Preventing Golf Injuries
Part Two – Joint-by-Joint

I am familiar with golf injuries. Not because I play golf but because I am a golf widow. I have seen acute injuries like when we had to take a friend to the emergency room. He pulled both his calf muscles from trying to jump out of the high side of a sand bunker. Probably from his frustration at being down there so long.

I have seen chronic injuries like the plantar fasciitis my husband suffers on his left foot from not being able to shift his weight properly because of an old soccer injury on his right knee.

Golf may not look as athletic as basketball or badminton but it has its fair share of injuries. A German study found that 80% of injuries are due to overuse and 17% due to trauma or accidents (like getting hit on the head with a ball). The professional golfers in the study experienced an average of three injuries a year (usually due to overuse) while amateurs had two injuries a year (usually due to bad technique and poor fitness levels).

Professional golfers were most likely to injure their wrist, hand, neck, and shoulders while amateur golfers tended to hurt their elbows and lower back.

Those who warmed up for ten minutes or less reported having at least one injury per player while those who warmed up for more than ten minutes reported 0.4 injuries per player.

Using a cart or caddie to carry the golf bag cut down significantly on injuries to the lower back, shoulder, and ankle, the study found. Unfortunately, playing four or more rounds of golf per week increased the risk of injury significantly. Here’s a brief overview of the most common golf injuries.

This is the site of the most common injury among amateur golfers. Pain on the outside part of the elbow (called a tennis elbow) is usually due to overuse, a grip that is too tight, inappropriate grip size, a lead arm that is too straight, and repetitive contractions in the forearm muscle to maintain control of the club during impact.

Pain on the inside part of the elbow (called a golf elbow) is most likely from always hitting the ground during the swing. The impact with the ground creates shock waves that have to be absorbed by the forearm muscles and the elbow joint.

“Tennis elbow” is four times more common in golfers than “golf elbow”.

To strengthen forearms, squeeze a tennis ball for five minutes at a time. Change swing mechanics so there is less impact on the forearms. Use more flexible shafts and club heads with larger sweet spots to reduce vibration. Use a counterforce forearm brace.

Wrist and hand.
In a right-handed golfer, injuries will usually occur in the left leading hand and wrist. Causes are poor wrist control, too tight a grip, poor swing technique, and overuse.

Meanwhile, tendonitis can develop in the right wrist of a right-handed golfer if he or she is prone to hitting the ground before hitting the ball sending off a large divot (chunk of turf).

A small bone at the base of the wrist on the small finger side can be fractured when a golfer performs a ‘fat shot’ while hitting an immovable object like a rock, root of a tree, or the ground. To prevent this injury, which is often overlooked (it may not be seen on standard x-rays) and may require surgical intervention, avoid obstacles and make sure the butt of the club extends past the palm of the leading hand.

Shoulder problems usually show up in the left shoulder of right-handed golfers. Overuse is the most common cause. Degenerative changes in the middle-aged shoulder joint also contribute to injuries. These changes may include a narrowing of joint spaces, thinning of the rotator cuff muscles, and bone spur formation. The basic prevention tips are to avoid excessive repetitive trauma (translation: too much golf squeezed into too few days) and to strengthen/stretch the shoulder muscles including the rotator cuff.

Another important tip is to improve trunk rotation. It has been noted that golfers with poor range of motion in rotation may unconsciously compensate with their shoulders. Golfers with a history of back problems may do the same.

Although knee injuries are not common in golf, they can hobble golf greats like Tiger Woods who ended up having knee surgery to treat a chronic knee problem that developed from childhood injuries and some say from changing his swing.

Even if a golfer uses a cart, knees can be stressed from playing on undulating and hilly terrain, especially if the golfer “likes” to visit the rough. The mechanics of the golf swing places stress on the lead leg during the follow-through phase. This can lead to degeneration and tears in the menisci, cartilage that act as shock absorbers in the knee joint.

Being overweight increases the risk of knee problems. Every pound of body weight is multiplied by six times on the knee joint. Being ten pounds overweight is the equivalent of 60 pounds of excess pressure on the knees.

Next week: Part Three – The Lower Back & Golf

American Academy of Orthopaedic Surgeons
Golf Injury Review, Sports Injury Bulletin
Harvard Men’s Health Watch

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