As a board-certified orthopedic surgeon specializing in shoulder and sports medicine at Illinois Bone & Joint Institute (IBJI), and an avid competitive golfer, Dr. Tom Antkowiak (pictured) understands firsthand how frustrating shoulder pain can be on the course.
Picture this: you’re lining up what should be a perfect drive, feeling the tempo of your swing, when a sharp twinge interrupts your follow-through. It’s a familiar scenario for many middle-aged golfers who refuse to let age or nagging aches sideline their passion.
The good news is that shoulder issues don’t have to end your game. With the right evaluation and treatment approach, most golfers can return to swinging confidently – and often with improved mechanics and strength.
Your Swing’s Foundation: The Rotator Cuff
The rotator cuff is a group of four muscles and tendons that stabilize the shoulder and help generate power through your swing. It plays a critical role in smooth rotation, control and follow-through.
Two of the most common issues seen in golfers are tendinitis and impingement. Tendinitis refers to irritation of the rotator cuff tendons, often from repetitive use or swing mechanics. Impingement occurs when those tendons become compressed under the acromion – a bony structure of the shoulder – particularly during the backswing or follow-through. Golfers typically notice a dull, nagging ache that worsens with overhead motion, along with reduced power or a “catching” sensation during the swing.
More significant problems can include partial or full rotator cuff tears. These often develop over time from chronic impingement, but can also occur suddenly with a poorly timed swing or awkward strike. Symptoms may include weakness, night pain or difficulty maintaining control.
The Labrum and Biceps: Subtle Sources of Shoulder Pain
Deeper in the shoulder, the labrum is a ring of cartilage that stabilizes the socket, acting like a gasket for smooth motion. The biceps tendon attaches at the top of the labrum and helps with control and force during the downswing. Because of the rotational stress of the golf swing, both structures can become irritated or injured over time.
Labral injuries, including SLAP tears (Superior Labrum Anterior to Posterior), often result from repetitive torque through the swing. Golfers may notice deep shoulder pain, occasional popping, or a sense of instability, especially with longer irons or the driver.
Biceps tendon problems include inflammation or tearing at its attachment near the labrum. Symptoms can overlap with rotator cuff issues and may include radiating arm pain, loss of grip strength and sometimes a visible “Popeye” deformity.
As a golfer, Dr. Antkowiak has seen how these can disrupt your swing, leading to compensatory habits that cause further problems down the line. Recognizing these early signs empowers you to seek help before they bench you.
Finding the Right Treatment Plan
At IBJI, the approach is straightforward: keep golfers playing whenever possible. That starts with an accurate diagnosis using advanced imaging such as MRI or ultrasound, allowing us to pinpoint the source of pain without guesswork.
Most golfers begin with activity modification and physical therapy. This may mean temporarily scaling back full swings while focusing on putting, chipping and swing mechanics. Our physical therapy team specializes in golf-specific rehabilitation, emphasizing rotator cuff strength, scapular stability and core control to support a more efficient swing.
When additional support is needed, anti-inflammatory medications or targeted injections such as cortisone can help calm irritation and allow therapy to progress. In select cases, regenerative options like platelet-rich plasma (PRP) may also be considered to promote healing in tendons and soft tissue injuries.
If non-operative care is not enough – particularly in cases of significant rotator cuff tears or unstable labral injuries – minimally invasive arthroscopic surgery can restore function. These procedures allow us to repair or reattach damaged structures through small incisions, followed by a structured rehabilitation program. Most golfers return to light swings around three months, with full return to play typically in four to six months depending on the injury.
Why Choose IBJI? Your Partner in Performance
What sets IBJI apart is our comprehensive, patient-centered approach. From initial evaluation with advanced diagnostics to customized PT and, if needed, expert surgery, everything happens in-house for efficiency and continuity. Remember, a healthy shoulder means more birdies and fewer bogeys. Let’s keep you in the game!
