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Injury Information
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Injury Information | Frequently
Asked Questions
The SA
Golf Injury Clinic is open to all members
and non-members with both
golf and non-golf related injuries
requiring physiotherapy assessment and treatment. Physiotherapy
treatment costs can be claimed through private
health insurance for
those with extras cover and members of the Grange Golf
Club receive a discounted fee for physiotherapy treatment and massage.
The clinic is situated in the professional shop at the Grange Golf Club. Ben
Corso also consults
from North Adelaide Manipulative Physiotherapy at 145 Tynte St North Adelaide
on Monday, Wednesday and Friday.
Golf
stretching brochures and specific regional exercises
programs for golfers are available from the SA
Golf Injury Clinic. For all appointments
contact 8361 6933.
Please
click on the links below for more information in a particular area...
Elbow
problems in golfers
Foot problems
in golfers
Hip and Knee problems
in golfers
Low back and
neck pain in golf
Musculoskeletal
screening in golf
Shoulder problems
in golf
Wrist and hand
problems in golfers ...................................................................................................................................................
Elbow
problems in golfers
The elbow is a hinge joint that allows a large range of movement to both bend
and straighten the arm and rotate the forearm. As a result the elbow is susceptible
to
injury in golf with the two most common conditions being TENNIS ELBOW and
GOLFERS ELBOW. Interestingly, it is tennis elbow that is more common in golfers.
Golfers Elbow: a condition which involves overload of the
tendons on the inside of the elbow leading to pain and tenderness at their
point of attachment to the bone usually
on the inside of the right elbow for right handed golfer and left elbow for
a left hander.
Tennis Elbow: this condition involves overload of the tendons
on the outside of
the elbow leading to pain and tenderness on the most outer point of the elbow.
As symptoms increase pain may radiate down the forearm and into the hand
severely limiting your ability to grip and swing the golf club.
CAUSES:
Stress on the forearm and wrist flexors and extensors during the golf swing
which is increased when these muscles are tight.
Gripping the club too tightly which increases the shock through the elbow.
Stiffness in the spine leading to increased use of the arms in the swing.
Poor technique;
- swinging the club too forcefully
- over emphasising wrist release on contact with the ball
- turning the hands over too much in the swing
- incorrect ‘cock up’of the wrist on the backswing
Incorrect equipment
- worn out, wet or small grips
- heavy clubs and bag
- club shafts being too rigid causing extra shock through the arms
Overuse: practising the same shot repeatedly, especially on hard
ground or practice mats.
MANAGEMENT:
REST from aggravating factors and seek treatment before the condition
becomes chronic.
PHYSIOTHERAPY- ice, ultrasound, deep tissue massage, stretching
and strengthening exercises.
Seek ADVICE from your golf professional regarding swing technique and grip.
Check EQUIPMENT- grips and shafts, weight of clubs.
Make sure you STRETCH your forearms before, during and after playing
and practicing golf.
Break up your PRACTICE routine by stretching after hitting every 20-30 balls
and alternate clubs regularly so you are not hitting the same shot repeatedly
ie. hit some short irons then long irons then driver and back to short irons.
...................................................................................................................................................
Foot
problems in golfers
The
feet are made up of bones, ligaments and muscles, which
form the arches of
the feet. These support the weight of the body and allow the feet to have both
flexibility and rigidity to assist propulsion of the body when walking the
golf course.
The arches also play an essential role in the golf stance helping to provide
balance
and stability.
Foot problems in golfers relate to the constant overload of joints, muscles,
tendons and ligaments with walking approximately 6-8 kilometers for 4 hours
in some cases several times per week!
The most common foot conditions in golfers are BUNIONS, PLANTAR FASCIITIS,
ARTHRITIS and METATARSALGIA.
CAUSES:
Poor biomechanics of the feet eg.excessive rolling in of the feet when walking
Tight calf muscles
Weakness in the lower leg muscles
Stiffness in the ankle joints
Incorrect footwear- lack of support particularly in the arch of the foot,
worn spikes or socks that are too thin
Excessive weight gain
Overuse: excessive practicing, playing and walking without adequate rest
MANAGEMENT:
REST from aggravating factors and seek treatment before the condition becomes
chronic eg. use a cart when playing.
PHYSIOTHERAPY- ice, ultrasound, deep tissue massage, stretching, strengthening
exercises and taping to support the arches of the feet.
Make sure you STRETCH your calves before, during and after playing and
practicing golf.
Break up your PRACTICE and playing ensuring you have adequate rest in between.
Check your FOOTWEAR including spikes and socks, you may seek the advice
of your physiotherapist, podiatrist or golf professional regarding the most
appropriate footwear.
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Hip
and Knee problems in golfers
The
hip and knee joints are placed under considerable stress
as a result of the
sideways movement and bodyweight transference associated with golf swing dynamics.
Muscles overlying the hip and knee joint as well as the ligaments have an important
role to play in stabilizing these joints during the golf swing.
