Almost every golfer has experienced lower back pain.
In fact, according to the
Titleist Performance Institute, it’s something that nearly 30% of golfers experience after every round.
So, what makes lower back pain
the most common injury in golf?
the repetitive and asymmetric nature of the golf swing creates inherent risk to the lumbar spine (lower back).
The result is often tight, painful muscles that can eventually lead to serious conditions such as
disc bulges, arthritis, stenosis, and more.
But that doesn’t mean injury to your back is inevitable. There are things we can do to prevent and relieve lower back pain associated with golf.
How do I prevent lower back pain when golfing?
Back pain is a complicated thing. The advice here is not intended to be a substitute for professional medical advice, diagnosis or treatment. Read the disclaimer here.
Even though pain might be felt in the lower back, the underlying cause of that pain is often elsewhere in the body.
In this article, we will look at those causes and how to fix them.
I will show you how to test yourself for mobility issues, and then give you exercises to do if you fail the tests.
We will also look at swing characteristics and lifestyle factors that might be contributing to your lower back pain.
By the end of this article, you will have a personalised plan to help prevent and relieve lower back pain.
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Part 1: The top 3 physical causes of lower back pain for golfers
Alongside each of the causes of lower back pain listed below are movement assessments that you can use to test yourself.
Each assessment is shown in a short video tutorial where I take you through the process step by step.
When performing the movement assessments, I suggest you get a family member or friend to film you. What you feel is happening can be very different to what is actually happening so the visual feedback is helpful.
Cause #1: Lack of thoracic rotation
The Thoracic Spine
The thoracic spine is located in the upper and middle part of the back.
each of the 12 thoracic vertebra can rotate approximately 3 degrees, meaning the entire thoracic spine is capable of rotating 30-35 degrees to each side.
The 5 vertebra of the lumbar spine (lower back), on the other hand, are only capable of rotating 2 degrees. The total rotation of the lumbar spine is just 10 degrees.
In other words, the thoracic spine likes to rotate and the lumbar spine doesn’t.
But, if the thoracic spine is unable to rotate, then the lumbar spine is forced to compensate, increasing the risk of lower back pain or injury.
As Bogduk describes in ‘
Clinical anatomy of the lumbar spine and sacrum’:
Rotation of more than 3 ° at any lumbar segment could damage the articular surface and tear collagen fibers that make up the disc between each vertebra.
What this means for the golf swing:
If you lack thoracic rotation, you are likely to find extra rotation through the lower back, increasing your risk of pain and injury.
How to test thoracic rotation
This is a simple drill to test your thoracic rotation that has the added bonus of testing your pelvic stability. The upper body should be capable of rotating without the lower body moving.
How to improve thoracic rotation
If you are unable to comfortably rotate the upper body without the lower body moving, here are 2 exercises to include in your routine.
Exercise #1: Shoulder Rolls
VIDEO Exercise #2: Torso Rotation Drill
VIDEO Cause #2: Lack of hip internal rotation
Hip internal rotation is the twisting movement of your thigh inward from your hip joint.
For a right-handed golfer, the right hip travels into internal rotation on the backswing, and then the left hip travels into internal rotation on the follow-through.
If you lack internal rotation in either hip, then you may compensate by
finding that missing rotation through the lower back, which increases your risk of pain and injury (as discussed in the previous section).
Alternatively, you may compensate with a Sway, Slide or both.
A Sway is any excessive lower body lateral movement away from the target during the backswing and a Slide is any excessive lower body lateral movement toward the target during the downswing.
Not only do these swing characteristics rob you of distance and accuracy, but
the lateral forces they produce put the lower back at greater risk of pain and injury. How to test hip internal rotation
According to the Titleist Performance Institute, the average amount of hip internal rotation for PGA tour players is 60 degrees.
You can test yours by following the assessment video below:
VIDEO How to improve hip internal rotation
If you were unable to pass the above test, here are 2 exercises to include in your routine.
Exercise #1: Supine Knee Drops
VIDEO Exercise #2: Lateral Hip Swings
VIDEO Cause #3: Lack of core stability
Trackman shows that the club speed of the average male amateur golfer is 93.4mph. This translates to compressive forces on the lower back of up to 8x body weight.
To protect the lower back from pain and injury,
adequate strength and stability in the surrounding musculature of the core is therefore essential.
These muscles include the abdominals, obliques and glutes.
While core s
trength refers to the ability of these muscles to produce force, core stability refers to the ability of these muscles to keep your spine from moving during physical activity.
While core strength is important,
lack of core stability, in particular, is linked with lower back pain in golfers.
If you lack core stability then the abdominals, obliques and glutes have a
reduced capacity to protect the lower back during the golf swing. How to test core stability
This is a great test for stability in the core, especially the glutes. The goal is to hold the bridge position with each leg extended for 10 seconds.
VIDEO How to improve core stability
If you failed the above assessment, here are 2 great core stability exercises to include in your routine.
Exercises such as these have been
shown to reduce chronic back pain by as much as 39%–76.8%. Exercise #1: Glute Bridge March
VIDEO Exercise #2: Quadruped Hold with Shoulder Tap
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Part 2: 3 swing characteristics linked to lower back pain
I have to preface this section by stating that, while I am TPI certified and an avid golfer, I am not a swing coach.
Therefore, the advice here should not replace that of your golf pro.
With that said, these are the 3 swing characteristics that,
according to the Titleist Performance Institute, are most likely to lead to lower back pain and injuries. Characteristic #1: Reverse spine angle
According to TPI co-founder Dave Phillips:
“Reverse spine angle is the number one cause of lower back pain in golf.”
For a right-handed golfer, reverse spine angle is characterised by any excessive upper body backward bend or excessive left lateral upper body bend during the backswing.
From TPI’s article on reverse spine angle:
Reverse spine angle puts excessive tension on the lower back due to a forced inhibition of the abdominal musculature during the backswing, and excessive compressive loads placed on the right side of the spine at impact.
Reverse spine angle has a number of causes, but the 3 main ones are the physical limitations described earlier in this article: lack of thoracic rotation, lack of hip internal rotation and lack of core stability.
If you failed the 3 assessments, then there is a good chance you will have difficulty maintaining a proper spine angle when you swing the golf club.
If you exhibit a reverse spine angle when you swing the golf club, then working on the exercises from the section above should be a priority.
Characteristic #2: S-posture