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Golfing Injuries and
Alternative Treatments
Ross
Hauser, M.D.
What hurts golfers the most?
-Lower back strain and injury
-Left shoulder strain and injury
for right-handed players
-Left lateral or strain (epicondylitis)
of left elbow for right-handed players (analogous
to
Tennis
Elbow)
-Right shoulder strain and injury
from overuse
-Right hip and knee injury from
aggressive driving motion of downswing
In our practice we see many golfers with various
problems related to "overplaying" or "over doing it" on the greens on the
weekend.
Building Golf Muscles
The major large muscles of the
upper body used are the "pecs" or pectoralis, the muscles connecting
to the shoulder blade, such as the rotator cuff muscles, including the
supraspinatus and infraspinatus, the muscles covering the shoulder, including
the deltoids, as well as the "lats" or latissimus dorsi, and
serratus posterior.
The large muscles of the lower
body used in the golf swing are the large pelvic muscles, the "glutes,"
or gluteus muscles of the rear end, "hamstrings," or semitendinosus
muscles in the back of the thigh connecting the power to the "glutes,"
for the downswing, and the "quads," or quadriceps muscles for
initiating and finishing the upswing.
The use of proximal muscles for
power, consistency, and "repeatability without strains" can make the
difference between a well-controlled powerful stroke and a weaker
"wimpy" hit.
The golfer must discipline
themselves to use the shoulder/chest muscles and the trunk/leg muscles
connected and coordinated with the smaller muscles of the arms for the
execution of the swing. Remember that the muscles closer to the hands and feet
are for fine movements and not for power, and are highly susceptible to injury
when used to generate power. I have seen men with "black and blue
marks" (ecchymoses or hematomas) on their forearms from the tension of
gripping their clubs so tightly, with their distal muscles, to force a
powerful swing.
Back and sacroiliac problems:
Usually,
the person with this problem finishes their downswing and follow-through
ending with a typical Reverse "C" position, thus straining the
vertebrae and sacroiliac joints, leading to chronic injury.
Left shoulder: The abuse
of the left shoulder from the age-old teaching of pulling the left arm on the
downswing has led to not only ligamentous injuries but also rotator cuff
injuries. Rotator cuff simply means injury to the four muscles adjoining the
shoulder, but most frequently the supraspinatus muscle.
h
Left elbow: This injury
results when those golfers who cannot rotate their body towards the direction
of the intended shot are overly zealous with the use of the left arm. They
fail to flex and externally rotate their left elbow, as they come into, and
through, the zone of impact. These individuals often have arm straps, worn
below the elbow, while playing tennis or golf. This problem is difficult to
treat using conventional methods because, over time, the tissues become
degenerated, including the tendinous part of the brachialradialis muscle, as
well as the wrist extensor muscles.
These golfers need to learn how
to strike the ball with maximum use of their body, and to externally rotate
their left elbow, while keeping the left wrist stiff and rolling the right
hand/wrist, as in a topspin stroke in tennis, during the impact.
Right shoulder: This
overuse problem occurs more in professional players and instructors.
Right and left pelvic and
gluteus muscle injury: The overzealous player who plays 36 holes for each
day of the weekend may feel the strain of repeated contractions of these large
muscles on the downswing. This problem is more pronounced in those who end with
the Reverse "C" posture after completion of the swing.
Right Knee Injury: For
those who have had previous surgery, such as an
ACL (anterior cruciate ligament)
repair, the overuse of driving the right knee and foot towards the ball on the
downswing may cause injury and strain.
The importance of using the CORE
or big proximal muscles in sports is the only way to lessen the visits to the
doctor and
chiropractor.
Case Studies on Golf Injuries
Treated by Prolotherapy:
Learn more about
Prolotherapy
and to find
Prolotherapy
doctors
J.M. is a 55 year old white male
professional golf instructor who noted severe back pain from his daily work
that he could not sit in a car for more than 20 minutes. Physical therapy and
chiropractic manipulations only temporarily relieved his symptoms. His lower
lumbar ligaments and sacroiliac joints were injected with 15 percent dextrose
in three sessions, two weeks apart. His symptoms were relieved by 90 percent,
and his awareness and correction of his swing, by avoiding the Reverse
"C" at the finish of his downswing helped prevent the recurrence of
the problem. These types of professional athletes are commonly prone to this
problem because of overuse, yet the relief of symptoms after
Prolotherapy
treatment is most impressive.
J.C., a 58 year old white male
executive "weekend warrior," developed a sore left shoulder after a
week of golf camp and noted a clicking sound when pressing down with his left
arm. His examination revealed tender coracoacromial and trapezoid ligaments in
the shoulder. The
MRI was negative for rotator cuff tear. He was treated with
five sessions of Prolotherapy, injecting the shoulder joint and the involved
ligaments. He recovered and can now play pain-free. Before his injury, he was
taught to use the body to "pull the left arm" on the downswing and
use as little of the right arm as possible. We advised him to use the
"handkerchief" technique of keeping his left shoulder close to his
chest, so that the handkerchief is trapped between his left arm and the chest
wall on the downswing. This promoted the use of the large muscles of the
shoulder such as the pectoralis, deltoid, latissimus, and the serratus muscles
to work together with the left arm muscles. The equal use of the left and
right arm swing, with proper left elbow external rotation and right wrist
pronation, prevented recurrent injury.
P.R., a 49 year old male
collegiate football coach, developed left elbow pain after excessive playing
during the summer months. The pain was severe and he used a forearm
compression brace on the tendinous portion of the lower arm muscles (brachialradialis),
as commonly used by tennis players. The lateral epicondyle and lateral
collateral ligament were injected. He received a total of six injection
sessions with "near" complete relief of symptoms. He was taught to
use proper external rotation of his left elbow on the point of impact and
follow-through on the downswing. The complete resolution of his problem was
possible only after he took four to five private lessons to correct his body
rotation to lessen the strain on his left forearm.
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