By Dr. Troy Van Biezen
Many athletes enter my office. A large portion of these athletes (weekend warriors included) are golfers. In a large percentage of the amateur golfer patients low back pain is the reason for their attendance to my clinic. It should also be noted a majority of amateur golfers struggle with a slice.
Last year there were 25 million visits to doctors’ offices for golf related injuries. Back pain was by far the most common reason. As anyone who has delivered a slice producing swing can attest, the spine positions at impact and into the finish is extremely stressful to the lower back.
At my office there are three parameters that I key in on initially.
1) Physical limitations
There are many causes of back pain. It is well beyond the scope of this article to describe all the possible contributors. I will however address one the most common causes, which falls into the second category. Technique. The Sway!!
Sway- During the sway, the lower body moves away from the target during the backswing. As a result, the weight of the golfer moves to the outside of the trail foot. With the weight on the outside of the foot it becomes difficult to generate the appropriate weight shift during transition.
Causes- In order to generate rotation in the right hip (for right hand golfers), there are several physical parameters that must be developed.
1) The most important is right hip internal rotation, if the body is not able to turn around the right hip due to joint or muscle restrictions, then lateral movement will be the compensatory pattern.
2) Secondly, the ability to separate your upper body from your lower body, and more specifically to move the spine segmentally as opposed to block movement, allows you to make a shoulder turn without swaying. Limited spinal mobility is the main cause of this physical restriction.
3) Proper mobility and stability in the ankle to allow appropriate pronation and supination and thus enabling an increase in relative hip internal rotation.
4) Finally, the ability to laterally stabilize your right leg during the backswing is directly proportional to the strength and stability of your glute muscles. These muscle help prevent the right hip from elevating and shifting laterally during the backswing.
A majority of golfers struggle with the sway, however most do not know that the sway is the beginning phase of the dreaded Slice. In trying to correct the slice, most will try to influence the grip and address posture, which is important.
What is forgotten is fixing the Sway. As with any sequence of dependent movement, you can’t fix the result if you don’t fix the instigating problem.
For many people it is difficult to understand how a move off the ball in the backswing results in a slice on the downswing. Let me try and give you a play by play.
If you sway, there is no stable foundation to drive your weight off the right foot during transition into downswing. This will hinder the golfer’s ability to generate power and a breakdown of the kinetic sequence will occur. As the golfer sways, both their head and upper body will tilt towards the target creating a reverse spine angle. This will put a tremendous amount of undue stress on the left side of the spine. Because the weight being shifted outside the golfer’s left foot prevents the legs from pushing appropriately into the ground the golfer will initiate the downswing with his arms creating an over –the-top move and an outside to inside swing path.
This path will put a clockwise spin on the ball and a slice will occur. At follow through, another reverse spine angle occurs creating a “Crunch Factor” (facet joint approximation, disc compression and shortened musculature) and right low back pain.
As is evident, there is a direct correlation between the slice and back pain. So, the question is how do I correct the slice and prevent back pain?
When the Sway is a consequence of a physical deficiency or body-swing disconnection, which can be limitations and weaknesses in the body (as have been described above) the top three target areas to address are:
This exercise called “Reach backs”, will help improve spinal flexibility. This will help the golfer initiate the downswing with the hips instead of arms/hands.
These X-walks will improve hip stability which will prevent the hips from moving away from target during the backswing.
This will help the golfer turn around the hip with the upper body.
I am still shocked by the amount of time and money golfers spend on gimmicky training aids, clubs, balls etc. to fix the slice. With all the new technology, the average score in America has not changed in 20 years.
I understand we live in a society where we all want a quick fix, however the old saying “Rome was not built in a day” holds true in the golf world.
As we have all witnessed, some of the best golfers in the world have worked to change their swing and have taken up to 2 years to see their results. We should not think any different. What is not seen is the dedicated training done behind the scenes, where the golfers work diligently on their bodies through treatment and training that will allow their bodies to get into positions that is needed for the swing change.
In summary, I highly recommend to seek out a specialist on the Tour Council nearest to you. They can assess you and provide a specific treatment/training program to prevent back pain and improve your body to improve your game.
In the next segment I will look at the Sway from the manual therapist’s perspective and give you a few options to help improve the golfer’s body and their ability to rotate through the hip and not sway off the ball.