Golf Season Is Here! But Is Your Body Ready to Play Your Best and Avoid Injury?

By Demetri Dimitriadis, PT, DPT, OCS, CMPT at Talari Physical Therapy and Wellness

After a long, harsh winter, nobody is feeling the itch of cabin fever more than golfers!   Despite the advent of technological advancements like indoor simulators and heated golf bays at driving ranges, golf remains an outdoor sport, leaving most golfers here in the Northeast trying to stay sharp and prepare for the upcoming season.   While the winter months provide a great opportunity to work on both fitness and their golf game, all too often recreational golfers that have the clubs tucked away and are ill-prepared for the demands of the golf swing are seen.  When Spring finally rolls around, golfers can often find themselves at risk for overuse injuries and a “Victim of the Too’s” . . . Too Much, Too Fast, Too Soon!

As with most sports, golf represents tremendous health and wellness benefits that can far outweigh any risk of injury.   In a 2017 review by Murray et al, golf was shown to provide moderate-intensity physical activity with an average range of about 4.5 METs (Metabolic Equivalent of Task), and it was associated with physical health benefits that include improved cardiovascular, respiratory and metabolic profiles, and improved wellness. To put that into perspective, sitting at the computer expends 1.5 METs, walking slowly 2 METs, walking briskly 4 METs, jogging 8 METs, and running at 10 minutes per mile (6.0 mph) 10 METs.  This means that playing golf is a great way to achieve the CDC/ASCM (Centers for Disease Control and American College of Sports Medicine) recommended amount of 150 minutes of moderate-intensity activity a week, or the equivalent to 500 to 1,000 metabolic equivalent (MET) minutes a week.   Even if we’re not playing well, as the saying goes “a bad day of golf is always better than a good day at work”, where so many of us spend hours a day sitting at a desk! 

                  So how does golf compare to other sports in terms of risk of injury?   While many perceive golf as a relatively safe sport without risk for serious injury, Wadsworth showed in 2007that golf does represent a moderate risk activity for injury compared to other sports.  That is because most golf injuries are the result of overuse.  By repeating the same golf swing motion over and over again, significant stress is placed on the same muscles, tendons, and joints, which can lead to injury.  Some studies quote the incidence of injury in amateur golfers annually to be between 15.8% and 40.9% and lifetime injury incidence between 25.2% and 67.4% (Murray et at, 2017).  This is even higher for professionals who play more, and are injured more frequently, with annual injury rates of between 31.0% and 90.0%, and lifetime incidence of 60.0–88.5%.  With professional golfers, over 85% of the injuries come from overuse due to the repetitive practice, hitting hundreds of balls a day, and the amount of golf played throughout the year.  In amateurs, the injuries tend to be in the lower back, non-dominant shoulder, and elbows also due to overuse; however, poor technique and dysfunctional movement patterns are also contributing factors.  Jack Nicklaus had it right when he said, "professional golfers condition to play golf; amateur golfers play golf to condition." The good news is that proper conditioning and simple activity modifications like using a pushcart versus carrying your bag and giving yourself adequate warm up time of at least 10 minutes has been shown to reduce the risk of injury (Gosheger, 2003).  

                  A generation ago the terms golf and fitness were seldom used in the same sentence, and fitness-minded golfers like Gary Player are now considered to be “before their time.”  But soon after that famous press in 1996 when a 20-year old Tiger Woods announced “hello world” in front of the flashing cameras, the idea of the golfer as an athlete truly emerged.  Nowadays it’s well accepted in the golf community among pros and amateurs alike that improving all aspects of your fitness(cardiovascular fitness, strength, flexibility, balance, and power) will not only lead to hitting the ball longer and straighter but more efficiently and with less chance for injury.   As a result, we see more golfers exercising to gain or regain yards, help improve their mechanics, improve their endurance, or rehab some old nagging injury.  

                  But when it comes to golf, there is a big difference between “fitness” and being “fit to play golf.”  So just bulking up to look like Tiger Woods at the height of his career may not translate into better, or safer golf.  A properly developed golf fitness program should be targeted to the individual’s unique body and their swing, addressing specific areas that need work in order to prepare for the repetitive demands of the golf swing.   That may be a stability issue, a mobility issue, a lack of strength, power or endurance, or simply a matter of injury rehabilitation.  And while there may be “an infinite number of swing styles, there is one efficient way for every player to swing and it is based on what the player can physically do.”  This “Body-Swing Connection” is the main principle behind the Titleist Performance Institute’s (TPI) evidence-based, educational pathway designed to increase player performance through a deep understanding of how the body functions during the golf swing.  With decades of data and research, TPI has developed a standardized way that golf professionals, medical professionals like physical therapists, and fitness professionals can all use the same language and proven systematic approach for assessing and training golfers.   Subjectively, there’s no better way to evaluate and train a golfer. It has been shown that a properly assessed player who is actively engaged in the right training program has a far better chance of playing for more years and at a higher level

                  The sport of golf should be enjoyed for a lifetime, so whether a golfer is returning to the sport after an injury/surgery or working with a physical therapist on fitness and injury prevention, the goals are the same:  To get them prepared for the physical demands of the sport, prevent injury, and improve their overall performance and enjoyment.  If you have an existing injury or want to make sure you have the best chance at playing golf injury free, you should consider seeking out a TPI Certified Professional physical therapist and have a golf evaluation performed.  A well-trained physical therapist can identify key areas of weakness or imbalance and develop a highly effective exercise or rehabilitation protocol.  It’s no guarantee that you’ll remain injury free, as the golf swing puts incredible forces on the body, but it puts the odds in your favor.  This one step may help you recover from an injury faster or identify issues that may cause injury down the road.  Along the way, you'll develop a much better understanding of your own body and the golf swing!

Dr. Demetri Dimitriadis is a Board-Certified Specialist in Orthopaedic Physical Therapy, a Titleist Performance Institute Certified Expert, and Certified Manual Physical Therapist.  He is the owner of Talaria Physical Therapy and Wellness, located in Norwood, NJ.  You can find Talaria physical therapy as well as hundreds of other quality physical therapy clinics in your area through the betterPT mobile app and betterPT website. Don’t wait for an injury to damper your golf season. Be proactive and have an assessment done today to be a BETTER and healthier golfer!

 

Additional Resources:

To find a local TPI Certified golf professional, fitness professional, or medical professional, you can visit: http://www.mytpi.com/experts. 

And for some great general tips on how to prevent golf injuries, visit Hospital for Special Surgery’s Tips for Golf Injury Prevention and Performance: https://www.hss.edu/conditions_golf-injury-prevention-performance-tips.asp

 

 

 

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