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Golf and shoulder pain: Know your treatment options

May 26, 2015

Recently I have had an influx of shoulder based injuries suffered by golfers. Now, not all injuries have been a result of their golf swing. Many patients have actually been recovering from other injuries and even surgery, simply wanting to return to the game that they love. I thought this would be a good opportunity to discuss the main causes of golf related injuries and what you can do to prevent them.

The most common shoulder injuries for golfers:

  1. Rotator cuff tear or inflammation
  2. Impingement (soft tissue swelling)
  3. Bone spurs
  4. Cartilage damage
  5. Arthritis

 

I feel sorry for the shoulder, especially for golfers' shoulders. It's often not the shoulders' fault that someone is experiencing debilitating pain. After screening these golfers, it’s pretty easy to see that the problem is often coming from somewhere else.

Golfers have a thirst for information, be it the latest technology, the recent PGA results, or simply an analysis of their own game. Most will know what a good golf swing looks like. It’s reproducing that swing ourselves that provides the challenge. We all know that movement should follow this basic sequence:

  1. Hips/pelvis
  2. Torso (thoracic spine)
  3. Shoulders/arms
  4. Clubface

Professional golfers from Rory McIlroy to Jim Furyk maintain this same sequence, despite looking drastically different. When we fall foul of this sequence, problems occur. These problems may include:

  • Repetitive strain on joints and muscles
  • Loss of distance
  • Poor ball striking
  • Unreliable distance control and accuracy

Golf Ball

The shoulder is a common site of injury for golfers

It is the main structure that transmits the force and power from the torso to the arms and club. Too often I see people in my clinic who use ‘too much arms’. This refers to an excessive reliance on the arms for power and distance. These people always have one (if not all) of the following results on a physical screen:

  1. Poor hip rotation trail leg
  2. Reduced torso rotation to the right (backswing)
  3. Poor core and glutes strength

This is often matched with:

  1. Poor shoulder and back flexibility
  2. Weak back/shoulder blade muscles

These issues create unnecessary loading and stress on structures in the shoulder joint. If the hips and back are not moving the way they should, then how on earth will the shoulder ever cope?

 Gary Player

How to fix shoulder pain

Screening is the priority. Knowing exactly what your body is unable to do is paramount to finding a fix. I see patterns as I have mentioned above, but everyone presents a slightly different case. By knowing exactly what a golfer needs to work on, I can eliminate the unnecessary exercises and focus on the most important.

Hip and back stretching will be a great start. Here are two excellent stretches to get started on better hip and back mobility:

  1. Thoracic rotation stretch with club
  2. Dynamic hip rotations

The next aim will be to control and transfer energy with a stronger core and glutes. Here are two exercises to begin to improve core and glute strength:

  1. Bridge with leg extension
  2. Bird/dog

Of course the shoulder needs special attention as well. Despite causes potentially coming from other areas of the body, the shoulder isn’t always so innocent. Here are two exercises to help the shoulder become more reliable in the golf swing:

  1. Pec stretch/external rotation stretch
  2. Rotator cuff strength and shoulder blade control (theraband row with ER in abdn)

These exercises are a great start. Of course, once you achieve a more efficient body, good coaching is paramount to improving skill. This is where good coaching can take your game to the next level - not only when it comes to injury management, but also to lower that handicap.

Good golfing!

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Thanks for reading!

This post has been written by PhysioActive physiotherapist Joel Bates.

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