Recreation Golf Injuries
By Gregory C Berlet MD, FRCS(C) Orthopedic Surgery

While golf is not typically a contact sport injuries do occur.  Surveys have found that up to one-third of golfers have experienced some kind of injury while playing the game.  For most golfers, the majority of injuries come from technical deficiencies in their swings that put some kind of stress or strain on part of the elbow, wrist, shoulder, or back where it doesn’t belong.  How much experience we have on the golf course tends to determine the type of golf injury we’re most likely to experience.  Pro golfers more often suffer from muscle and joint overuse.  Injuries to recreational golfers, however, are more likely to come from two sources: poor swing mechanics and lack of physical preparation.  This column will examine many common golf sport injuries. We will review current scientific data and provide prevention programs and treatment strategies.

A period of warm-up is accepted as the price of participation in many sports (eg. Tennis).  Unfortunately golfers often arrive at the course just in time to drive the ball down the first fairway.   Before going out on the course, everyone should do about 15 minutes of exercises that will stretch the muscles of their hands, wrists, shoulders, back, and pelvis.

Stretching Is Protective Tiny tears or spasms cause the soreness many of us experience following a round of golf.  This is due to exerting joints and muscles that are literally “cold,” meaning they lack the warmth of blood flow through the tissues.  This causes connective tissue to contract, inhibiting elasticity, or the ability to smoothly react to movement.  Overstressing muscles and joints that haven’t been warmed up also can cause more serious conditions like severe elbow pain carpal tunnel syndrome, and herniated discs.

As a result, sports medicine physicians generally recommend that golfers get 10–15 minutes of warm-up exercise before playing.  Exercises should focus on stretching muscles involved in the swing — the hands, wrists, arms, shoulders, back, and pelvis. Warmed-up muscles promote the ingredients of a good, powerful stroke: balance, flexibility, and muscle control.  Stretches should start off easily, proceed slowly (never bounce to achieve a stretch), and stop just before the stretch becomes painful.

A good warm-up routine could include across-body stretches for the shoulders, trunk and knee-to-chest rotations for the back and spine, and hamstring stretches for the legs.  The wrists are high-use joints, so they don’t require as much preparation as other parts of the body.  But squeezing a soft rubber ball, or even a steering wheel, then slowly releasing your grip can increase both wrist flexibility and strength.
After warming up, move on to more sport-specific conditioning by practicing your swing.  Start slowly with a nine iron, progressively increasing the range of motion and speed.  Once you reach a full swing with the nine iron, repeat, using gradually longer clubs.

Strength in Conditioning Technique generally trumps physique in the sport of golf.  But strength training can play an important role in the game.  Conditioning programs are available through many gyms and generally incorporate exercises — many of which use machines — such as leg extensions and presses, abdominal and leg curls, biceps curls, triceps extensions, and neck exercises.  People with a history of heart disease, back problems, or osteoporosis, or who are at high risk of developing these conditions, should consult their physicians before starting a strength-conditioning program.

To improve your fitness while you’re on the course, carry your own clubs or pull them whenever possible, providing this doesn’t cause back pain.  Try walking from hole to hole wherever the course is flat, instead of using a golf cart.

The Bottom Line: a Better Score, Fewer Injuries Very few studies have evaluated pre-game conditioning for preventing golf injuries, but those that do suggest it can help us play better, reduce our risk of injury, and improve our scores.

Researchers at Brown University conducted a small study comparing three 8-week exercise regimes: strength conditioning, strength and flexibility conditioning, and flexibility training only.  All groups trained approximately 40 minutes a day, three times a week, and all experienced an improvement in general health and increased club speed.  But only the groups incorporating stretching exercises had significantly greater flexibility.  Mean range of motion improvement was 24%.  All the participants, even those who worked only on strength, reported lower scores, longer drives, and no injuries during the following season.

Unfortunately, no amount of training and conditioning can eliminate all the injury risks related to playing golf.  And it appears that driving lessons — of another kind — might also be in order: according to the National Safety Council, some 8,000 people a year are involved in golf cart accidents.

Adapted from The Harvard Letter