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Golf a pain in your back? A poor backswing might be the culprit

Guest blog: Robyn Smith is a board-certified sports physical therapist in Mary Free Bed’s Sports Rehabilitation Program. She facilitates Titleist Performance Institute (TPI) physical assessments to help elite and amateur golfers avoid injury while advancing to the next level of play. For questions or more information regarding golf physical assessments, email robyn.smith@maryfreebed.com.

In this blog, Robyn offers tips to avoid back pain caused by swing faults.

And in the video below, Robyn shares how the rehabilitation- and performance-based components of the program help participants move better and get better at the game they love.

Low back pain is very common in golf and can prevent you from achieving your best swing. The problem is, the way you swing a club may be the catalyst for that pain.

The most common swing characteristic for development of low back pain is a reverse spine angle. This is defined as any excessive upper-body backward bend (trunk leaning towards the target) or excessive left-lateral upper-body bend (for a right-handed player) during the backswing.

This swing fault makes it very difficult to start the downswing in the proper sequence, because the lower body is placed in a position that limits its ability to initiate the downswing. When the lower body can’t start the downswing or has a limited ability to initiate the movement, the upper body tends to dominate the swing. This will eventually create path problems and limited power output.

Reverse spine angle puts excessive tension on the lower back due to a forced inhibition of the abdominal muscles. It also compresses the spine during backswing and impact. During the backswing, the spine is excessively extended and compressed, leading to abnormal flexion and side bending on impact. The body tries to compensate by flexing and side bending to make up for the poor backswing position and to get the clubface open. This leads to a cascade of events, including swinging over the top and hanging back on the follow through.

In my field of work (physical therapy and golf fitness), I am always concerned why these swing characteristics happen. What physical parameters are causing faults, such as reverse spine angle or hanging back? I want to find a way for the player to move his or her body correctly to avoid swing faults that cause pain or inconsistent/poor play.

In order to maintain your spine angle during the backswing, several physical characteristics must be developed:

  1. The ability to separate your upper body from your lower body. This allows your shoulders to rotate around your spine without going into backward bend or, for the right-handed golfer, excessive left lateral bend. Limited trunk-to-pelvis separation is usually caused by reduced spinal mobility and shortened latissimus flexibility.
  2. For a right-handed golfer, right hip internal rotation is paramount for full rotation without any lateral movement. If your body is unable to rotate around your hip due to joint or muscular restrictions, then a lateral sway may occur. Any lateral sway during the backswing will force the spine to tilt into backward bend and create the reverse spine angle.
    Other mobility problems that may factor into this include poor thoracic (upper/mid-back) rotation, lack of shoulder range of motion or even stiffness in the ankles.
    The bottom line is, if you can’t move correctly in one segment, the body figures out a way to cheat somewhere else. This leads to excessive stress on other regions in the body and/or poor play.
  3. The ability to stabilize your spine angle during the backswing is directly proportional to the strength and stability of your core musculature (your abs and glutes). When it comes to spinal stabilization, the core is the king and the glutes are queen. These muscles help keep your trunk forward flexed throughout your golf swing and prevent coming out of posture or cheating through side-to-side movement vs. rotation.

Here are a few exercises to facilitate good body separation, trail leg and core stability, and trail leg flexibility to help prevent reverse spine angle in the backswing:

Stride Stance Punch/Rotate
Start in a stride stance position with the trail leg positioned in front and 80-90 percent of your weight on the front leg. Place a small weight in your hands (typically no weight or a lighter weight in the arm that reaches across the body). Rotate the right arm back and up, turning the torso as you would in the backswing. At the same time, punch the left arm across the body. DO NOT let the hip/leg move or rotate in this exercise. Work on stabilizing your core and lower extremity. Perform 2-3 sets of 10.

Reach and Row
Stand in a stride stance or square stance golf posture, holding a slightly heavier weight in the arm that’s rowing (right, for right-handed golfer), lighter weight in arm that is reaching across body. Simultaneously reach across your body and row with the opposite arm. Make sure the torso is rotating with the arms as you would in the backswing. Perform 2-3 sets of 10.

Trail Leg Flexibility
Sit on the floor in a side-sit position with knees bent to 90 degrees, your right leg parallel with the side of your body. Place your right hand on the right hip and tighten the buttock muscle while rotating the hip forward. Hold 1-2 seconds, relax, repeat 10 times, 2 sets.

Trail Leg Flexibility and Strength
Sit on the floor in a side-sit position with knees bent to 90 degrees, right leg parallel with the side of your body (as in the previous exercise). Now, try to lift the right foot toward the ceiling. Hold one second, relax, perform 10 times, 2 sets.

Psoas 3-D Dynamic Stretch
Lower onto one knee with the other leg in front in a half kneeling position. Place your club overhead to start. Tuck buttock under into a flat back position (don’t let the low back arch), then gently rock forward and backward for 20 seconds, then rock hips and hands side to side for 20 seconds, and lastly rotate around side to side 20 seconds. This improves overall hip flexibility, allowing better rotation in the golf swing.

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