It is quite common for golfers to develop back pain or injuries. They can injure their backs from the game of golf itself or by other means. Once the back becomes painful, it may affect the golf swing and also the enjoyment of the game. It may also become aggrevated by the game causing some to have a break from the game or worse to give it up all together. Common injuries may be caused by the golf swing, putting, pitching as well as teeing and picking up the ball. Nine out of ten of the right handed golfers I see get worse pain on the right side.
The main reason for this is that during or just after the clubhead comes into contact with the ball, the golfer tends to flex his body to the right causing hip rib impingement. This then injures the lateral abdominal muscles, iliopsoas muscles, gluteal muscles and the paraspinal muscles on that side. As these are the stabilizer muscles of the lumbosacral region, repeated injury would cause the development of trigger points in these muscles with associated referred pain to the back, down the legs or into the groin. Loss of lumbosacral stability in this region would increase the risk of injury to the lumbar spine creating disc protrusions and osteoarthritis of the facet joints. Myofascial trigger points in this area could also contribute to the development of groin, hip joint or knee injuries.
Apart from treating these myofascial trigger points, we aim to get the golfer back into the game and play his/her best as soon as possible. I instruct them on how to perform the Airbag Technique as described on page 23 of my book and to reduce flexion and rotation at the waist during the golf swing (page 56). As most people are unaware of their posture and movement, it helps to get the assistance of a Golf Professional.
Andrew Mowatt, the head professional at the Royal Fremantle Golf Club Pro Shop uses video to great effect in guiding golfers to change their posture and the way they move during the golf swing. He has observed that by avoiding these musculoskeletal impingements during the golf swing, not only does the golfer avoid further back problems but also drives further. The Airbag technique improves the stability of the whole trunk during the golf swing and so improves consistancy and accuracy.
Walking on grass is one of the best ways to train up the stabilizer muscles of the spine as long as the golfer avoids walking on a side slope such that one hip is higher than the other. Kneeling instead of squatting when teeing up or picking up the ball will also reduce the risk of hip rib impingement during the game. The handle of the putter can also be fitted with a grip with a suction cup to retrieve the ball without bending.
In my opinion, hip rib impingement is the most important previously unknown cause of back pain and injuries in golf. By preventing impingement in the golf swing we can avoid the development of this common injury and produce better golfers in the future.