With golf becoming one of the most popular past times, an increase in overuse orthopedic conditions and acute musculoskeletal pain has become more common in all ages.    Golf related injury and overuse pathology can occur in anyone from the high school athlete to the weekend warrior if certain steps toward prevention are not addressed. Two of the most common golfer’s injuries are lumbar strain/sprain (low back pain) and medial epicondylitis (golfer’s elbow). These two conditions can be easily avoided with a solid stretching and strengthening program. In order to prevent or fix any type of overuse or acute orthopedic injury you must first understand the predisposing factors to each specific condition.

Lumbar Strain/Sprain -- Low back pain can be linked to numerous musculoskeletal, neurological, and systemic conditions. For the purpose of this article, I will address only the musculoskeletal/orthopedic predisposing factors for experiencing lumbar pain. Lumbar pain is most commonly attributed to five factors in the athletic/active population...[read more]

Postural Dysfunction -- forward head/forward shoulder posture, poor pelvic alignment, flat back/excessive lumbar lordosis or arched back.

Core Weakness -- weak abdominals/obliques/low back resulting in poor pelvic positioning.

Tight Hamstrings -- often causes poor pelvic positioning/flat back

Poor Trunk Flexibility -- results in poor swing mechanics due to overcompensation of lumbar musculature

Decreased Cardiovascular/Muscular Endurance--fatigue can lead to poor posture and swing mechanics resulting in overuse on the back nine.

If a golfer walks onto the golf course with any of these factors, their chance for experiencing low back pain significantly increases. The good news is that each one of these risk factors can easily be eliminated with a stretching, strengthening, and cardiovascular program addressing postural dysfunction, core strength, and golf specific flexibility. Not only will such a program decrease your chance for injury, it will also encourage more flexibility and strength to hit the ball 10-20 yards farther off the tee (without that new oversized driver).

Medial Epicondylitis -- Another common golfer’s injury is medial epicondylitis, more commonly known as “golfer’s elbow.”  Medial epicondylitis is defined as inflammation of the medial epicondyle (bony attachment of the forearm flexor muscle/tendons at the inside or medial portion of the elbow).   This inflammation is often caused by repetitive wrist flexion/extension and supination/pronation (wrist rotation) movements required by the golf  swing.  This condition will present with increased pain around the inside portion of the elbow, especially when lifting objects and striking the golf ball. Medial epicondylitis is often predisposed by two common factors:

1)  Increased wrist/forearm tightness

2)  Decreased wrist/forearm strength/endurance

This is often an overuse or tendonitis condition that can be resolved with a progressive wrist/forearm stretching and strengthening routine.  These symptoms may also be managed through ice massage to medial epicondyle following golfing activity as well as a golfer’s elbow strap.

In some cases, golfer’s may need to seek medical attention or physical therapy consultation if symptoms persist. Other physical therapy treatment for lumbar strain/sprain and medial epicondylitis include electrical stimulation, iontophoresis, ultrasound, hot/cold packs, and manual therapy/soft tissue mobilization techniques. If you are experiencing any of these symptoms or have any questions regarding these conditions, please contact us for a physical therapy or wellness evaluation.

Justin Weisbrod, MPT, BS