By: Chris Cooper PT, DPT, CSCS

golf low back painMost golfers will experience some form of lower-back pain over the course of time. The nature of the golf swing is inherently unhealthy for the human spine. Forward flexion (bending forward) combined with rotation (twisting) creates torsional stresses throughout the spine, including the discs, the joints between each vertebra, and the ligaments connecting the vertebra to each other and the surrounding musculature. Through proper awareness, coordination, warm-up, and training, however, a number of factors can be influenced to give the best chance of keeping your lower back pain-free.

To keep the back as safe as possible, a couple of things have to come together. One, you need to be able to find “neutral spine.” Assume a standard “5- iron posture.” Arch your lower back, then flatten your lower back (I tell patients/clients to “tuck their tail” if they had one, aka “pelvic tilt”), and then migrate back to a point about half way in between those two extremes. A recipe for lower-back issues and an inefficient swing is to set up in one of two faulty address postures. The “S” posture has too much “sway” or arch in the lower back and the “C” posture has too much “slump” throughout the spine.

When the spine is in neutral, those anatomical structures mentioned above have the least amount of baseline tension on them. The other thing neutral spine does is create a more efficient platform to transfer power from the muscles of the lower body through the core, into the mid-back, and finally into the club via the arms. It is crucial to find that position which is going to give you the most power and the least probability of creating injury. To find neutral, it takes some coordination and awareness of how to move your pelvis back and forth. To maintain neutral posture through the majority of the golf swing takes “core” strength as well as hip, hamstring, and calf flexibility.

Proper warm-up is essential to getting your back loosened and ready. Just like a cold rubber band needs a little heat prior to being able to fully stretch, so do the muscles of the lower back. Movement-based dynamic warm-up exercises versus prolonged static stretching are important to prepare the back for the rigors of 4+ hours on the golf course. Dynamic stretching where you hold stretches about the time it takes to exhale and repeating 5-10 times is a good start.

The core is made up of the abdominals, glutes, and lower-back muscles. These muscles absolutely need to be in good condition to minimize lower-back injury. Rather than just doing crunches and oblique crunches for the abdominals, I like to find a resistance (resistive bands, cables, medicine ball, etc) to move against with the upper body while the lower body stays stationary—preferably while in your golf stance. The glutes strengthen well with exercises such as squats, lunges, deadlifts, and bridges. I use a physioball as well as the previously mentioned glute exercises to strengthen the lower back muscles. A good strength training program would incorporate these types of exercises 2-3 times per week.

Flexibility is key in the joints above and below the lower back. So the mid-back and the hips (both mainly into rotation), as well as the hamstrings, hip flexors, and calves are crucial to create a healthy environment for the lower back to exist. General and more golf-specific stretching programs should be performed daily to combat the stiffness our tissues suffer from each passing day.

To help avoid seeing me in the clinic for low back rehabilitation, strike a balance between strengthening, stretching, and going through an adequate pre-round warm-up routine. Your back and your pocketbook will thank you. Contact the office to schedule your TPI physical assessment to see where you need to focus your exercise attention.