Golf is the choice of sport for a growing number of people in Australia and around the world. It is a sport people can play for much longer periods than some other sports, with careers often spanning 50 years or more. The golf swing is quite an explosive, powerful movement that requires a large amount of stability and coordination to produce the necessary force. With the increase in popularity, longevity of its athletes and the demands of the golf swing – there has been an inevitable increase in golf-related injuries in recent history.
Factors affecting injury
- Changes in loading – this could be the number of times per week golfers are playing a round, or the number of balls hit per session at the driving range. It could even be something completely unrelated to golf such as a new hobby like running or gardening. Overuse is often the most common reason behind golfing injury.
- Technique – as with other sports, when trying to adjust technique, you may inevitably shift load to other areas. A recent change in swing mechanics may have contributed to the injury in question. Occasional golfers may also exhibit poor execution of their swing, leading to possible injury.
- Specific mechanism of injury – patients will often present to clinic knowing exactly the moment their injury occurred. Examples commonly experienced in clinic include: trying to outdrive their son in a long drive contest (resulting in a back injury) or catching their club in deep rough (resulting in a sprained wrist or sore elbow).
- Poor physical conditioning – reduced mobility and strength, as well as a lack of warm-up or strength training in your weekly schedule may predispose you to injury on the golf course.
- Age – golfer’s over 50 have a higher prevalence of injury compared to their younger peers. Normal physiological changes in the musculoskeletal system as we age can leave the older athlete less resilient to the forces undertaken with golf.
- Handicap – those with a lower handicap tend to get injured more often. This is likely down to increased time playing better golfers.
Golfers commonly present with injuries to the elbow, wrist, shoulder and back regions. The ratio of injuries at each site tends to differ between professional and weekend golfers. Professionals more commonly present with back, wrist and shoulder injuries. Amateur golfers have more elbow injuries, followed by back and shoulder. This can be attributed to a natural difference to their levels of loading, background conditioning and biomechanical characteristics of their golf swings. Head injuries are rare but do happen on the golf course and care should be taken to educate beginner golfers on safety components of the game.
Medial epicondylalgia (golfer’s elbow) is a common elbow complaint, occurring more often in the trailing arm, whereas lateral epicondylalgia (tennis elbow) occurs more commonly in the leading arm. Interestingly, tennis elbow is actually five times more common in amateur golfers compared to golfer’s elbow.
Lower limb injuries in golf are comparatively low, although increasing age sees higher rates of knee, hip and ankle injuries.
Managing golfing injuries is a multimodal approach that should be tailored to the specific needs of the athlete, but common strategies employed will include:
- Load management – adjusting the intensity and consistency of both training and gameplay will be critical in returning from injury. This will be dependent on the stage of the injury and may include some complete rest, starting back with just putting and chipping, or simply reducing the number of shots per day at the range.
- Strength and conditioning – Maintaining flexibility and strength in key areas such as the thoracic and lumbar spine, the hips and the core will help build resilience and prevent re-injury. It also has potential to put more yardage on those drives!
- Golf swing technique – assessing and improving golf swing biomechanics may help to distribute load more efficiently. Receiving some coaching from a professional may help to identify key swing faults, which can then be rectified.
- Short-term strategies – if a player is after something quick to help them get on course that day or weekend, temporary treatments such as strapping, massage, dry needling or medications may be warranted, as long as the long-term resolution is worked towards afterwards.
If you experience pain on the golf course, come and see one of our physiotherapists to help get you back on track and continue playing long into the future!
Article by Kieran Watson