Golfing Injuries

Changes in lifestyle of reduced activity or busy corporate work lives within a middling to aging population will present in dramatic increases in musculo-skeletal conditions and disability. The uniqueness of our culture, spiritual and mechanical history affects both our posture and health.

“Success in golf depends less on strength of the body than upon strength of mind and character”- Arnold Palmer

Golf is one activity (as with many daily activities) that involves an adequate rotation of the spine. A reduced range of movement and unequal trunk motion can significantly play a role in the development of low back pain with a risk of injury through poor conditioning.

The muscles in the bottom (gluteals) and lower back (quadratus lumborum) generally work together in walking, running, change of direction sports and the downstroke and contact point of the golf swing. During sporting activities, namely golf and activities for daily living, the quadratus lumborum (QL) engages and maintains a sustained contraction to stabilize the trunk.

The stress of golfing and running, along with twisting motions can overload this low back muscle. Long distance driving and airplane rides can create stored tension in the low back muscles causing stiffness and pain. Coughing or sneezing will sometimes create sudden spasms in this already tight area making it painfully difficult to bend forward at the waist. A common finding in literature, is that the impact and follow through phase accounts for most injuries.

If the gluteals are weak or overused their ability to stabilise the hips and lower back upon trunk rotation is reduced. Lower back muscles are then excessively recruited in order to stabilise the pelvis. This can then result in low back pain with a notable side bend (hip hike) to the same side as the pain.

Flexibility is an important measure for joint and muscle range of movement, without which dysfunction can result. Over time and if not addressed, poor flexibility can lead to postural overload and altered spinal curvature.

Muscle activation studies have shown multi muscle engagement during the golf swing and a lack of trunk rotation may place greater demand on the smaller shoulder rotators to maintain swing momentum and by doing so, creating shoulder problems (information on shoulder pain and rehabilitation can be found in the shoulder blog).


The most common injury site for golfers is the lower back with the risk of injury through poor conditioning compounded with age. Low back pain accounts for 34.5% of all golfing injuries.

It is estimated that 38% of adults are affected by back pain in any one year with costs to the National Health Service in the region of £1 billion per annum. Acute low back pain is a common reason for patient visits within primary healthcare and is one of the most prevalent presentations.

The second most common injury site is the elbow where tennis elbow which affects the outside of the elbow is more common, affecting at a ratio of 5:1, than so called “golfer’s” elbow, that affects the inner side of the elbow.

Lower Back Stretch

Golf is a game that is played on a five inch golf course – the distance between your ears”- Bobby Jones



Stability of the lower back and spine comes from the engagement of muscles and other structures known as the “inner core” in readiness for action. Those suffering from low back pain will have a delayed contraction or engagement of these muscles. This delay, creates unwanted spinal movement causing instability. These muscles are namely: Transverse abdominis, Multifidus and those supporting the pelvic floor.

Golf is a puzzle without an answer. I’ve played the game for 50 years and I still haven’t the slightest idea how to play”- Gary Player



A dysfunction in flexibility (as discussed earlier) can be exemplified by reduced spinal rotation where adequate rotation of the spine is required for an efficient golf swing and the generation of power (club head speed)

The modern swing has components when put together produce what is called a “coupled movement”. These are a side-bending movement and a lower back curve called lordosis which looking from the side looks like a bow. These connect, whereby the joints in the spine act like geared teeth and together these produce trunk rotation (the “spinal engine”). If this isn’t working, more muscular effort is required that creates swing dysfunction and potential injury. Many golfers will adopt a “classic” swing in response to this to overcome reduced trunk rotation.


The rotation that is required for the golf swing come from the mid – upper back. This is called the thoracic spine. Secondly, the hips provide rotation in the swing too! A decrease in hip rotation as with the trunk forces the lower back into rotation during the swing and can contribute to low back pain.

A key point here is that club head speed is not limited by physical constraint – lack of movement in the thoracic spine.


Osteopathy can optimise range of movement, modulate pain and significantly equalise trunk rotation to reduce low back pain.

Osteofituk in collaboration with the Ascot Health Practice – CAN HELP YOU:

  • Recover from injury;
  • Prevent injury;
  • If you are prone to repeat injury;
  • Optimise movement and function to improve your game

From a golfing perspective and monitoring improvements within rehabilitation and treatment plan effect, the osteopath assesses range of movement (ROM). Upon this assessment the osteopath will determine whether the golfer has good or poor functional control. Poor control is the inability to actively rotate through a full range of motion under the control of their muscles. ROM is a key aspect to injury evaluation and performance enhancement programs and assists the osteopath in identifying the right treatment.

“Make your only handicap a number – and not your health!”

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