|This article outlines the importance of injury prevention. There are times when the physical demands of training, tournament golf and lifestyle schedules may exceed your body’s ability to endure these demands.|
|Alice at work
Typically people don’t think about injuries and rehabilitation when they are performing well and feeling on form - contemplating how to prevent injury is likely to be the last thing on your mind. Unfortunately, it is often not until you are receiving treatment for pain or an injury that has affected your performance that you start to think about what you could have done better or differently to avoid it from happening. While rehabilitation that includes recommendations to stop playing golf for an extended period, or even taking a short break from playing and practising, is problematic and undesirable for all golfers, having time off golf is often what is necessary to allow your body to recover and prevent the injury from recurring.
The ‘Health and Fitness’ section on the LET website includes exercises which, when integrated into a comprehensive training program, can develop elements of golf performance such as increasing club head speed, ball velocity, carry distance and driving distance, change swing mechanics and improve specific fitness characteristics. It is important to note that many of these training exercises and stretches also serve as preventative strategies to protect the body and prevent injury occurring.
Overuse injuries are the most common type of injuries that golfers experience. Overuse injuries are chronic injuries which result from golfers repeated practice, overexertion and repetitive strain on the body’s musculoskeletal system1. The musculoskeletal system comprises muscles, joints, tendons, ligaments and bones. Soft-tissue injuries develop over time and usually present initially as a nagging ache or niggling pain that is experienced during or after exercise. Soft tissue injuries are commonly triggered in response to an accumulation of training and the physical stress of repetitive movement patterns. In addition, increases in the volume, intensity or frequency of performance without sufficient preparation or recovery time are contributing factors. This is more likely to happen during busy spells like at training camps, tournaments and competitions.
Physical screening, where athletes are assessed during the pre-season period, is recommended with the aim of identifying risks for injury2. Golf specific physical screening tests work by testing physical parameters including joint range of movement, muscle strength, extensibility, endurance and balance which are all key components for physical integrity in sport. Weakness, imbalance and restriction in any of these may indicate a vulnerability to injury and possibly reduced performance. The good news is that these parameters are trainable through golf specific training programs6.
How can we build best practice on injury prevention into our daily training regimes?
- By practicing flexibility training to include stretching exercises such as the ones presented in the ‘Flexibility’ section. Although stretching is sometimes not very exciting, these exercises are a positive intervention to maintain suppleness and full range of movement through your golf swing. Research reports that the areas of your body to most frequently sustain injury in golf performance are the lower back, shoulders, elbows, knees, ankles and wrists1, 3, 4. It is important to stretch these areas and any other area identified by your physiotherapist or trainer. Stretching will help prevent restrictions in range of movement and muscle extensibility from developing and also help alleviate any associated symptoms of tightness, stiffness, shortening and fatigue in soft-tissues. If these symptoms accumulate over time, they can result in injuries such as muscle strain, ligament and tendon sprain and soft-tissue inflammation such as medial epicondylitis (golfer’s elbow).1.
- By practicing a dynamic warm up program that includes some aerobic activity with stretching through golf specific movement patterns and drills to prepare your body for the demands ahead.
- By practicing strength and conditioning training to include exercises such as the ones suggested in the ‘Strength and Endurance’ section. Developing strength and endurance is important in golf to allow your joints to be stable through the phases of the golf swing, in particular the hip, shoulder and wrist joints. Core/trunk endurance is suggested to protect against lower back pain and injury. Considering this, exercises that train your abdominal, lower back and pelvic floor muscles are beneficial. Strengthening muscles and connective tissues allows them to become more robust to resist excessive overload which can be harmful. This is very important in golfers who have excess range of movement known as ‘hypermobility’. This more often presents in junior and adolescent golfers. While being hypermobile affords greater flexibility and range of movement, it increases risk of injury such as joint dislocation, subluxation and multiple joint pain5. With this in mind training the supporting muscles to be strong and stable through repeated performance is fundamental.
- By practicing balance and proprioception training to include exercises shown in the ‘Balance and Control’ section. Dynamic balance training is important for you to maintain control of posture through all phases of your golf swing. Developing awareness and intuition on proprioceptive feedback, coordination and joint position sense through movement patterns are essential to protect against unstable movements, over stretching and over reaching which may cause injury. This type of training is also significant as part of post-injury rehabilitation programs.
- Whether you are a golf professional on tour, assistant pro or amateur possibly juggling career, studies and family, it is beneficial working with your coach to plan training cycles considering your competition dates. Including pre competition tapering phases is positive in terms of physically pacing the body. Integrating rest and recovery days is essential to allow training adaptations to take place and to avoid overtraining syndromes and burn out. Examples of lighter activities away from the driving range and golf course that you can engage in, are taking a yoga or Pilates class or going for a swim, fresh walk, bike ride or something you enjoy and find fun in.
- Follow your judgement and response to training carefully and progress intensity gradually. If you experience soreness, tenderness, swelling or pain which develops a few hours after exercise and is not gone by the following morning, then you did too much, so reduce the intensity of your next session. Many factors can affect your physical capacity such as sleep, hormones, travelling, changing time zones and jet lag, nutrition, psychological mood and motivation. Balancing these is easier said than done, but being aware and intuitive of your limits is advantageous.
- Receive physical therapy and sports massage treatment as a maintenance strategy even if you are feeling well and free from pain and niggles. A therapist’s techniques assist in stretching, relaxing and de-toning soft-tissues at key times like between games and as part of your recovery.
- If you do suspect you have an injury make it a priority to see a physical therapist as soon as you can. Early diagnosis and an individual treatment plan will reduce the intensity and duration of symptoms and help you to return to optimal physical condition for health and performance.
Be well, good luck and enjoy the tournament season!
Fradkin, A. J., Windley, T. C., Myers, J. B., Sell, T. C. & Lephart, S. M. 2007. Describing the epidemiology and associated age, gender and handicap comparisons of golfing injuries. International Journal of Injury Control & Safety Promotion, 14, 264-266.
MacAuley, D. (ed.) 2007. Sports Injury. In: Oxford Handbook of Sport and Exercise Medicine. Oxford University Press, pp. 46-50.
Evans, K., Refshauge, K. M., Adams, R. & Aliprandi, L. 2005. Predictors of low back pain in young elite golfers: A preliminary study. Physical Therapy in Sport, 6, 122-130.
Kim, D. H., Millett, P. J., Warner, J. P. & Jobe, F. W. 2004. Shoulder injuries in golf. The American Journal of Sports Medicine, 32, 1324-1330.
Lysens, R. J., Ostyn, M. S., Auweele, Y. V., Lefevre, J., Vuylsteke, M. & Renson, L. 1989. The accident-prone and overuse-prone profiles of the young athlete. American Journal of Sports Medicine, 17, 612-619.
Sell, T. C., Yung-Shen, T., Smoliga, J. M., Myers, J. P. & Lephart, S. M. 2007. Strength, flexibility and balance characteristics of highly proficient golfers. Journal of Strength & Conditioning Research 21, 1166-1171.