Golfer's Back

Biomechanical Analysis of the Golfer's Spine

Among professional golfers, low back pain is the most common complaint among touring professionals in both PGA and LPGA tours. It is estimated that 10-33% of touring professionals are playing injured at any given time and that half the group will develop chronic problems. Low back pain has also been cited by amateur golfers as the most common golf related injury.

Presently, there are more than 21 million recreational golfers throughout the United States.  The modern swing, differs from the old classic swing in that it incorporates a more physically demanding swing mechanics, which resulted in increased injuries for the less flexible and less conditioned golfer.

The classic swing originated in Scotland and was best used with a hickory shaft.  The classic-swing differs from the modern swing in few respects, but important differences are noted on the effects of each swing on the lower back.  To summarize, the classic-swing uses a flatter swing plane having a very large hip and shoulder turn.  In the follow through of the classic-swing, the golfer finishes in a relaxed straight up and down position.

On the other hand, the modern swing promotes a creation of tightly coiled body turn to provide maximal energy for club-head acceleration and force.  The modern swing differs in that it restricts the hips to turn significantly less than the large shoulder turn. On average, the hips rotate 1/3 of the shoulder rotation.  The modern swing also changes the horizontal balance of the shoulders.

In the modern swing, the right shoulder is lowered more than the left in the right-handed golfer. Additionally, the hands are held high over the head in order to increase the distance in the downswing.

Another difference in the classic-swing, the golfer remains vertically stable, straight up and down, termed the “I” position.  In the modern swing, the golfer finishes in a lordotic, “reversed C” position. This reversed "C" leads to hyperextension of the low back, which adds increased stress on the facet joints and paraspinal muscles of the lumbar spine. 

Studies of amateurs and professionals reveal that amateurs demonstrate poor swing mechanics and as they swing harder, thus creating larger loads and torsion.  The professionals, on the other hand, demonstrated a fluid and distinct "on and off" muscle firing pattern that is consistent with a grooved swing that exhibits less force loads and tension of the spinal elements. 

Compression loading on the lumbar spine occurs at two points of a golf swing.  The first compression load of the lumbar spine occurs in the transition where the backswing turns into a downswing.  The second moment of high compression to the lumbar spine occurs when the hands pass the waist and continue on the following through the highest compressive forces occur at L3-4 level of the lumbar spine.

Clinical Implications

Increased loads to the lumbar spine during the golf swing as well as the large forces generated by these muscles predispose the golfer to muscular strains, spondylosis, degenerative facet changes with associated risk of herniated discs. 

The importance of proper warm-up and stretching routines prior to play cannot be overemphasized.  The golf swing exerts a large force when driving the ball in a matter of less than 1.5 seconds.

Cadaver studies  helped identify the compression load that produces prolapsed discs.  An average compression load of 5448 Newtons produced a prolapse disc in cadavers. The spinal load generated by swinging a golf club can range from 6000-7500 Newtons. Fortunately, the speed at which the spine is loaded during the swing provides a protective mechanism for the disc. A normal disc is well suited to withstand large compression loads; however, a degenerative or dessicated disc loses its elasticity and increases the susceptibility for injury. 

In summary, the golf swing creates intense loading forces on the lower back that are rapid and complex. The loading patterns are similar in both amateur and professional golfers. Amateur golfers having poor swing mechanics develop higher loads as compared to the professionals. By incorporating proper mechanics, professional golfers have fluidity in their muscle movement that increases their ability to minimize this force on the spine. 

The abdominal muscles may be the most important golf muscles, yet the lease attentive by the golfer.  These muscles promote posture and balance and provide support to the spine.  Increasing pressure in the abdominals helps protect the back from injury. 

The abdominal muscles are divided by the direction of where they are located.  The oblique muscles on the sides of the ribcage are important in rotating the trunk as well as providing increased power during forward acceleration.  The transverse muscle acts like a girdle to stabilize the trunk by compressing and increasing the abdominal pressure.  The rectus abdominis group allows bending forward and has a lesser role during the golf swing. 

Different muscles and different parts of the body have different roles in the golf swing.  It should be important to provide an appropriate stretching and strengthening training to help optimize the performance of these muscles.

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

Copyright © 2004 - 2008 Taras V. Kochno, M.D.  All Rights Reserved
Board Certified in Physical Medicine and Rehabilitation

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