What every golfer should know about injuries
with advice from Brandon Brackeen, PT, DPT,
Marc Schoettle, PT, DPT
and Chris Wickel, PT, DPT, Cert. MDT
Whether you just started hitting the links or have been playing golf for years, understanding the variety of injuries that can result from playing golf will help your game, as well as your overall wellness.
For beginners, says Chris Wickel, a physical therapist at Conshohocken Physical Therapy (a Physiquality member in Pennsylvania), injuries can often happen because of poor body mechanics. While many people may think it’s simple to pick up a set of clubs and hit the links, a bad golf swing can lead to years of bad habits (and bad scores).
If you’re new to the sport, consider taking some lessons with a teaching pro — the PGA certifies teachers who can ensure that you learn the game with proper form. If you’ve tried playing and have felt pain during your swing, consider consulting with a physical therapist, whose musculoskeletal expertise can reduce pain and improve your game. As a Titleist Performance Institute Certified medical professional, Chris is an expert in evaluating a player’s golf swing and pinpointing where an error occurs in its mechanics.
More seasoned players can experience a variety of pain and problems. Brandon Brackeen, a physical therapist at Moreau Physical Therapy in Louisiana, points to a Harvard Medical School study that underscored overuse as the key reason golfers have back, shoulder and elbow problems, unsurprising when you consider how many times a golfer swings his clubs during a round of 18.
Brandon points out that many golfers experience back pain due to a lack of mobility in the hips and lower back, and weakness in the lower back and core muscles. He cautions golfers to seek help from a physical therapist if they experience back pain, especially with bending or twisting; excessive back stiffness during or after playing golf; muscle spasms; or pain or weakness in the legs. “A physical therapist can address such pain, then assess the person’s movement patterns and golf swing to determine the probable cause of the pain,” Brandon says.
Golfers are also prone to medical or lateral epicondylitis, also known as tennis elbow or golfer’s elbow, notes Chris. While the pain may be felt in the elbow, he says, it is often a cause of poor swing mechanics or weak back muscles. Tightness in the back or improper form can lead to compensation, putting more strain on the elbow joints. If the golfer feels pain in the elbow, especially while gripping a club, or a loss of grip or wrist strength, it’s time to consult a PT about the problem, adds Brandon.
Shoulder injuries are less common for the casual player but are one of the most common injuries for professionals. Excessive force on the joint can cause tendinopathies, rotator cuff tears and labrum tears, says Marc Schoettle, a physical therapist at the Physical Therapy and Wellness Institute in Pennsylvania. He cautions golfers to be aware of pain in and around the shoulder joint and arm, clicking and popping in the joint with movement, and shoulder weakness that makes it difficult to move. Such symptoms are signs to seek medical treatment, as such tears can only get worse with further activity.
Finally, all players, especially those that are retired or nearing retirement age, should be aware of arthritic pain in all of their joints. Such knee and hip pain may cause golfers to compensate and adjust their swing mechanics without even realizing it. Arthritis shouldn’t stop you from playing golf; in fact, playing golf and being active can actually reduce arthritic symptoms. That said, if you do suffer from arthritis, it’s a good idea to have your swing evaluated to make sure that your swing mechanics haven’t changed for the worse as you’ve aged.
There are a variety of things a golfer can do to reduce her chance of injury. Brandon suggests investing in a walking cart for your clubs if you usually walk the course: “It has been shown that you are twice as likely to injure your back if you carry your clubs,” he says.
Having a more efficient swing can also reduce injury, says Chris. An efficient swing will be different for each player, depending on his body type and strength, but it can be improved by working on strength, flexibility and muscle control. As Titleist Performance Institute Certified medical professionals, both he and Marc are certified to evaluate swing mechanics and to create a strengthening program that will optimize a person’s golf swing.
Several stretches and exercises can help players to improve their game and reduce pain — and the chance of injury. Brandon strongly advises warming up before walking to the first tee. “A proper warm-up should be dynamic,” he says, “increasing your heart rate and taking your joints through full ranges of motion.” He recommends starting with squats, lunges, trunk rotations and arm circles, then gradually working from half-speed swings with short irons to full swings with a driver.
Marc suggests a variety of exercises to do off the course that will help to strengthen your core and reduce injuries. These can be done on your day off or before hitting the links.
Increases flexibility in the lower back, glutes and piriformis muscles.
Open book stretches
Improves thoracic (chest) rotation, allowing for a more efficient swing and less strain on the lower back.
Half-kneeling hip flexor stretch
Limits hip flexor tightness, which weakens the glutes and overworks the lumbar paraspinal muscles.
Activates the glutes and strengthens the core, leading to a more efficient and powerful golf swing.
Improves flexibility in the latissimus, increasing the ability to bring the lead arm across the body in the back swing and to rotate the trunk away from the target.
Lateral shoulder rotation stretches
Enables the trail arm to assume the proper position at the top of the backswing.
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||Brandon Brackeen, PT, DPT, is a physical therapist at Moreau Physical Therapy, a Physiquality member with several locations in Louisiana. He has advanced training in MDT, instrument-assisted soft tissue mobilization, spinal manipulation and functional movement assessment. Brandon works in industrial rehabilitation and performs FCEs, return to work testing, and work conditioning while also spending time at the on-site clinic at Georgia Pacific Paper Mill.
||Marc Schoettle, PT, DPT, is a physical therapist at the Physical Therapy and Wellness Institute, a Physiquality member with several locations in Pennsylvania. Marc earned his Doctorate of Physical Therapy from Temple University in 2013 and is a Titleist Performance Institute Certified medical professional that specializes in addressing physical impairments impacting the golf swing.
||Chris Wickel, PT, DPT, Cert. MDT is a physical therapist at Conshohocken Physical Therapy, a Physiquality member in Pennsylvania. Chris has taken extensive continuing education courses on advanced treatment of the spine, including manual therapy, mobilization and manipulation. In addition, he is a Titleist Performance Institute Certified medical professional and runs the Golf Therapy program available at Conshohocken Physical Therapy.
||Physiotec, a PTPN Preferred Vendor, is an online service that offers personalized visual tools explaining and demonstrating more than 7,000 home exercises for physical therapy patients.
For further reading, look through our selection of articles on sports and fitness, in addition to the below links:
Conshohocken Physical Therapy channel. YouTube.com.
Moreau Physical Therapy.
Smart tips for golfing with arthritis. Arthritis Foundation.
Gillanders, Robert: American Physical Therapy Association. YouTube.com. January 3, 2011.
Shoulder surgery exercise guide. American Association of Orthopedic Surgeons, 2007.
In the swing: Golf and your health. Harvard Health Publications: Harvard Medical School Newsletter, September 15, 2004.