Low back pain is by far the most common nagging injury in our game. From the highest level of professionals to the weekend amateurs, they all deal with back pain at some point throughout their golf career. Up to 50% of amateurs and 33% of pros are playing with low back pain at any given time. Like many of us know, it can prevent you from getting power behind your drives, cause discomfort while putting, or even prevent you from playing rounds on consecutive days but what’s most encouraging is that there is usually a way to solve this problem. We use a team approach that incorporates a swing coach, a medical provider, and a fitness coach in order to get the best results, but you can begin this process on your own as well. Our physical therapists have identified 3 body limitations that may be the main contributing factors to your lower back pain.
Fix Core and Pelvis Position
One of the biggest contributing factors to lower back pain in golfers begins at the setup position when addressing the ball. Beginning in poor pelvis positions can create faulty positions and lead to an inability to properly use your core muscles during the swing. This poor start position can influence your backswing and leave you playing catch up during the downswing, leaving your lower back to pay the price. But how do you know if you’re beginning your swing in a poor pelvis position? The easiest way to tell is to take a picture of yourself at the ball address. If you see yourself in excessive forward pelvic tilt (sticking your tailbone out and arching your back), your core motor control may be a cause for your back pain. When beginning in this position, you set yourself in excessive lumbar extension. During the swing, this will cause your spine to place increased compression and torque on the joints and discs of your lower back. The best way to combat this is to improve your pelvic and core control in the setup position. An easy way to correct this is to engage your core when you address the ball. Engaging your core can help put your spine and pelvis in a more neutral position which will help decrease extension and lessen stress placed on the spine. Engaging your core at setup is great, but teaching your body that pattern with exercise is even more important. Core positioning and strengthening exercises are a great place to start if your pelvis and lower back position at setup is causing your pain
Improve Your Hip Rotation
Hip mobility and adequate hip rotation is more closely related to lower back pain than most people realize. Decreased hip mobility is your classic case of robbing Peter to pay Paul. Without the proper internal and external hip mobility, your body will compensate by requiring more range of motion than necessary for your lower back or result in improper swing mechanics. The average golfer will require up to 43 degrees of both internal and external rotation on the lead leg. If a player is unable to achieve these ranges of motion, they may have trouble shifting their weight during the backswing or downswing causing increased torque on the lower back. It can also cause mishits or faulty swings due to the player being unable to rotate through their lead hip causing them to early extend at ball impact or they may substitute core sidebending for rotation in the downswing leading to excessive compression on the joining of the lower back. Improving your hip mobility may be the key to decreasing your back pain which will result in better scores and more frequent, pain-free rounds. When increasing mobility passive stretching is only a small part of the puzzle. You should be able to load the ranges of motion with weight or resistive exercises to maintain the range that you acquire when stretching.
Improve Your Thoracic Rotation
The thoracic spine is the portion of your spine that connects your lower back and your neck. It is the most important part of the spine for rotation. Spine rotation is the difference between the hips and shoulders in the backswing and follow through positions. The key to thoracic spine rotation is to have ample range of motion, but also being able to successfully control that range of motion. Players require about 45 degrees of spine rotation in the back swing and the downswing. If a player has excessive rotation without control, it can significantly increase the risk of injury, much like if a player doesn’t have full mobility. When there is decreased range of motion in the thoracic spine, a player may tend to substitute lumbar side bend or standing up during the swing which can cause lower back pain. When the player is unable to control or reach an increased range of motion he or she can put excessive torque or stress on the lumbar spine during every swing.
Article written by Nicholas Petroski, DPT of Petroski Physio.
You can access more of this information by visiting petroskiphysio.com or emailing him at nick@petroskiphysio.com