Is your back swing ruining your back?

The last major of the year is underway! The Open is one of my favourite sporting competitions and so many us enjoy playing but is your back swing ruining your back?

Golfers and back problems are pretty synonymous with some of the worlds greatest golfers having suffered from this pain, the likes of Rory McIlroy, Jason Day and Justin Rose have all had time away from the course to recover but none of them are quite at the level of Tiger Woods when it comes to back issues. Woods had 4 back operations between March 2014 and April 2017, missing many tournaments including all 4 majors of 2016. Woods did complete one of sport’s greatest ever comebacks recently, coming back from all of these serious back injuries and operations to win this years Masters, his first major for 11 years! 

An article in the Journal of Neurosurgery: Spine titled ‘Golf: a contact sport. Repetitive traumatic discopathy maybe the driver of early lumbar degeneration in modern-era golfers’ (Walker, Uribe and Porter) discusses how modern day golf swings are causing much of the back pain experienced by golfers at all levels. They go on to say that back injuries comprise 55% of all injuries to professional golfers and 35% to amateurs, being the most common injury for both. The article explains that professional golfers are experiencing back problems at a much younger age than the general population, they argue that the new style of swing is to blame.

Modern players of the last 20 years or so have really focused on getting as much power as possible into their swing and to achieve this most players undergo extensive strength training. Indeed, the longest average driver in 1998 was John Daly who averaged 299.4 yards, 3 yards clear of Tiger Woods that year. In comparison, at the end of the 2018 year the leading average had soared to 319.7 yards with Rory McIlory leading the way and another 59 players averaging at least 300 yards in addition to 8 more players driving further than Daly did 20 years previously. It isn’t just the strength training that has added the distance but the style and technique of swing has changed.

During the downswing, excessive compressive force is directed to the spinal disc and facet joints. Golfers repeat this act 100’s, even 1000’s of times a day, 6 time major champion Lee Trevino was quoted as saying “There is no such thing as a natural touch. Touch is something you create by hitting millions of golf balls.” Trevino was the first player to win the US Open, Canadian Open and The Open in the same year, a feat accomplished only once since and that was by Tiger Woods. Tiger Woods’ himself used to spend the typical day with 2 hours driving and swing work followed by around an hour of putting practice, he then plays 9 holes followed by another 3-4 hours of swing and short game work, maybe another 9 holes included, this was interspersed with cardio and weight sessions. Since his long list of surgeries he has cut down slightly. Many players are said to hit around 1000 balls a day while training so this compression repeatedly exerts minor traumatic injuries to the spine countless times every day and can over time, unsurprisingly, lead to what the authors coined in their title ‘Repitive Traumation Discopathy’ (RTD).

The authors of the article, Drs Walker, Uribe and Porter discuss modern day swing and biomechanics and how this relates to the development of RTD, the younger players are exhibiting signs of RTD and whether the addition of all the strength training is exacerbating RTD.

This is still being researched and as such should be treated with some caution according to consultant physiotherapist Nigel Tilley, who has worked on the PGA European Tour and the Ryder Cup. He stated “If you scanned a lot of people in their 40’s, 70% of people would have disc degeneration, that doesn’t mean they necessarily have a back problem with it though and Tiger has had a very long golfing career doing repetitive movements, so it’s perhaps not that surprising that he has had back problems.” Tilley did agree with the change of swing style over the same period and that “it’s become much more powerful and it can put more force on the spine” and they way to counteract the potential for injuries is through strength and conditioning “if you are training properly, there’s no reason why you can’t resist these forces and have no problems or injuries.”

So what can we do to reduce injuries while playing golf? Well, first off warm up properly before you play, we’ll go into detail a bit more below. Secondly, work with a golf coach who can identify poor swing technique or mobility issues, if they see any issues they can work on changing the swing or body movements to reduce the load on the back. Strengthening the core and even activities such as yoga would be useful to help with mobility. If you haven’t played golf for a number of weeks then please, do not go out and smash a load of balls, gently play back in by perhaps going to the range with 100 balls a few times a week. If you do have any problems then see a physiotherapist sooner rather than later who can help in the short and long term.

The warm-up!

Don’t just turn up on the tee and pull the driver out and try to smash the ball as far as possible, like all sports warm up first.

• Stretch the shoulders and torso by holding a golf club behind the neck and shoulders and rotating the torso.
• Pulling the knee to the chest will help stretch the hips.
• If you bend over at the hips and try to touch your toes then you can stretch your hamstrings.
• Gently swinging the golf club will warm up the muscle groups and prepare them for the all the twisting and force that golf swings produce. If you have time, go to the range first to slowly build up from small irons to large woods, this helps the muscles slowly build up. Although Tiger Woods nowadays starts with the driver and works his way down following advice from Fred Couples. To find the best way, I’d recommend speaking with your physio and golf coach.

Perfecting the smooth, rhythmic swing that produces the best drives also produce less stress on the back which will in turn tend to reduce injuries. Once again, a good golf coach will help you produce this and alongside a physiotherapist will reduce pain while producing an effective game.

Finally, get a good golf bag. Obviously the pros don’t need to worry about this one but for the amateur many golfers prefer to carry their bag so as to get more exercise but this can lead to a lot of stress on the back. From picking it up off the ground which can lead to muscle strains and pressure on the lower back to carrying a heavy bag on one shoulder, which adds more asymmetric pressure on the spine, something that your swing maybe also doing. You can get bag stands that open when you set the bag down as well as using a dual strap bag to evenly distribute the weight.