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Attention to Prevention
The key to successful golf

A PGA  player’s golf swing looks so effortless, it is easy to think no one can get hurt playing golf. However, such a swing involves many body parts moving through maximum ranges of motion and speed. A typical male golfer’s swing reaches speeds of around 160 kilometres per hour in less than a fifth of a second. The muscles work as hard as possible. Although the motion doesn’t last long, it is extremely powerful. In a round of golf, it repeats hundreds of times in practice and ‘real’ swings.

Research shows that golf injuries occur surprisingly often. Injury rates tend to go up as handicap goes down. Almost 70 per cent of players with a handicap under nine have suffered a golf-related injury. In comparison, only 60 per cent of those with a handicap over 18 are injured. About half of all golf injuries are chronic, meaning they drag on and sometimes never fully go away. On every single golf course around the world, at least one in every foursome teeing off will be bothered by pain during the round. Golf injuries really do happen!

Preventing golf injuries

Of course, the best solution to the problem of golf injuries is to avoid them in the first place. Preventing injury requires good judgment, knowledge and awareness of the roles of:

• activity progression
  
• strength and flexibility
  
• proper warm-up
  
• technique
• equipment
• and paying attention to symptoms.

With proper care golfers can lower the risk of injury, hopefully saving unnecessary pain, frustration and time away from the course.

Activity progression

Walking a golf course is about the same as doing a 10-kilometre hike. It requires reasonable cardiovascular endurance. The average male golfer burns about 1500 calories per typical round of 18 holes. Females burn a little over 1000 calories. Carrying clubs adds another 10 to 15 per cent to these numbers.

Women can reach 80 per cent of their maximum heart rate while walking some of the uphill fairways. For men, the peak is about 70 per cent of their maximum heart rate, depending on the age of the golfer and whether the terrain is level or uphill.

To prevent injury and better meet the physical challenges of the course, golfers should gradually increase exercise tolerance. Improving cardiovascular fitness could be as simple as going on a good walk three to four times per week. Slowly increase the distance and intensity of walks during the weeks leading up to the start of golf season.

Aggressively swinging a golf club challenges both the cardiovascular system and certain parts of the body, including the lower back and lead arm. Take care when returning to golf after a long layoff or after an injury. Following a few simple rules can greatly reduce the risk of injury or re-injury. Overuse causes most golf injuries, so gradually build up the intensity of your swings. Since impact with the ground is where most of the stress of a golf swing occurs, know how to control these forces (see equipment factors section).

Improving strength and flexibility

The ideal golf swing is a relaxed fluid motion. To achieve this, muscle strength and a range of motion (ROM) in joints are required from all parts of the body. Without adequate flexibility, the swing becomes less efficient and even unsafe.

If you lack strength and flexibility, you are working with a physical handicap. Not only is your score affected, the chance of suffering an injury increases. A complete strength and flexibility program for golf can be a great benefit. Studies have shown that rotation exercises for the hips, trunk and shoulders are particularly helpful.

Preparation and warm-up

The golf swing is a very complex movement involving powerful muscle contractions. It is repeated 100 or more times per practice session or game. Considerable stress is generated and absorbed during each session. To prepare for this stress, an adequate warm-up should be done before playing or practicing.

Spend at least ten minutes warming up for a golf session. Studies from Canada, the U.S. and Europe all show that about 80 per cent of recreational golfers do not spend enough time warming up before playing. Those who do warm up report 60 per cent fewer injuries than those who do not.

A warm-up plan

An ideal golf warm-up should take 10 to 20 minutes and involve each of the following steps.

• General body warm-up – Begin with low intensity activity that uses as many large muscle groups as possible. Working muscles produce heat that is transported by the blood vessels to the rest of the body, raising your temperature. Good warm-up exercises include brisk walking, climbing a flight of stairs, or simply placing a club behind the back and carefully rotating from side-to-side for a few minutes. Start warming up when you arrive at the course by parking at the far end of the lot. The longer walk to the clubhouse will help.

• Stretching – Next, stretch key muscles used in the golf swing. Concentrate on back, hip, groin, hamstring, quadriceps, calves, neck, shoulders and forearm muscles. Gently hold each stretch for 10 to 20 seconds. You should not feel pain. Pre-game stretching exercises for golf can be found at www.fitforegolf.com.

