Better Golf (and Less Injuries) with a Balanced Body

By Ada Wells, MPT
As seen in the Fall 2009 Balanced Body Pilates COREterly

As Pilates instructors, we possess a unique set of tools that can help golfers decrease their chances of injury and improve sports performance. To have a successful golfing experience, the individual must not only possess the proper skills to know how to properly swing a club, but they must also possess the range of motion, strength, and neuromuscular control to allow their body to actually execute the swing. While it is helpful to understand the complex biomechanics of the golf swing motion, focusing on just a few key critical areas will help most golfers.
Why golf is so difficult and why all the injuries?
Having a consistent golf swing with good form is a difficult task because of the complexity of its biomechanics. Without going into too much detail, there are a few aspects of the golf swing that are helpful to understand. First, the spine is subject to a very rapid and complex loading pattern. In less than 1.5 seconds, the spine and extremities are taken to their end ranges of motion, making the extensibility of soft tissues dictate the path of the swing. Lacking flexibility in the mid-back and hips may cause the lumbar spine to bend and rotate in ways that increase spinal stress. The golf swing also involves a combination of non-functional movement patterns and rotational movements around multiple axes. Since these are not typical motions, i.e. the head moves opposite the body through most of the swing, there are different neuromuscular firing patterns that must occur. Individuals may be prone to upper body injuries if they don’t possess the strength to control their flexibility in these atypical positions. Regardless of age, gender, or experience, muscle strength and flexibility imbalances can impair one’s ability to play effectively, especially when combined with poor instruction or form.

backswing1-400x570.png
Critical Areas:
Many swing faults and injuries are the result of lacking range of motion or motor control in a few key areas. Below are some suggestions that are helpful when working with your golf client.
Spine Range of Motion and Control: Optimal spinal mobility at all levels is critical since limitations at one area will increase compressional forces on another. This is particularly important during the end ranges of the swing when control of thoracic extension and rotation need to be maximal. The pelvis should also stay relatively neutral throughout the swing to allow the body to rotate around a neutral spine axis. Note that the pelvis stays neutral despite changes in hip position and its directional orientation throughout the swing.

Mat exercises such as the mermaid and saw are helpful for encouraging spinal rotation and pelvic control, whereas the swan and swimming are helpful in working with spine control in extension.
Hip Range of Motion and Control: Good hip range of motion, particularly hip internal rotation and hip extension, is very important. A tight iliotibial band combined with weak hip abductors can be a culprit for many swing faults. What is often overlooked is the importance of also working on hip and lower extremity control in weight bearing positions.
The reformer is the obvious place to work on hip flexibility, whether performing the supine legs in straps series or the standing lunge/hip flexor stretch. Performing hip work on the reformer with the client standing in their golf address position is helpful for training muscular control with the hips in flexion and spine in neutral think speed skater or the standing splits series.
Cervical Mobility and Scapular Control: Integrating postural exercises is necessary for any sport, but with golf, the added complexity of the head moving in an opposite direction of the arms and thoracic spine makes it critical. Also, the potential for repetitive upper extremity injuries exists if the golfer doesn’t have good scapular control.
Lying supine, parallel to the foam roller is a great place to start with most golfers, as it allows them to engage their core stabilizers while mobilizing their mid-back and stretching out their pectorals. Prone exercises on the combo chair are helpful to encourage scapular stabilization while the spine moves into spinal extension and rotation positions. On the mat, the spine twist is excellent for working on good spinal mobility in neutral. Performing variations with neck and arm position can make it very functional for the golfer. Arm springs on the trapeze table can be used in standing or kneeling to work on scapular control in a variety of directions.
Summary
In general, a non-specific, but balanced Pilates session with good form and cues, will be of benefit to golfers, whether or not you even mention golf or have ever played yourself. However, if you choose to specifically target golfers or if you frequently have golfers as clients, it is helpful if you have a deeper understanding of the complexity of the golf swing. Take lessons, talk to a pro, take golf-specific fitness courses, and try it yourself so that you understand what is physically required to have a good golf swing and to maximize results with your golfing clients.
Ada Wells, MPT, owner of Rebalance, Inc., graduated from UC Davis with a B.S. in Physiology. She received her MPT from Chapman University. She is Polestar certified and a member of APTA and PMA. Ada specializes in combining manual therapy with Pilates-based exercise for sport-specific rehabilitation and performance programs with a special interest in golf. For the past 7 years, she has provided Pilates services to the celebrity golfers at the American Century Golf Championship.

