Golf Injuries on the PGA Tour

Common Golf Injuries

What are the common golf injuries that you have to treat?

"From my perspective working with a small select group of players and predominantly on injury prevention, it is difficult to say what the most common injuries are in golfers. Certainly what has been found over the years is that any part of the body can be affected in golf, probably due to the range of movement and the repetitive rotational stresses that are placed throughout the body. The following are some examples of injuries that I have encountered over the years and a brief description of their management.

"Low Back Pain - L5/S1 inter-vertebral disc bulge and irritation due to continual flexion and rotational loading, placed upon this region. Management involved Chiropractic adjustment to set the sacrum and reduce the disc bulge. Physiotherapy treatment was required to release tight and adhered myo-fascia of the global mobilizing muscles such as hamstrings, Tensor Fascia Latae, IlioTibial Band etc. Core strength training is important to develop control of local and global stability muscles, especially rotational control of the lumbo-pelvic region. Another important objective of physio treatment for low back pain in golfers is to improve the function of posterior oblique, longitudinal, lateral and anterior oblique slings, that provide force closure to the lumbo-pelvic area (Gibbons and Comerford 2001). Improving hip function and gluteal control to off load torsional (twisting) forces on the pelvis is also important.

"Shoulder Pain - Another important area to observe is right shoulder internal impingement affecting the Supraspinatus and Infraspinatus tendons of the Rotator Cuff. This can occur due to tight and overactive posterior structures of the shoulder. Because of the mechanics of the golf swing the lateral rotators and posterior capsule become tight altering the motion of the shoulder joint. In external rotation the head of the humerus (upper arm bone) is pulled backwards and upwards due to the tightening of the posterior structures; and this causes Impingement Syndrome. This responds well to soft tissue release of the lateral rotator muscles of the shoulder and stretching. Other areas for the physio to work on include mobilizing the posterior joint capsule, developing good Scapula (shoulder blade) control and Rotator Cuff muscle stability.

"Hip Pain - Left hip anterior (front) impingement due to tightening of short Adductor muscles, Iliopsoas and External Rotator muscles of the left hip. The left short Adductors become overactive by pulling the pelvis through in the right-handed golf swing. Also the left Hip Flexor muscles and Hip External Rotator muscles become tight and overactive, as they eccentrically contract to decelerate the left hip on the follow through in the swing. Soft tissue release and stretching of the tight areas mentioned, along with mobilization of the hip joint is usually effective in relieving symptoms.

"Tennis Elbow (Lateral Epicondylitis) to the left arm is often due to impacting hard ground; the grip being too small or a sudden increased work load causing tissue failure. Tennis Elbow is a typical tendon lesion that needs rest and a chance to heal. Alteration of small grips to larger ones ensures that there is not too much tension in the forearms, by off-loading the common extensor tendon. Adjusting workloads and practicing on softer ground may also help to reduce irritation, even using a tee peg to practice off, when Tennis Elbow is irritated during ball strike. Treatment involves Ice Therapy, Anti Inflammatory medication, myofascial release of the extensor muscles, neural mobilization and eccentric strengthening of the tendon and attachment.

"Shin Pain - Left leg Peroneal tendonitis due to overuse or new golf shoes altering foot mechanics. Management of this condition requires rest by reducing workload or using old shoes. Treatment includes ice, Anti Inflammatory medication, myofascial release of the Peroneal muscles, neural mobilization, eccentric strengthening and proprioceptive exercises to improve ankle and foot stability."