The main muscle groups include the gluteal muscles, ilio-tibial band (outer
thigh),
hip flexors, adductor (groin) muscles, quadriceps, hamstrings and calf.
THE LEGS AND GOLF
From the top of the backswing many players push off the right leg to gain power
(if you are right handed). The weight is transferred from the right to the
left leg
so that at the end of follow through there is significant lateral and inward
rotation
of the left leg. This creates significant stress on the hip and knee joints.
With chipping, pitching and bunker play you are placing increased loads on
the left leg which if
maintained for long periods can cause a build up of stiffness and tightness
around
the outside of the left hip and knee.
Putting involves standing for long periods with the knees in a flexed position
as
well as reading putts involves squatting and kneeling which places significant
loads
on the hip and knee joints. This can cause tightness in the hip and knee joints
and
related stiffness. Therefore adequate strength and flexibility is essential
to prevent
injury and maximize performance.
SIGNS AND SYMPTOMS OF EXCESSIVE LOAD ON HIPS
AND KNEES:
Early morning joint stiffness the day after practicing or playing
Swelling or pain in specific joints
Difficulty achieving rotation of the hips and lower body in the golf swing
General feeling of fatigue at the end of playing or practicing
CAUSES:
Excessive practice
Poor technique such as over swinging or reverse pivoting
Poor muscle tone which reduces joint protection
Poor flexibility in the spine and lower limbs which increases joint stresses
Obesity which increases the load on weight bearing joints
Poor footwear
MANAGEMENT:
REST from aggravating factors and seek treatment before the condition
becomes chronic eg use a cart when playing.
PHYSIOTHERAPY- ice/heat, deep tissue massage, stretching, strengthening
exercises for the lower limbs and advice on posture and swing mechanics.
GENERAL EXERCISE preferably non weight bearing exercise such as swimming
and cycling to reduce joint loading, maintain fitness and promote weight loss
Make sure you STRETCH the major muscle groups in your legs before, during and
after playing and practicing golf.
Break up your PRACTICE and playing ensuring you have adequate rest in between.
Check your FOOTWEAR including spikes and socks, you may seek the advice
of your physiotherapist, podiatrist or golf professional regarding the most
appropriate footwear.
COACHING to correct any swing faults which may be putting undue stress
on the hips and knees.
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Low
back and neck pain in golfers
Low
back and neck injuries are common in both amateur and
professional golfers.
Most golfers will either suffer a back injury or will be restricted in playing
golf due
to back or neck problems. In amateurs, poor swing technique, overuse, failure
to
warm up, reduced trunk muscle strength, reduced general fitness and ill-fitting
equipment are potential causes of lower back and neck problems. In professionals,
overuse due to the repetitive and asymmetrical nature of the golf swing is
thought
to be the cause of lower back and neck problems.
Lower back and neck pain is most commonly caused by stresses to the discs,
ligaments and muscles in these areas. Excessive flexion or ‘slouching’ of
your
spine in various positions such as when bending forward or sitting usually
brings
on these stresses.
Think of the number of times you as a golfer are in a flexed position
and therefore stressing both your lower back and neck:
Driving your car to the golf course
Lifting your clubs and buggy in and out of the car
Assembling your buggy
Searching through your golf bag
Hitting and then picking up practice balls
Putting practice
Selecting your clubs from your golf bag
Teeing up the ball
Checking your ball in the rough or looking under trees for your ball
Pushing/pulling your buggy especially up hill
Filling up the sand bucket at the sand pit and filling up divots
Repairing pitch marks
Getting the ball out of the hole
Sitting down to a drink at the 19th hole
SO HOW DO WE PREVENT BACK AND NECK PAIN OCCURRING IN GOLF?
1. Warm Up
This should incorporate specific stretching exercises, driving range and putting
practice and practice swings on the first tee and take no longer than 15 minutes.
2. Correct Swing Technique
Discuss with your local pro and ask them to review or video your swing and
provide
advice on how you may be best able to reduce loads on your lower back and neck.
3. Correct Lifting and Bending Technique
It is important when lifting your clubs in and out of the car and
onto/off your buggy to:
Keep your knees bent and maintain the normal curves of your spine
Keep the load close to you and use the handles of your golf bag
When bending to tee the ball up and pick your ball out of the hole:
• Bend your knees to get down rather than bending your back
• Maintain the normal curves in your spine
• Brace your tummy muscles to protect your spine
4. Correct Equipment and Usage
Try to keep your golf bag as light as possible by removing any
unnecessary accessories.
If carrying clubs adjust the strap of the bag so that it is not too slack
and alternate between right and left shoulders.
Also ensure that clubs are evenly distributed in your bag and
ideally use a bag with carry straps.
When using a buggy ensure that it is in good working order with well-oiled
wheels and good tyres to reduce the resistance when manoeuvring.
For golfers with neck and back pain pushing the golf buggy is generally easier
however if manoeuvring over uneven ground pulling may be provide better control.
If it is a habit to pull your golf bag ensure that you alternate between right
and left arms and maintain a good spinal position.
