| Golf with a Bad Back |
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Back Muscles
The complex array of musculature in the
back is meant to allow subtle variation in trunk flexion and
extension, coupled with varying degrees of rotation. When
these muscles are reasonably flexible, but without excessive
flexibility, and when they are well conditioned in terms of
endurance, they have the potential to protect and unload some
of the forces described above, which otherwise can be injurious
to the disc or facet. However, unfortunately, most golfers,
especially if golf is their primary athletic endeavor, are
not especially well conditioned. One need not have adequate
back muscle strength or endurance in order to take up golf,
or even to hit a reasonably good shot. Because of this mismatch
between skill and fitness, many golfers suffer chronic muscular
pain. This may be felt between the shoulder blades (interscapular),
or in the mid or lower back. One unique condition is associated
with novice golfers who tend to chop into the ground when
swinging, causing frequent divots (scoops of dirt and grass
originally meant to have been left on the golf course). There
have been reports of chronic strain in the muscles which attach
on the rib cage, the serratus anterior, even occasional reports
of stress fractures, from repetitive strain associated with
production of divots.
Macrotrauma Versus Microtrauma
The vast majority of back conditions associated
with golf result from repeated minor injuries and over-use,
in other words, the result of sustained abnormal forces, rather
than any single event. True, the occasional unfortunate golfer
falls over the edge of a sand trap and fractures his ankle.
Poor drivers may crash their golf carts into trees. But in
general, if we can make a number of small modifications in
the golfer’s playing habits and in overall lifestyle,
we can help to avoid recurrent episodes of pain and chronic
facet or disc symptoms.
GUIDELINES FOR GOLFERS WITH LOW
BACK PAIN
While Playing Golf
A number of simple suggestions serve to
reduce the impact of golfing on the back.
- Between strokes, stand up with hands
on hips and arch backwards for 3-5 seconds approximately
5 times. This will direct the nuclear material anteriorly,
away from pain sensitive structures in the spine.
- Choose the longer club to allow for
an easier swing, less rotational force, and less need for
flexion over the ball. In addition, one should concentrate
on maintaining arch in the lower lumbar region, “hinging”
at the hips rather than actually flexing the spine.
- Consider slightly reducing the amount
of rotation in your golf swing. When available, lessons
or videotaping can help perfect this.
- Keep the number of practice swings to
a minimum. The most strenuous golf activity for those with
bad backs is driving a “bucket” of balls at
driving range. Similarly, taking for or five practice swings
before each shot during a game greatly overloads the structures
of the back.
- When driving in the cart from one shot
to the next, be sure to maintain an upright posture, do
not slouch. If necessary, a lumbar pillow or seat can be
of benefit.
- Avoid carrying one single heavy bag
when walking the course. Purchase the lightest bag available,
or at least alternate the bag from side to side so that
the same shoulder does not carry the bag throughout the
course.
- Be sure to maintain upright posture
if pushing a hand cart.
- When bending to pick up a ball or club,
face it squarely, bend with the knees,
and maintain slight arch in the lower back. Too many people
casually reach down as they rotate, then find it difficult
to straighten back up.
- Wearing a molded or firm lumbosacral
corset is recommended, especially if the golfer already
suffers recurrent back pain episodes.
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