Whether you are a gym goer who enjoys a fun golfing session on the side, just like Dwayne Johnson, or harbor more serious dreams of raising the PGA Championship, you’ll be aware that the sport of golf is far more physical than it may first appear. The act of swinging a club uses multiple bodily processes and as a result, golfing injuries are often picked up on the course. So, M&F talked to Dr Andrew Creighton who us an Assistant Attending Physiatrist at the Hospital for Special Surgery, and also an Assistant Professor of Clinical Rehabilitation Medicine at Weill Cornel Medical College, to master the biomechanics of golf and get some top tips for injury prevention and recovery.

Man recovering from an ankle injury due to muscle soreness
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What are some of the common golfing injuries?

While golf may look to be a fairly gentle affair, bad technique and a poor understanding of the mental and physical requirements of the game will take you straight off course at any age. “The low back, lumbar spine is the first area of injury,” says Dr Creighton. “In the young, especially in the skeletally immature golfer, the concern is an injury to the bone, particularly the pars bone.” The pars bone is positioned between the joints within the spine and is often vulnerable to injury in younger athletes.

“As the golfer grows older, a common injury is to the discs of the lumbar spine. Often times, the golfer will hurt with bending, lifting or twisting especially if weight is added,” says Dr Creighton. “As the golfer continues to age, they can develop arthritis of the facet joints of the lumbar spine which again typically hurt with twisting and with the extension of the painful area. Most of the time, injury to the low back occurs as a result of mobility issues in the thoracic spine (at the back of the chest), mid back or mobility issues in the hip. Issues with mobility in the thoracic spine and hip result in more torque and shear force taking place in the lumbar spine, causing injury to the bones, discs and joints.”

Dr Creighton, a former collegiate golfer and current competitive amateur golfer says that injuries of the upper extremities are very common too, particularly in the elbow and wrist. “The most common injuries that occur at the elbow are medial and lateral elbow tendinopathies, also known as medial and lateral epicondylitis,” he says. “The tendon undergoes change and sometimes has partial tearing as a result of overuse and poor technique. The golfer typically hurts at the prominent bone on the inside or the outside of the elbow and just down the arm from those areas. When looking at the wrist, injuries frequently occur on the inside or outside of the wrist, ulnar and radial side respectively.”

What are the most common causes of golfing injuries?

“Injuries to the wrist most commonly occur from hitting an object with the club, such as a tree root or tall grass, which causes a sudden decrease in movement of the accelerating hands and wrists,” says Dr Creighton. “In addition to inadvertently hitting something with the club, injuries can also occur from overuse and poor technique similar to how the elbow can be injured. Common causes of golf injuries include overuse or poor swinging mechanics and hitting an object while swinging. All these issues can take place with golfers of any age. As with any activity, there is likely a point when the golfer is playing too much. However, that point of excessive golf is likely different for each individual. The golfer has likely reached that point once the pain and injury occur. So, it is recommended that the golfer should address this pain and injury and consider taking some time off to allow for recovery. It is important to investigate if there is anything modifiable with their golf swing or golf routine before playing again.”

Golfer wearing a track suit playing golf on a foggy day increasing his chance of getting a golfing injury
Photo by Tom Hills on Unsplash

Should golfers take note of outside weather conditions?

“The cold can slow down your nervous system’s ability to generate a muscle contraction,” says Dr Creighton. “Overall, flexibility is important in the golf swing and when you are cold, flexibility can be impaired. Impaired flexibility can lead to stress of the joints and soft tissue and potential injury. Therefore, it is recommended to wear additional clothing to stay warm when playing golf and to carry out a dynamic warm-up to make sure the tissues are mobilized before playing. However, excessive layers can also be restrictive on the golf swing so there is a balance to be struck. Make sure to practice hitting balls on the range after a dynamic exercise warm-up to get this layering balance correct for you.”

Is warming-up important for playing golf?

Research has indicated that warmups may play a part in injury prevention and even golfing improvement, but statistically, few golfers prime themselves in this way before a round. “I strongly recommend that every golfer commits to having a dynamic warm-up focused on mobilization of the body before playing,” says Dr Creighton. For many, the idea of warming-up before a round of golf may seem strange, but when you consider that the body needs to be mobile in order to extend and hyper extend, then a pre match warm-up begins to make perfect sense.

“Having a dynamic warmup is key before you play golf,” adds Creighton, who says that warm-ups for golf are important for muscle activation, and can reduce lower back and upper extremity pain, while also helping to increase swinging power. Incorporate functional exercises such as the side plank, hip rotations and elbow raises. Additionally, prepare the wrists by completing up, down, left, right movements. Early indications are that dynamic warm-ups and those that include resistance are superior to static stretching.

Golfer setting up the lie on the green
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What other steps should be taken to limit or avoid golfing injuries?

Dr Creighton recommends that golfers should take advantage of certain screening measures that look at strength and flexibility measurements such as the Titleist Performance Institute level 1 screen, as physical limitations can often lead to golf swing faults. He also recommends that golfers should seek out instruction from knowledgeable PGA professional in order to fine-tune the golf swing and correct any faults. “Make sure your clubs are fitted and gripped appropriately,” adds Creighton. “Also, long-term, preseason physical conditioning can potentially help golfers to avoid injury related to fatigue.”

What treatments are available for golfing injuries?

“Treatment of the golfer, for any injury, really involves a collaborative approach,” says Dr Creighton. “First, see a physician who can give a clear diagnosis on what the injury is. A knowledgeable physical therapist can take the athlete through an exercise-based approach to rehabilitation and rebuilding the athlete. Finally, the golfer can also benefit from having a swing coach who is aware of the injury and can modify the swing as necessary to help avoid exacerbating the healing injury, thus helping to avoid injury recurrence.”

Should golfers be aware of nutrition?

Dr Creighton says that some research has suggested that a caffeine supplement may decrease fatigue towards the end of a round of golf, helping to improving energy levels.  “For golfers, major emphasis needs to be placed on appropriately hydrating during the round, as even mild dehydration can affect performance,” he adds. “Golf is viewed by many as a moderately intense activity and even at a moderately intense exercise level, at least half of our total energy comes from carbohydrates, and this indicates that golfers need to consume carbohydrates to maintain blood glucose levels when playing golf. Additionally, maintaining normal glucose levels allows the golfer to maintain concentration.”

So, be sure to warm up, perfect your technique, hydrate, and know when it’s time to rest and rebuild. That’s how to stay on course all season long.

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