Last year my friend Steve (fellow golf fanatic) came to me after injuring his back doing yard work. The pain was not only hampering his daily routine, but he was struggling to get through a round without severe low back pain and burning pain down his left leg into his calf. He had recently moved into a new house and was concerned that he could not complete the home improvement projects he had planned on, let alone play golf!
Steve knew he had to find a quick solution to his low back pain before it worsened or caused him to not be able to work! He had visited our office in the past for his shoulder pain, so he knew he could schedule the same day appointment to see us for examination and treatment.
As a Chiropractor and avid golfer myself, I ran Steve through a comprehensive low back evaluation. Upon our evaluation, we noticed the following findings regarding his low back condition.
- Spasm of the low back musculature in the low back.
- Antalgic (altered posture) positioning to the right
- No hard neurological findings such as weakness in the leg
- A lack of mid-back mobility
- Full strength in all extremities
- Significant pain when assessing the left side of his low back muscles.
After evaluating Steve, we discussed our findings and the prognosis of his condition and ability to get back to his home improvement projects but more importantly…golf. We first addressed some of Steve’s concerns which were his desire not to take medications and how quickly can we get him out of pain and fully functional.
When the lower back finally does break down, you can typically expect one of the following conditions to occur:
From the Mytpi.com article
- Muscle Strain or Ligamentous Sprain – A muscle strain or “pulled a muscle” as well as an injured ligament will usually resolve itself in 2-4 weeks with plain old rest and recovery. However, there can be some residual muscle stiffness, fascial restrictions, joint fixations or movement alterations that may need to be addressed afterward. Sprains or strains are the most common form of lower back injury we see. Symptoms may range from a minor ache to sharp debilitating pain. Most sprains and strains are localized in the lower back region, meaning pain does not radiate into the butt or leg. The chemical inflammation around the injury is usually sore to the touch, and the pain usually subsides with rest.
- Disc Injury – The lumbar intervertebral disc acts as a spacer between adjacent vertebrae to help absorb compressive forces and create space for the spinal nerves to exit the spinal column. Imagine the disc as a jelly filled donut. If excessive or abnormal stressors are placed on the disc, tears can occur. When this happens, the force of the jelly against that tear can cause a bulge in a portion of the donut leading to a “bulged disc.” In more severe cases, the jelly can actually exit through the donut wall leading to a “ruptured disc.” The discs are also susceptible to degenerative changes over time. To continue the analogy, imagine the jelly inside of the donut drying up. Any of these disc problems can leave the spinal nerves vulnerable to irritation or compression resulting in dysfunction and pain. Most disc pathologies create radiating pain into the buttocks or the leg (think sciatica) due to the irritation of spinal nerves. Sitting for prolonged periods of time, bending forward into a slouched position, or lifting heavy objects can all exacerbate disc symptoms.
- Altered Joint Mechanics or Motor Control – Interestingly, the brain can completely change the lumbar spine’s ability to move just by changing which muscles are firing or by altering the sequence of when muscles fire. This can occur in the absence of any visible injury. These altered motor control or joint mechanics can begin as a protective mechanism, but can lead to chronic problems over time. Most experts believe over 80% of all chronic lower back problems begin this way.
- Degenerative Arthritis – Just like all joints, with over-use, abuse, or even lack of use, spinal joints can become arthritic. Bone spurs and osteophytes act like stalactites and stalagmites inside a cave closing in on the opening for the spinal nerves. With time, these bony outgrowths can fuse joints, irritate nerves and create general inflammation in the area. Stenosis, the narrowing of the canal or cave that houses the spinal nerves is a very common problem with arthritic changes. Most arthritic problems in the spine create sharp pain with certain movements. The resulting inflammation can then cause chronic dull pain over time.
- Bone Fracture – Stress fractures and pedicle fractures (spondylolysis) are common problems seen in the lumbar spines of rotational athletes. This occurs due to the rapid extension and rotation of the spine, causing adjacent vertebrae to collide into each other at their end range of motion. This action places high forces on the posterior portions of the vertebrae and can lead to these types of fractures. Injuries of this sort can lead to deep dull pain and instability in the spine.
The rest of this article can be found at:
http://www.mytpi.com/articles/health/the_golfer’s_guide_to_lower_back_pain_part_1
I discussed with Steve our treatment plan and that we could achieve the results he desired with conservative Chiropractic care and rehab exercises specific to his low back. I explained to him that we could accomplish these results in a short period. Based on our findings and experience with this condition, we set a goal of 1 weeks to where he could get back to some less intensive home improvement projects, and in 2 weeks he would presumably be able to golf pain-free. We also discussed a potentially longer time frame to where he would have full function and strengthening of his low back. Most of that strengthening work would be done as part of his at-home care program.
We provided Steve with four low back exercises, which he can do without any equipment and in the comfort of his own home.
Another key aspect of injury prevention we needed to implement for Steve, was a proper golf specific warm-up he could do at the driving range. This is the one that I personally use every time before a round or range session!
By adhering to our treatment plan, implementing the At-Home Care, and proper warm-ups, Steve’s was able to return to golf teaching and playing relatively pain-free after a few days and then was fully functional and pain-free after a few short weeks. He didn’t have to see any other specialists or take any medications.
There are many causes of low back pain from golf and addressing those will go a long way for optimal performance and injury prevention. Some of the key aspects of prevention include:
- Proper Technique
- Flexibility/Mobility
- Core Stability
- Optimal Functional Movement
- Properly fitted equipment
- Warm-up before practice and play
- Full Recovery from the previous injury
- Proper Posture
With that said, golf is a physically demanding and highly repetitive sport. Even golfers who optimize all of the above may fall victim to the dreaded golf injury. However, if you address the above, you will have less injury frequency, severity and recovery time. We can help you get there!