• Golf-specific drills – Now, gently swing a short iron back and forth. Gradually increase the tempo until your muscles feel loose. Add more resistance by gently swinging two clubs at once. Warm-up swings should be done both left-handed and right-handed for the best muscle balance and coordination.

Practice – If a driving range or hitting area is available, take time for a few practice shots. This further warms the golf muscles and improves timing and consistency. To start, use a short club such as a wedge to hit only 20-yard shots. Gradually build up to longer shots and longer clubs. Starting with easy gentle shots is easier on the body and also helps build confidence. It is hard to miss-hit a 20-yard shot!

Technique – take a golf lesson!

The golf swing is a very challenging activity. A full swing is one of the most difficult motions for the body to do. Less efficient and inappropriate movements used by less-skilled recreational golfers increase the risk of injury.

Often, less skilled players fail to transfer their weight correctly on the downswing. Studies show that these golfers use:

• side-to-side movement rather than turning movement of their feet during back and down swings
• less and late weight shift towards the front foot on the downswing
• more weight on the toes rather than on the mid-foot through impact.

Such differences reduce the transfer of energy, lower stability, and delay timing in the joints. All slow down the speed of the club head. A visit with a CPGA certified instructor can help correct swing flaws that lead to over-compensation and increased injury risk.



Equipment factors

Two equipment factors may increase the risk of a golf injury. The first is whether the golf club is properly matched to the golfer. The second involves the type of surface the golfer hits balls from while practicing.

Clubs are a critical link between the human body and the golf ball. A poor fit makes it more difficult to swing efficiently, increasing the risk of injury. The body is forced to work around clubs unsuited to its particular dimensions or swing. The standard men’s club length is designed for someone five feet 10 inches or 178 centimetres tall. Women’s clubs are meant to fit someone five feet four inches or 163 centimetres tall.

Using a shorter golf club forces the spine to bend forward (flex) more when setting up and hitting golf balls. Shorter clubs also produce more spinal side bending during the downswing. Both can cause low back pain. To reduce back pain, warm up before playing, select equipment (such as proper shaft length) matched to body size, use good posture to address the ball and avoid over-swinging.

Hitting off artificial surfaces such as driving range mats can also contribute to upper limb stress. Players typically contact the turf before, during or after ball impact. This repetitive and excessive stress may cause to wrist, elbow and shoulder pain.

While a number of manufacturers produce simulated turf mats, two different types are usually installed at practice facilities. One type is a solid mat that typically has a thin layer of a durable synthetic turf. This is implanted onto a 30 millimetre thick base of dense foam. The other common mat consists of a pliable brush-like surface of closely packed vertical strands of nylon fibres (about 40 millimetres long) set into a hard polymer base. Studies have shown that the latter type of surface (brush fibre) is greatly preferred by golfers because there is less stress on contact with the surface.

Listen to your body

The old saying ‘no pain no gain’ remains one of the most mistaken ideas in sports. Pain is part of the body’s incredibly valuable warning system. It alerts us when tissue damage is occurring so we can avoid serious injury.

Pay attention to your symptoms. Certain key patterns of discomfort give warning signs that should not be ignored.

The first is sudden onset (acute) pain. Pain that strikes suddenly and persists (such as sudden back pain immediately after taking a swing) indicates that something has gone wrong. Take appropriate action before the situation gets worse.

Another pattern is severity – the more it hurts, the more likely it is that something serious has happened. A good rule of thumb is if the pain makes you grimace, do not continue to play.

One of the trickiest patterns to sort out is intermittent or recurring pain. We have all experienced nagging injuries that come and go. In fact, this is common with many golf injuries. If mild pain returns consistently with activity and is in the same general location, pay attention. Take appropriate action, including warming up properly, applying ice after activity, and having your technique checked by a golf professional. However, if the pain becomes worse with less effort or comes on earlier in each round, stop and have it properly investigated!

Get help if you are injured

Since many injuries arise from poor technique, taking a lesson from a certified golf professional can be an important first step towards injury prevention. If you already have an injury that started or is aggravated by golf, see a sport medicine doctor or physiotherapist who understands how golf affects the body and is experienced in treating golf injuries. Find someone who can adapt advice about treatment remedies to your specific needs.

Remember, the best injury is the one that never happens. Listen to your body. If in doubt, seek the advice of a health care professional. Proper attention to prevention will ensure a lifetime of enjoyable golf ‘par’ticipation.