5. Trunk Muscle Strength and Conditioning
It is important for golf to maintain a degree of physical fitness off the course
with
activities such as walking, swimming or cycling. This will ensure you don’t
fatigue
on the course and indirectly increase the stresses on your lower back and neck
through poor posture and breakdown of technique.
A good lower back and neck and trunk conditioning program will also help to
reduce
stress on these areas by providing greater stability and control of your spine
with
the golf swing and in day to day activities.
Ask your physiotherapist for advice on warm up
and trunk muscle conditioning
programs specific for golf.
...................................................................................................................................................
Musculoskeletal
screening in golf
Musculoskeletal
screening involves the assessment by a physiotherapist,
coach
and fitness trainer of various aspects of the golfers’ physical make
up to determine
the players strengths and weaknesses.
The areas of weakness highlighted may be the cause of current symptoms or
could have the potential to cause injury.Therefore the benefits of undertaking
a musculoskeletal screening by your physiotherapist are to both prevent injuries
and enhance performance.
Musculoskeletal screening involves the evaluation of:
General medical status- in consultation with your GP
Alignment and Golf Posture
Flexibility - of muscle groups relevant to the golf swing
Stability - of joints and body segments such as the trunk and pelvis
which play an important role in golf
Strength/power/endurance
Technique - in consultation with your golf coach ideally by video analysis
of the golf swing
Fitness testing - usually by an accredited fitness trainer or sports scientist
to assess areas such as cardiovascular fitness and agility which are often
forgotten but very relevant to golf.
At the completion of the screening assessment a summary of the major findings
are provided to the golfer and then a program is designed to rectify problems
in
the form of treatment, home exercise programs and coaching advice.
This results in:
LESS TIME OUT + BETTER PERFORMANCE
....................................................................................................................................................
Shoulder
problems in golf
The
shoulder is a ball and socket joint that allows a wide
range of motion in day to day activities and particularly
with playing golf. The shoulder is also susceptible to
injuries
in golf and primarily injuries to the shoulder are related to the bio-mechanics
of the golf swing and typically occur to the lead arm at the top of the back
swing.
Various shoulder structures are susceptible to injury such as the rotator cuff
tendons which are a group of four deep tendons that blend to surround the ball
and socket joint
in an effort to provide both stability and mobility to the shoulder. The causes
of rotator cuff injury in golf relate to stress on these structures particularly
at the end of the back swing and on impact during the down swing.
FACTORS LEADING TO ROTATOR CUFF INJURY IN GOLF:
Poor flexibility of the shoulder joint particularly taking the arm across the
chest and the hand behind the back
Weakness of the rotator cuff muscles
Stiffness in the neck, upper or lower back which can lead to increase use
of the arms in the swing
Poor technique such as swinging the club too forcefully or over-swinging the
club
Incorrect equipment – excess heavy clubs and bag; shafts being too rigid
Overuse – repetitive swinging of the club in one direction without appropriate
warm up or cool down
MANAGEMENT:
Rest from the aggravating factors and seeking treatment before the
condition becomes chronic.
Physiotherapy which may incorporate local treatment such as ice, and
ultrasound, deep tissue massage and exercise.
Strengthening of the rotator cuff muscles using various types of resistance
including elastic band and free weights.
Seeking advice from your Golf Professional regarding your swing technique.
Checking equipment.
Making sure you stretch your shoulders before during and after playing
and practicing golf.
Breaking up your practice routines by stretching in between hitting balls.
....................................................................................................................................................
Wrist
and hand problems in golfers
The wrist and hand region is made up of over 30 small bones and numerous
tendons and ligaments. The hands play an essential role in daily life and are
crucial when playing golf due to the bi-lateral gripping action.
The way we grip the club will determine our swing path and ultimately the
effectiveness of our shot making. The wrists help to stabilise the hands when
gripping the golf club and are important in the ‘cock up’ phase
of the backswing
and wrist release at impact with the golf ball.
The hands are also important in developing ‘feel’ for the short
game ie. putting, chipping and bunker play. Due to the demands of both mobility
and stability the wrists and hands are prone to injuries. The common injuries
are tendonitis,
ligament tears, joint sprains and fractures.
CAUSES OF INJURY:
Gripping the golf club too tightly with poor/ineffective grip position
and swing technique.
Excessive forceful contact with the ground ie. taking heavy divots
causing shock forces to be dissipated through the wrist/hand.
Worn or wet grips requiring tighter grip.
Shafts that are too ‘stiff’.
Excessive practice/ playing without adequate warm up.
Reduced strength in the hand/forearm muscles.
Tightness in the hand/forearm muscles.
Stiffness in the upper back requiring increased use of the hands during the
swing.
MANAGEMENT:
Ensure grips and glove are in good condition.
Stretching and strengthening exercises for the wrist and hand- ask your physiotherapist
for advice regarding these.
Break up practice routines with wrist stretches.
Technique and grip modification- ask your pro for advice.
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