Golf Injuries
Back PainBack injuries are the most common complaint among golfers. The modern swing technique is suspected as the main cause, with the most stressful elements likely being the rotation of the lumbar spine at the end of the back swing and the subsequent uncoiling and hyperextension through the downswing and follow through. The differential diagnosis of back pain in golfers should include all potential causes: mechanical, discogenic, spondylogenic, and facet arthropathy.Treatment generally includes activity limitation, physiotherapy, anti inflammatory medication, and use of a lumbar support. Patients need to consult a physiotherapist to address mechanical problems, muscle imbalances, and pain. They need to practice proper swing mechanics and warm up before playing golf to prevent reinjury. Elbow InjuriesThe main factors involved in golfers' elbow injuries are overuse, age, swing mechanics, conditioning, warm up, equipment, and pathology. Usually, medial epicondylitis occurs in the dominant elbow and lateral epicondylitis occurs in the nondominant lead elbow.Treatment options for elbow injuries involve rest, ice, compression, and elevation (RICE); bracing; physiotherapy to reduce inflammation, break up scar tissue, correct muscle imbalances, to strengthen the musculotendinous unit, anti-inflammatory medication; lessons to correct swing mechanics, and equipment changes. Surgery is not usually considered until after a patient has been treated with physiotherapy for more than 6 months and if all conservative measures have failed. Arthroscopy is reserved for mechanical elbow symptoms such as loose bodies and spur formation. These injuries are most frequently associated with overuse and excessive grip tension. Proper grip tension optimizes the function of the forearm muscles, allowing smooth, rapid pronation and supination of the forearms and reduced stress on the wrist flexor and extensor tendons at the elbow. Whether a patient is suffering from golfer's elbow or tennis elbow, improved swing mechanics can bring relief. Particularly important is correct swing plane - the plane that the club shaft makes during the back swing and downswing. If it is too steep (i.e. too close to perpendicular to the ground) the hands and wrists overcompensate to position the head of the club for ball impact, increasing the risk of hitting a fat shot, which transmits decelerative forces to the hands, wrists, and elbows. If the swing plane is too flat, (i.e. too close to the horizontal) the elbows undergo undue stress. Proper swing mechanics also require correct wrist technique. Changing equipment may help, too. Using cavity backed irons that have larger heads and sweet spots will dampen the vibrations transmitted to the wrists and forearms from off-centre hits. Graphite shafts are more flexible than steel shafts and will reduce vibrations from hitting fat shots. A professional golf shop can help select club heads and shafts for a golfer based on his or her swing. Wrist InjuriesThe golf swing is also responsible for wrist injuries in golf. From overuse, many patients suffer tendinitis in various parts of the wrist, such as the extensor carpi radialis and extensor carpi ulnaris, and the flexor carpi ulnaris, but fractures of the wrist are very rare.Most golf injuries to the wrist are successfully treated non operatively but require activity restriction. To prevent injuries, golfers should understand the importance of proper equipment, swing technique, and conditioning. Strengthening forearm musculature to help reduce undue wrist motion during the swing could bring relief to some. Knee InjuriesIn a study of golfing knee injuries, most injuries were from overuse, rather than from acute trauma. In the study, 35 golfers with knee pain were evaluated over a 2 year period. The most common cause of knee pain was a torn medial meniscus; the second most common was medial osteoarthritis in older golfers. Two subjects in the study, both teachers, had patellofemoral pain that most likely developed from frequently bending their knees while teaching.All of the patients were first treated conservatively, primarily with rest and then with medication, physiotherapy, steroid injections, and braces; however, 17 patients continued to have pain and required surgery. Of the surgery patients, 15 responded favourable to orthopaedic procedures, but 2 patients required total knee replacements. All of the patients returned to golf after a gradual program that included using pain as a guide to reduce the amount and intensity of playing golf; using proper equipment; improving golfing technique; and understanding the principles of flexibility, endurance, speed and strength as they relate to golf. Shoulder PainAlthough shoulder injuries are rare in golf, overuse from continuous shoulder revolutions are a risk factor, particularly in professional golfers. In addition to overuse, shoulder injuries can develop in golfers older than 35 years from degeneration of the shoulder and in younger golfers from instability.One way to reduce the stress on the acromioclavicular joint of the leading shoulder without sacrificing club head speed is to shorten the swing by ending the back swing with the club head at 1 or 2 o'clock instead of a 3 o'clock position. Conditioning the rotator cuff and scapular muscles with light weights or other resistance training may also help. Developing a grooved swing with the help of a golf pro to ensure proper mechanics can also be useful. To generate power, in addition to strengthening the core, the golfer should also strengthen the pectoralis major and latissimus dorsi muscles. Treatment is directed primarily by a patient's age, diagnosis, and the mechanics of his or her swing. If physiotherapy is not successful, surgery may be warranted depending on the diagnosis and other underlying conditions. Remember, this information is not intended as a substitute for medical advice. If you have any pain see your family physician.
|
