possible injury. Therefore, it is recommended to wear extra clothing when playing golf to stay warm and to do a dynamic warm-up to ensure tissues are mobilized before playing. However, excessive layers can also limit the golf swing, so a balance needs to be struck. Practice hitting balls on the range after a dynamic warm-up to get that lie balance right for you.”
Is warming up important when playing golf?
Research has shown that warm-up exercises can play a role in preventing injury and even improving golf, but statistically few golfers prepare in this way before a round. "I strongly recommend that every golfer commit to a dynamic warm-up that focuses on mobilizing the body before playing," says Dr. Creighton. For many, the idea of warming up before a round of golf may seem strange, but given that the body needs to be flexible in order to stretch and hyper-stretch, then a pre-game warm-up makes perfect sense.
"A dynamic warm-up is key before you play golf," adds Creighton, who says golf warm-ups are important for muscle activation and can reduce lower back and upper extremity pain while also helping to relieve muscle pain to increase momentum. Incorporate functional exercises like side planks, hip rotations, and elbow raises. Also, prepare the wrists by doing the up, down, left, and right movements. Early signs are that dynamic warm-ups and those that involve resistance are superior to static stretches.
What other steps should be taken to limit or prevent golf injuries?
dr Creighton recommends that golfers use specific screening measures that address strength and flexibility measurements, such as: Take the Titleist Performance Institute Level 1 screening, for example, as physical limitations can often lead to golf swing errors. He also recommends that golfers seek advice from a knowledgeable PGA professional to optimize the golf swing and correct any errors. "Make sure your clubs are seated and gripped properly," adds Creighton. "Additionally, long-term preseason physical conditioning can potentially help golfers avoid fatigue-related injuries."
What treatments are there for golf injuries?
"Treating the golfer for any injury really requires a collaborative approach," says Dr. Creighton. “First see a doctor who can make a clear diagnosis of the injury. A knowledgeable physical therapist can guide the athlete through an exercise-based approach to rehabilitation and athlete recovery. Finally, the golfer can also benefit from a swing coach who is aware of the injury and can modify the swing as needed to avoid aggravating the healing injury and thereby avoid injury recurrence.”
Should golfers pay attention to their diet?
dr Creighton says some research suggests a caffeine supplement may reduce fatigue towards the end of a round of golf and help improve energy levels. "It is important for golfers to be properly hydrated throughout the round as even mild dehydration can affect performance," he adds. “Golf is considered by many to be a moderately intense activity, and even at a moderately intense level of exercise, at least half of our total energy comes from carbohydrates, indicating that golfers need to consume carbohydrates to maintain blood sugar levels while playing golf. Additionally, maintaining normal glucose levels allows the golfer to maintain focus.”
So make sure you're warming up, perfecting your technique, hydrating and knowing when it's time to rest and rebuild. This will keep you on course throughout the season.