Golf is not a contact sport. So why can the game be so physically painful sometimes?
There is golfer's elbow, wrist problems, shoulder problems, hip problems and leg problems. But the most common physical problem is back pain. A swing starts and stops with back movement. With a golfer taking more than 100 swings (practice and real) during an 18-hole round, it's easy to see why the problem develops.
"When you play a sport, you're at risk for an injury," said Lisa Chase, a physical therapist who owns Back 2 Normal Physical Therapy in St. Petersburg, Fla. "It's just part of sports. But there is a lot that you can do to prevent it."
Chase has worked with athletes for more than 20 years. From 1998 to 2009, she worked with the Women's Tennis Association as director of sports sciences and medicine before focusing on her practice. She is also an adjunct professor at Michigan State University.
Her patients include golfers who have sustained back injuries.
"Just doing a proper warm-up is going to decrease your injuries," Chase said.
"Golf is a rotational sport. If you don't have good rotation throughout the joints that need to rotate -- and commonly people don't -- then you rotate right through and create a lot of repetitive stress in the back."
Chase's advice is to mimic the actions of a swing before the first tee. She suggests putting a club behind your neck and doing rotational movements.
"You want to try to mimic the movement you're getting ready to do," she said. "Instead of passively stretching, you want to do a little bit of cardio. Increase the blood flow to the muscles."
Once the round is completed, Chase suggests stretching as part of a cooldown. Just putting the clubs in the trunk and sitting could cause the back to tighten. Do trunk twists and waist bends to give the back a final stretch. Golfers can use a band or a towel stretched above the head as part of the exercises.
If these steps are taken and back pain persists, then other potential causes need to be considered.
The next steps
Chase believes many back injuries are caused by inadequate spinal, hip and shoulder mobility. Before seeing a therapist, she suggests seeing a golf pro to clean up mechanics.
"They can look at how you move to make sure you have good rotation throughout," Chase said.
When golfers complain about any sort of injury, Chase goes to the back.
"If they complain about golfer's elbow, for example, I'm going right to the spine," Chase said. "It's because they can't rotate enough in their spine and they overcompensate either at the shoulder or the wrist. That's putting a load on the elbow or shoulder or neck."
Chase said she will watch how a golfer moves and try to get him better aligned. Many golfers bend over too much or have a swing that is too reliant on the back. Her main focus is to make sure a golfer's rotation fits his body.
"We can look and make sure you have good rotation throughout the body," Chase said. "That should definitely decrease the impact."
Camille Raciopio is a trained Pilates instructor who works with Chase. She is also a golfer, so she knows the kinds of stretches and exercises that benefit a swing. Raciopio believes the key to avoiding back problems is flexibility.
Flexibility increases the amount of turn and club-head speed, which make for better and longer shots.
"There have been several golfers who have told me their games have gotten better after doing some Pilates," Raciopio said. Pilates' aim is to increase strength, flexibility and control of the body.
Along with stretching exercises, Raciopio uses Pilates machines that simulate a backswing and follow-through, and side-to-side trunk movement.
"The key is to inhale on the upswing," Raciopio said. "And exhale on the downswing. That's where all the power comes from."