The Senior Golfer - Age and Injury

Statistics from the National Golf Foundation indicate that in 1996 there were over six million seniors, 50 years of age or older, playing golf in the United States. This group accounted for approximately 25% of the golfing population but reflected 50% of the total number of annual rounds played.

In terms of spinal stress, the golf swing produces a complex loading pattern involving shear, compression and axial portion loads with rapid changes in the directions of these forces. Studies show that the lead hip experienced a much greater rotation torque than the trailing hip during the downswing. These findings help explain the asymmetrical hip deterioration in golfers.

The knees in the golf swing differed in their motion and torque.  The lead knee was subjected more to an internal rotation, posterior and varus force on the downswing, while the trail-side experienced an external rotation, anterior and valgus stress.

Studies concluded that golf was not a very strenuous arm activity but did require synchronous activity of the rotator cuff muscles in order to protect the glenohumeral complex of the shoulder.  The findings noted that right-handed golfers had left-sided rotator cuff problems.

Studies examined the role of the scapular muscles (levator scapula, rhomboid, trapezius, serratus anterior) during the golf swing. They concluded that the upper, middle and lower trapezius muscles all work together to help retract the scapula during different parts of the swing. Activity in the trailing arm primarily occurred during takeaway whereas activity in the leading arm occurred during acceleration. The lead side levator scapula and rhomboid muscles also helped elevate and retract the scapula in the downswing.

Researchers studied the activity patterns of the gluteus maximus, gluteus medius, adductor magnus, biceps femoris, semimembranosus and vastus lateralis muscle in competitive golfers. These researchers concluded that extensors and abductors of the trail hip in conjunction with the lead adductor magnus contract powerfully to initiate pelvic rotation during the downswing. The lead vastus lateralis and the hamstrings acted to stabilize the knee joints during this pelvic rotation.

The most common injury in senior Japanese golfers was to the lumbar region.

Overuse through excessive practice (repetitive swings) was consistently identified as the most common cause of injury for all golf players. The ramifications of this are particularly important to senior golfers as their ability to recover from the micro trauma associated with repetitive motion decreases with age.

Several studies of stress fracture of the ribs in golfers have been reported in literature. Golf ranks fifth in terms of the frequency of reported cases among 19 different sports. The lead side of rib fractures was involved in most 80% of cases. Most fractures occurred in the mid-axilla line of the ribs six and seven in one study whereas another study found the posterior postural lateral portion of ribs 4-6 to be the most susceptible region. Weakness and fatigue of the serratus anterior muscle was proposed as a key risk factor to developing rib stress fractures from golf.

Another problem facing senior golfers relates to exposure to ultraviolet radiation. Blue-eyed, fair-skinned, Caucasian redheads were identified as the greatest risk for developing skin cancer. The most common skin cancer was basal cell carcinoma.

Loss of strength due to aging has been an increasing problem for older adults. As one ages, there is a reduction in the total number of motor units as well as atrophy of the Type II fast twitch muscle fibers. While it is generally thought that normal genetic program of aging reduces the total number of motor units, a more sedentary lifestyle of an older person results in atrophy of the Type II fast twitch muscle fibers. Studies show that strength training is advantageous for golfers of all ages but especially for seniors. Older adults who remain physically active exhibit only moderate losses in skeletal muscle mass and strength compared with sedentary controls. One study, reported that high intensity training reached a greater strength gains in older persons than low intensity training.

Researchers suggest that reduced shoulder flexibility with the onset of articular degenerative processes, acromioclavicular joint arthrosis with secondary osteophytes, was a common problem for older golfers. These degenerative changes could lead to impingement syndromes and muscle imbalances around the glenohumeral joint.

Another study found that trunk lateral bending range of motion measured during the golf swing of senior golfers was 25% less than that recorded from college players who had a mean of 19 years old. Axial rotation also decreased although the exact amount was not reported. The authors commented that the decreased range of motion was partly the expected sequela of aging and lost flexibility.

Studies show a decrease in speed and movement among older golfers. Lumbar axial rotation velocities decreased with increasing age. However, it was encouraging to note that the speed of movement and power development could be improved in older adults with specific training exercises. Of particular interest to senior golfers are resisted movement patterns that mimic the swing such as exercising with a specially weighted golf club. 

The ability to maintain the proper balance is also compromised with aging. Changes in occur in several body systems that maintain postural control. These include muscular, skeletal, neural and cardiovascular (regulating blood pressure).

American College of Sports Medicine guidelines suggest that individuals should perform aerobic exercise for 20-30 minutes a day three times a week at 60-80% of vital capacity to improve cardiovascular function. Recent studies have demonstrated that mild to moderate exercise such as walking or cycling can be effective in increasing aerobic capacity, especially in elderly persons, and can also be beneficial at lowering blood pressure in hypertensive patients.

To summarize chronologic age creates changes in our bodies that hinder athletic performance.  Proper physical activity, conditioning, stretching and task specific resistive  exercises lessen the effects on the musculoskeletal system and promote wellness and the enjoyment of the golf game.

Should you have any further questions regarding this article, please direct your questions or comments to "Ask the Doctor" section.

Copyright © 2004 - 2010 Taras V. Kochno, M.D.  All Rights Reserved
Board Certified in Physical Medicine and Rehabilitation

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