There is nothing more frustrating than not being able to play golf because of injury. Maybe you over did the practise, or perhaps five rounds of golf in a week proved too much for your knees. My guess is that most golfers over 50 years old have experienced one or more of the common injuries.
Isy Fergusson at Elite Performance Therapy is an important part of the infrastructure for golfers on the Costa del Sol.
I met with Isy and talked to her about common golf injuries, how to prevent them, how to recognise that you might have one and what to do if you pick up an injury.
JW: Hi Isy, let’s talk about the most common injuries you see from your golfing clients.
IF: Here at Elite Performance Therapy we work with a lot of professional and amateur golfers. One thing that they have in common is that they love to play golf but hate being injured!!! The chances are that if you are a devoted player, you will suffer from one or more of the common golf injuries at some point.
If golfers were more aware of the problems and how to prevent them, or in the worst case come and get treatment as soon as a niggle appears, then we can keep you playing great golf with fewer days lost to soreness and less strain on your body.
JW: Can you run us through the most common injuries?
IF: Let’s start with Back Pain.
BACK PAIN
A golf swing puts rotational stresses on your back. A practise session where you hit 60 balls is more or less equivalent to 2 rounds of golf. Twenty minutes on the putting green can start to feel very uncomfortable as you hunch over your putter. Tiger Woods famously had his putter lengthened by an inch in order to make his practise sessions more comfortable.
Lower back pain is the most common discomfort you are likely to feel, it is also common to experience a shooting, stabbing pain between your shoulder blades.
To prevent back issues, practice correct form and regularly exercise the muscles of your back (focusing specifically on trapezoid and pectoral muscles). Flexibility exercises such as yoga can also help to prevent back injuries.
The moment you feel a twinge or stiffness begin treatment. Do not delay! To treat back pain once it has begun, choose from the following depending on severity:
Rest!
Alternating hot and ice packs – natures way of dealing with inflammation
Pain medicine that also reduces inflammation, such as ibuprofen.
Seek guidance from a qualified therapist that can help diagnose your condition and so refer or suggest soft tissue release / structurally influence
Steroid injections
Surgery
If you exercise and stretch regularly, 3 to 5 times a week the difference you feel will amaze you. When you have finished a round of golf you might be delighted to realise that you don’t feel stiff at all!
ROTATOR CUFF INJURIES
The rotator cuff are the four stabilizing muscles located in each of your shoulders. Rotator cuff impingements are when the muscles swell and pinch the space between the arm and shoulder bones. Another type of injury occurs when one of the tendons or muscles tear. Very painful and very restrictive.
Both common types of rotator cuff injuries cause pain and inhibit your game. If you feel tightness, even a slight discomfort or restriction in your shoulders or when raising your arms then please do not ignore it! The longer you leave it the greater the risk of doing long term damage. Long term damage means months of rehabilitation to fix it!
Preventing injury to the rotator cuff is not difficult. As always practise correct form and engage in strength training alongside stretching the muscles of the shoulders, back and abs.
Also be aware of proper posture and engagement of the muscles in your upper back.
If you have suffered a rotator cuff injury, first please follow the RICE Principle: rest, ice, compression, and elevation. Follow up with exercises designed to strengthen and engage your shoulder and back muscles. There are lots of great channels on YouTube that show you the exercises you need and also show you how to do the exercises correctly using proper form.
If after 2 weeks you see no improvement please do seek guidance from a qualified therapist that can help diagnose your condition and so refer or suggest soft tissue release / structurally influence.
TENNIS ELBOW AND GOLFER’S ELBOW
Tendinitis in the elbow is commonly referred to as either Tennis or Golfers Elbow.
Tennis elbow or lateral epicondylitis refers to irritation and inflammation of the outer tendon, whilst golfer’s elbow or medial epicondylitis refers to irritation and inflammation of the inner tendon. Strangely, more golfers suffer from tennis elbow than golf elbow, either affliction can be very painful.
Symptoms to look out for:
Pain and tenderness on the inside / outside of the elbow.
Symptoms usually develop gradually over time and are an uncomfortable niggle. Specifically over the medial epicondyle (prominent bony protrusion).
Pain is worse when attempting to grip things.
You will have general weakness in the wrist.
Many of the golfers that visit me with this condition believe that repeated impact on driving range mats can be a trigger. Tendinitis shows up after overuse of the tendons involved, so be sure to rotate your practice regimen to allow your elbows and arms to get adequate rest.
Treating tendinitis is usually fairly simple, although you might have to grit your teeth and put the clubs away while you allow your body to heal.
KNEE PAIN AND DAMAGE
As you stabilize the rotation of the hip axis at the beginning of a swing, you can end up putting a lot of stress and strain on a weak knee. Knee injuries vary in type and severity, and it’s no secret that knees suffer more as you age. If you are noticing knee pain during your game, visit your doctor sooner rather than later!
Location / Type of Knee Pain
1) Sudden Onset / Acute Injuries
Sudden onset knee injuries involve injury to various structures of the knee, including ligaments, tendons, cartilage, and bone.
2) Anterior knee (front)
This refers to the front of the knee. Injuries often involve the patella (kneecap) or the patellar tendon which connects the patella to the tibia (shin bone).
3) Lateral knee pain (outside)
Lateral knee pain refers to the outside of the knee. It usually, but not always, develops gradually through overuse and can be linked to your ITB tendon. Iliotibial band (ITB) syndrome is a very common , stubborn and painful condition that is usually a repetitive strain injury.
4) Medial knee pain (inside)
Pain on the inside of the knee can develop gradually over time from wear and tear. Sudden onset injuries often result in injury to the medial ligament and cartilage meniscus. A major cause, particularly in older athletes, is Osteoarthritis (degeneration) of the joint.
5) Posterior knee pain (back)
Pain on the back of the knee commonly is seen as either:
Inflammation, or more likely degeneration of the Biceps femoris tendon. (One of the muscles that make up your Hamstring).
A strain of the small Popliteus muscle located at the back of the knee joint.
A tear or one of the hamstring tendons which insert at the back of the knee (usually the Biceps femoris).
To prevent knee pain, be sure to gently stretch your calves, hamstrings, ITB, thighs, and core muscles before heading out for a round.
A simple yet often overlooked factor in prevention is to wear good quality golf shoes. Wear quality shoes with good arch support, and use a brace or support if you feel weakness or twinges.
If you already suffer from knee pain, you’ll need to seek guidance from a qualified therapist that can help diagnose your condition and so refer or suggest soft tissue release / structurally influence. Please be aware that if you ignore knee pain, you can end up doing incredible damage, which has the potential of greatly affecting your ability to play.
Summary
As a simple guide you should not feel any points of discomfort or pain after a game of golf. Do some research on YouTube and find a golf related stretching program that you can do at home. Just 15 minutes a few times each week can be a huge help in preventing issues and also make a huge difference to your flexibility and mobility.
If you feel any discomfort then take action. Rest, do something to alleviate the inflammation. Contact a therapist. Do not ignore it!
As a therapist my goals are to reduce inflammation, gently strengthen the muscles and tendons, and advise you on how to avoid future injury.
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