A s a golf performance physical therapist, my clientele can be divided into two categories:
• performance-based
• injury-based
Our golf performance program allows me to work with players as young as 12 years old and as old as 90+ years old. Our injury-based clients seek us for physical therapy services designed to help them overcome their injuries and return them to the course before eventually transitioning to a performance-based program.
On the rehabilitation side, we primarily see patients dealing with elbow, hip, shoulder and low back pain, with low back pain by far being the most prevalent. This isn’t a shock, as studies have shown that between 40 and 80 percent of adults will experience low back pain at some point in their lives. So, how do we attack this for the typical golfer dealing with low back issues? We look above and below!
The lumbar spine can be classified as a stability segment during the golf swing, meaning its primary role is to provide stability (think the abdominals and power generation). Whereas, the thoracic spine (above) and the hips/pelvis (below) are classified as mobility segments (think rotation).
Typical thoracic rotation range of motion norms require 45 degrees of rotation to each side (90 degrees total), but we even see this number increased in elite level golfers. Range of motion norms for the hip include 30-40 degrees of internal rotation and 40-60 degrees of external rotation (leading to a full motion of around 90 degrees). For golfers experiencing low back pain, there is a high correlation between limited hip internal rotation and back pain. A lack of motion in either segment (thoracic or hips/pelvis) causes the lumbar spine to increase range of motion and move away from a “stability” role and into a “mobility” role. An example I use for clients to help them understand is this:
Imagine you have a coworker who slacks off one day at work. You have to pick up the slack and perform more work. No problem for one day. But if this is every day, then you are going to become irritated and eventually quit. The same thing happens with our body. The low back increases motion due to limitations above and/or below, eventually leading to injury. This happens with every swing, which ends up being over 80 swings in a round when you factor in practice swings.
Low back pain? Look above and below and begin your treatment plan.
Dr. Cale Alexander, a 2023 GFAA Off-Course Award winner and 2024 GFAA Recognition Award winner, is the Founder of Next Step Physical Therapy and Wellness, serving the Greater Memphis/Northern Mississippi area.