All being well, the golf courses will open up again before too long.
Many of my clients are frustrated golfers, itching to get back out on the golf course, especially with the weather improving and longer stretches in the evenings.
When a return to golf is the main aim for having a bout of low back pain treated with physiotherapy, I need to be certain my client's whole body is prepared.
An effective course of treatment for a golfer not only involves settling pain symptoms but also making sure the injured area is ready for the stresses and strains of golf. For most of my golfing clients, these are not stresses and strains their bodies have had to deal with for quite a while, given the length of the current Covid-19 lockdowns.
Once we arrive at the correct stage of a treatment and rehabilitation programme, I like to have my clients develop the following key golfing fitness areas.
It is important to develop grip strength avoid developing golfers elbow and a critical measure of general health and fitness. One of the best ways to improve grip strength is to hang from a door-mounted pull-up bar for 90 seconds each day. Performing safe heavy-lift exercises such as deadlifts with barbells or kettlebells are also a good option. Resistance bands can also be used to develop grip strength.
The twisting motion during the golf swing should occur mostly in the mid back area, so having enough mobility in this part of the spine is essential. If you are too stiff in your mid-back, the lower neck or lower back takes up the extra strain; the result is usually overload injury.
Hanging from a door-mounted pull-up bar is also a great way to improve thoracic mobility as the spine elongates under the effects of gravity. Careful and specific foam rolling on the thoracic spine is also an option.
We like to prescribe several Pilates-based thoracic mobility exercises, which can be done on the floor. The benefits of floor-based exercises also include developing hip mobility and strength.
Walking in a relaxed manner, allowing the thoracic spine to rotate gently while breathing with the diaphragm is another way to improve thoracic mobility.
Core abdominal and gluteal strength
Not sit-ups, which are very hard on the lumbar discs and usually cause tightness in the hip flexor muscles. Golfers need to balance good spinal, hip and pelvic muscle engagement with mobility to allow a strong, controlled and fluid motion through the golf swing.
Once again, Pilates method exercises can be adapted for the golfer to improve core stability. Other exercise options use gym balls and resistance bands. I like to mix it up to keep the exercises fresh and challenging with lots of variety.
Stiff hips, which don't rotate well during the swing, often lead to low back pain. Specific hip mobilisation exercises can help; I also find manual therapy techniques and dry needling of the hip and groin region's deep muscles very effective to improve hip movement.
Thigh strength and strong knees
Strong thighs help create strong injury-resistant knees and help stabilise, control excess shear stress, and protect the menisci of the knee. If you have some arthritis in your knees, especially on the inside, good thigh and gluteal muscle strength are critical.
Strong thighs, which allow you to bend your knees adequately during the golf swing, also help take the stress from the lower back.
Ankle mobility and balance
Finally, and often most neglected, is ankle mobility and balance. Given we tend to walk most of the time in stiff, supportive shoes on fairly even surfaces, we tend to lose both.
Walking barefoot on grass or sand (if you are lucky enough to live near a beach) helps get stiff ankles moving.
Around the house, walking on your toes and heels alternately up and down the corridor is simple and effective to improve general ankle mobility, strength and balance.
My favourite method for improving functional balance and mobility is the wobble board, aka balance board. We have a few of these in the clinic; always good fun when I start with catching and throwing balls on the wobble board. When used safely and regularly, I am always surprised at how quickly my clients' balance starts improving. The wobble boards are fairly inexpensive and easy to order for home use as well.
In good health.
Simon Coghlan MSc, BSc Physio, DipMedAc
Images by Hebi B. & David Mark from Pixabay