SINGAPORE'S CHIROPRACTIC GOLF SPECIALIST PRESENTS:
Golf and Chiropractic: A Natural Combination
A significant percentage of golfers suffer
from chronic back pain. Many golfers pop aspirin and over-the-counter
anti-inflammatory drugs like candy. What about chiropractic care? Surprisingly,
available data from 1994 suggests that less than two percent of golfers chose
to visit a chiropractor.1 The same
source revealed that MDs and PTs treat most golfers. This information is
somewhat shocking considering that back pain is the most common problem among
golfers and recent studies show the the most effective care for back pain is chiropractic.
golf has seemingly overlooked chiropractic is unclear. Considering that
golfers suffer mainly with spinal nociceptive pain, i.e., mechanical back pain,
one would think that DCs would be the caretakers of choice. This article will
discuss some of the basic mechanics of the golf swing and suggest some ways
that chiropractic can help golfers overcome some of their physical problems
thus improving their scores.
Myths that Promote Injury
of the biggest myths about the golf swing involves the notion that club head
speed at ball impact is dependent on maximum spinal rotation during the
backswing. In this regard, the term "x-factor" has been coined to
describe the difference (in degrees) between hip position and shoulder position
at the top of the backswing. Many instructors advocate this theory and
recommend that golfers keep their pelvis as stationary as possible while the
spine is maximally rotated. These swing positions are popular because it is
believed that maximal spinal rotation somehow engages the "big"
muscles of the back, allowing for a sling-shot effect during the downswing,
i.e., the modern golf theory of power generation.
respect to the "big muscle" theory, we are never told how maximal
spinal rotation helps to engage spinal muscles or muscles such as the
latissimus dorsi. Nonetheless, it is difficult to understand why modern golf
instruction would promote such concepts. Regarding spinal muscles, it is known
that they provide only five percent of the torque generated during spinal
rotation, the abdominal obliques doing nearly all the work.3
the spinal muscles, the latissimus dorsi have nothing to do with generating
spinal rotation. Nor is maximal spinal rotation necessary for the latissimus
dorsi to perform its normal function, i.e., adduction, medial rotation and
extension of the humerus.4
true source of power generation in the golf swing involves the creation of
elastic energy, which is thought to be the power generator for most athletic
maneuvers.2 Briefly stated, elastic energy is created by
imparting a short, quick stretch on the muscles involved in performing a
particular movement. In the case of the golf swing, it is generally thought
that the rotator cuff, latissimus dorsi and pectoralis major muscles are the
"power muscles,"2 as well as the muscles of the arm
and forearm. To effectively pre-stretch these muscles, no spinal rotation is
only purpose for pelvic and spinal rotation in the backswing is to achieve a
body position that allows for effective club head delivery at ball impact.
There are three main reasons to urge you to adopt a short backswing that
reduces spinal rotation:
1. A short swing with less spinal rotation
gives a golfer more control of the golf club and club head throughout the
swing, which translates into better control of the golf ball.
2. Research has demonstrated that short
backswings achieved the same clubhead speed at ball impact as long backswings.2
3. A short backswing will help to minimize
the torsional stress in the lumbar spine, thus limiting the negative effects of
golf on the body. (i.e. lower back pain)
Golfers should keep their shoulders and pelvis parallel to each other throughout the majority of the golf swing. This is called rigid parallelization, the loss of which can generate rotational strain in the lumbar spine.5 With this information in mind, you can imagine how stressful and injurious the golf swing can be when golfers try to achieve a large x-factor. This swing method is dangerous and should be abandoned.
are several avenues of care that chiropractors can offer golfers, including
spinal adjustments, preventive swing advice, rehabilitation exercises and
anti-inflammatory nutrition. As most DCs know, spinal adjustments are known to
be effective in reducing pain, improving spinal mobility and overall health.
While the adjustment provides these beneficial outcomes, it is important to
realize that adjustments cannot prevent injury when there is maximal stress on
the spine. For this reason, DCs need to urge their golfing patients to reduce
spinal rotation during the swing to lessen the chance of torsional injury.
Golfers should be urged to adopt the principle of rigid parallelization
throughout the golf swing, which requires rigid abdominal control.5
previously alluded to, an aggressive lumbar spine rehabilitation program should
be instituted as both a therapeutic and preventive measure. The golf swing is
inherently stressful and injurious to the lumbar spine. Thus, it is very
important to make sure the lumbar spine's stabilization mechanism is well-
trained. Treating golfers without taking this into consideration can lead to re-injury
and dependence on passive care. Research has recently demonstrated that lumbar
stabilization exercises can reduce pain and disability in patients with spinal
instability caused by spondylolysis and spondylolisthesis.6 McGill
has recently discussed the stabilizing exercises that impart the least amount
of stress on the lumbar spine, which included the cat stretch, curl-ups,
isometric horizontal side support, and the quadruped track of exercises.7 These
exercises will also help golfers develop the rigid abdominal control needed to
maintain pelvis and shoulder parallelization during the swing to reduce
factors should also be considered when treating golfers. As mentioned earlier,
golfers commonly self-medicate with aspirin and NSAIDs to help deal with
inflammation and pain. These medications are known to cause gastrointestinal
ulceration and reduce connective tissue
healing (this is the healing process your body goes through after a golf injury,
this slows recovery and causes permanent damage to the tissues). It would
be wise for golfers to adopt a diet that is rich in dark green and other
colorful vegetables, which are known to be sources of anti-inflammatory omega-3
fatty acids, bioflavonoids and other phyto-chemicals. Supplementation with
omega-3 fatty acids, flavonoids, ginger, turmeric, Boswellia and bromelain can
add additional anti-inflammatory support,8 while supplemental
glucosamine and chondroitin sulfate are useful for enhancing the repair of
few golfers hit the fairways armed with the modest amount of information
presented in this article. Please take note and if you have any further
questions or would like to schedule a time to get evaluated in our office,
please feel free to call and schedule an appointment today.
Very few golfers hit the
fairways armed with the modest amount of information presented in this article.
Please take note and if you have any further questions or would like to
schedule a time to get evaluated in our office, please feel free to call and
schedule an appointment today.
1. McCarroll JR, Mallon WJ. Epidemiology
of golf injuries. In: Stover CN, et al. eds. Feeling up to Par:
Medicine from Tee to Green. Philadelphia: FA Davis; 1994: p.9-13.
2. Seaman DS. Back pain in golfers:
etiology and prevention. J Sports Chiro Rehab 1998;
3. Macintosh JE, Bogduk N. The axial
torque of the lumbar back muscles: torsion strength of the back muscles. Aust
N A J Surg 1993; 63(3):205-12.
4. Cramer GD, Darby SA. Basic and
Clinical Anatomy of the Spine, Spinal Cord and ANS. St Louis: Mosby;
5. Watkins RG. Lumbar spine injury in the
athlete. In: Liebenson C (ed.) Rehabilitation of the Spine. Baltimore:
Williams & Wilkins; 1996, p.341-54.
6. O'Sullivan PB et al. Evaluation of
specific stabilizing exercise in the treatment of chronic low back pain with
radiologic evidence of spondylolysis or spondylolisthesis.Spine 1997;
7. McGill SM. Low back exercises: evidence
for improving exercise regimens. Phys Ther199; 78:754-65.
8. Seaman DR. Clinical nutrition for pain,
inflammation, and tissue healing. Hendersonville, NC: NutrAnalysis, 1998.
9. Bucci LR. Nutrition Applied to
Injury Rehabilitation and Sports Medicine. Boca Raton: CRC Press,