Low Back Pain and Golf – Causes (Part 1)

Low back pain is the most common golf-related injury. Roughly 25% of amateur golfers and 55% of professional golfers experience lower back pain at some point in their golfing career. The forceful twisting motion of a golf swing places significant stress on the low back, contributing to a high rate of low back pain. Golfers that play more rounds per week and practice excessively are at higher risk of developing low back pain.  Unaddressed back pain can continue through the season and even start affecting day to day activities.

Understanding the Causes of Low Back Pain in Golfers

Swing faults may be caused by one or more of the following:

• Lack of mobility – limited hip and torso mobility can cause undue stress to the low back

• Poor Mechanics – poor hip hinging and a poor ready position can place undue stress on the low back

• Inability to separate upper and lower body motions – moving as a block doesn’t dissipate force well throughout the body overloading the low back

• Poor kinematic sequencing and motor control – leading with the shoulders can overload the low back

• Strength deficits – Weak hips or glutes can cause compensation in the low back

• Poor segmental stabilization – a weakness at the specific segment of the back can create irritation and pain

• Inadequate stability – Lack of balance can cause excessive sway or shift in a swing

• Poor conditioning – endurance issues and fatigue can cause pain due to mechanics failing over time

• Poor equipment – poor “fit” can place the golfer in poor positions leading to a bad swing

Poor Posture, Swing mechanics and kinematic sequencing – How you swing (Technique)

• Proper stance and alignment create the most efficient swing, leading to hitting the ball further and straighter.  Poor setup can create poor swing mechanics and lead to pain over time.

• S-Posture (arched low back) and C-Posture (rounded low back) lock up the spine and limit overall spinal mobility leading to extra torque on the low back joints and muscles.

• Losing the swing plane (front to back) causes a change in spine angle leading to excessive strain on the low back.  Think early extension or loss of posture.

• Swaying, sliding and excessive side-bending are all examples of losing the swing plane (side-to side), limiting rotation and overstressing the low back.

• Poor equipment “fit” can create poor posture, alignment, setup and grip.

• Issues such as poor rhythm/tempo and swinging too hard create overcompensation.

• Usually issues in sequencing is related to rushing the backswing or downswing.

• Poor weight shift or body rotation can put more pressure on your spine.

Lack of Core Strength, Stability and Flexibility – Ability to swing (Efficiency)

• The core muscles stabilize the spine.  Weakness of these muscles can cause irritation to the joints, disc, nerves and muscles of the spine creating pain.

• Limited torso mobility (trunk) and hip mobility places undue stress on the low back.  Rotation has to be made up from the low back, which it does not like.

• Tight hamstrings, hip flexors, and weak glutes contribute to lower back pain due to limiting motion and effecting timing of the swing and stability.

Overuse and Repetitive Stress – How much you swing (Capacity)

• Frequent play and practice can lead to chronic pain due to overuse and lack of recovery.

• Excessive bending or twisting can strain the back, faults like swaying and sliding add extra stress to the low back.

• Rest and recovery are super important for reducing overall inflammation and irritation as well as letting your muscles recover from the workout.

• Poor “fit” of clubs leads to positions that put more stress on your body.

• Volume = warm up swings, range swings before a round and actual swings x number of days per week.  If your volume is too high you may break down eventually.

• Poor conditioning and lack of endurance leads to fatigue and a breakdown of swing mechanics.

  
  

In the next article we will discuss some options to correct issues in Technique, Efficiency and Capacity.

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About the author: David Potucek, PT, MSPT, CFMT

David is an orthopedic physical therapist with over 20 years of experience. He has worked with hundreds of golfers to improve their pain and their game.

Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.