Blake Loxtercamp
Back Pain in Golfers
Updated: Aug 3, 2022
This article is going to explain how Chirostrength Twin Cities treats golfers by following the journey of a mock patient called Bob. Bob is a Minneapolis golf teaching professional who hurt his back significantly doing yard work. The pain was not only hampering his daily routine, but he was struggling to perform his job as the golf professional. His job working with golfers requires physical activity and demonstrating the golf swing. He was concerned that not only have to suffer from the pain, he would also be unable to work.
Bob knew he had to find a quick solution to his low back pain before it worsened or caused him to miss teaching lessons with his golfers. He had visited our office in the past for his shoulder pain, so he knew he could schedule the same day appointment to see us for examination and treatment.
I ran Bob through a comprehensive low back evaluation. Upon our evaluation, we noticed the following findings regarding his low back condition.
Spasm of the low back musculature in the low back.
Antalgic (altered posture) positioning to the right
No neurological findings or red flags associated with disc injury
Full strength in all extremities
Significant pain when assessing the right side of his low back muscles.
After evaluating Bob, we discussed our findings and the prognosis of his condition and ability to get back to teaching Golf. We first addressed some of Bob’s concerns which were his desire not to take medications and quickly getting out of pain. In his years in the golf industry, he has known many golfers who have missed weeks and even months of golf because of low back pain. He expressed to me that he couldn’t afford to miss that much time from work and was tired of dealing with the constant pain.
Some common low back injuries in golfers include:
From the Mytpi.com article
Muscle Strain or Ligamentous Sprain - A muscle strain or “pulled a muscle” as well as an injured ligament will usually resolve itself in 2-4 weeks with active recovery. However, there can be some residual muscle stiffness, restrictions, joint fixations or movement alterations that may need to be addressed afterward. Sprains or strains are the most common form of lower back injury we see. Symptoms may range from a minor ache to sharp debilitating pain. Most sprains and strains are localized in the lower back region, meaning pain does not radiate into the butt or leg. The chemical inflammation around the injury is usually sore to the touch, and the pain usually subsides with rest.
Disc Injury - The lumbar intervertebral disc acts as a spacer between adjacent vertebrae to help absorb compressive forces and create space for the spinal nerves to exit the spinal column. Imagine the disc as a jelly filled donut. Your discs are much stronger than a jelly doughnut and they rarely get injured, but for the sake of the analogy imagine you have doughnuts in your back. If excessive or abnormal stressors are placed on the disc, tears can occur. When this happens, the force of the jelly against that tear can cause a bulge in a portion of the donut leading to a “bulged disc.” In more severe cases, the jelly can actually exit through the donut wall leading to a “ruptured disc.” The discs are also susceptible to degenerative changes over time. To continue the analogy, imagine the jelly inside of the donut drying up. Any of these disc problems can leave the spinal nerves vulnerable to irritation or compression resulting in dysfunction and pain. Disc pathologies can create radiating pain into the buttocks or the leg (think sciatica) due to the irritation of spinal nerves. Sitting for prolonged periods of time, bending forward into a slouched position, or lifting heavy objects can all exacerbate disc symptoms. However, it is important to note that exercise and movement are great for disc injuries and that just people can have disc herniations without any pain. So, a herniation does not doom you to pain.
Degenerative Arthritis - Just like all joints, with injury, lack of use, or normal aging, spinal joints can become arthritic. Bone spurs and osteophytes act like stalactites and stalagmites inside a cave closing in on the opening for the spinal nerves. With time, these bony outgrowths can fuse joints, irritate nerves and create general inflammation in the area. Stenosis, the narrowing of the canal or cave that houses the spinal nerves is a very common problem with arthritic changes. Most arthritic problems in the spine create sharp pain with certain movements. The resulting inflammation can then cause chronic dull pain over time. However, arthritis does not guarantee you will have pain. Exercise and manual therapy are great treatments for arthritic pain, and if you put your mind to it, you can overcome that pain.
Bone Fracture - Stress fractures and pedicle fractures (spondylolysis) are common problems seen in the lumbar spines of rotational athletes. This occurs due to the rapid extension and rotation of the spine, causing adjacent vertebrae to collide into each other at their end range of motion. This action places high forces on the posterior portions of the vertebrae and can lead to these types of fractures. Injuries of this sort can lead to deep dull pain and instability in the spine.
The rest of this article can be found at:
http://www.mytpi.com/articles/health/the_golfer's_guide_to_lower_back_pain_part_1
I discussed with Bob our treatment plan and that we could achieve the results he desired with conservative Chiropractic, Active Release Technique, and rehab exercises specific to his low back. I explained to him that we could accomplish these results in a short period. Based on our findings and experience with this condition, we set a goal of 1 week to where he could get back to teaching golf, and in 2 weeks he would presumably be pain-free. We also discussed a potentially longer time frame to where he would have full function and strengthening of his low back. Most of that strengthening work would be done as part of his at-home care program.
We provided Bob with four low back exercises (examples of 2 of them are videos below).
By adhering to our treatment plan and implementing At-Home Care. Bob was able to return to golf teaching and playing relatively pain-free after a few days and then was fully functional and pain-free after a few short weeks. He didn’t have to see any other specialists or take any medications.
Once Bob was fully healthy, he still fully abided by his core stability and other corrective exercises to help fend off any recurrence of the pain.
There are many causes of low back pain from golf and addressing those will go a long way for optimal performance and injury prevention. Some of the key aspects of injury prevention include:
Proper Technique
Flexibility/Mobility
Core Stability
Optimal Functional Movement
Properly fitted equipment
Warm-up before practice and play
Full Recovery from the previous injury
Proper Posture
With that said, golf is a physically demanding and highly repetitive sport. Even golfers who optimize all of the above may fall victim to the dreaded golf injury. However, if you address the above, you will have less injury frequency, severity and recovery time. We can help you get there!
If you want to see how chiropractic can help with pain and injury, book an appointment with Chirostrength Twin Cities at 612-314-0268.