 

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IMPROVE MY GAME How To Improve Rotation While Protecting Your Lower Back

Tue Jun 2, 2015 by Mike Boyle

The thoracic spine is often a neglected section of twelve vertebrae stuck between the much more talked about lumbar spine and the forever-painful cervical spine. 

 Thoracic Spine

By definition, the thoracic spine is the twelve vertebrae that connect with the rib cage and is located between the lumbar spine and the cervical spine. Because we rarely get thoracic pain we tend to overlook this critical area. Neck and low back pain are rampant so the thoracic spine is often completely overlooked. Unfortunately a big key to avoiding both lower back pain and neck pain may lie in the mobility of your thoracic spine.

In the simplest terms, the body does what is easy, not what is best. As we age the thoracic spine stiffens. As a result we tend to turn the head at the neck (cervical spine) or rotate at the lower back (lumbar spine). A mobile thoracic spine can help to avoid or relieve both low back and neck pain by allowing rotation in this key area.

In the simplest terms, the body does what is easy, not what is best.

For years we have been warming up the wrong area with the wrong exercises. Lots of “experts” recommended exercises like hip crossovers and scorpions to “warm-up” the low back.

Here’s a video I put together for Golf Digest discussing common “rotational” exercises that are probably doing more harm than good.

https://www.youtube.com/watch?v=tXEECZzqO-0

The video was essentially a spin-off of an article I wrote a few years ago titled “Is Rotation Training Hurting Your Performance?”  In the article I recommended that athletes, particularly golfers, avoid most exercises that rotate the lumbar spine and instead focus on developing motion at the hips and thoracic spine.  The truth is that good motion in golf comes from turning the hips and the shoulders not from rotating the lumbar spine. In her book, The Diagnosis and Treatment of Movement Impairment Syndromes, author Shirley Sahrmann notes a key fact that I believe has been overlooked in the performance field: 

“The overall range of lumbar rotation is …approx 13 degrees. The rotation between each segment from T10 to L5 is 2 degrees. The greatest rotational range is between L5 and S1, which is 5 degrees…The thoracic spine, not the lumbar spine should be the site of greatest amount of rotation of the trunk… when an individual practices rotational exercises, he or she should be instructed to “think about the motion occurring in the area of the chest”
(Sahrmann, p61-62)

Therefore, a way to get good hip motion and good shoulder turn is to focus on the hips and thoracic spine, not the low back. Bottom line, bad golfers turn at the low back. Good golfers turn at the hips and shoulders.

Additionally, the ability to resist or to prevent rotation may in fact be more important than the ability to create it. Clients or athletes must be able to prevent rotation before we should allow them to produce it.

As I mentioned in the video above, golfers should seek to improve internal and external rotation of the hips.  Exercises like the Comerford Hip Complex, a progression developed by Australian physio Mark Comerford, strengthens the rotators of the hips and improves lateral stability in your golf swing.

Comerford Hip Complex

Comerford Hip Complex – Video

Mobility at the thoracic spine is actually simpler to develop than you think. It doesn’t even involve rotation. What you are going to do to mobilize the thoracic spine is to perform a series of simple crunch type exercises while lying on two tennis balls taped together with masking tape or your can even put them in a sock.  It’s a simple exercise that you can do at the gym or even in front of the TV.  Dr. Rose demonstrates in the following video:

Tennis Ball Thoracic Spine Mobility

Tennis Ball Thoracic Spine Mobility – Video Link

Place the tennis balls under your back with one ball on either side of the spine. Begin at just above bellybutton level. With the balls in position do five crunches. You should feel the balls pushing into your spinal erectors (the big muscles on either side of the spine). The balls are actually pushing the vertebrae slightly forward, in effect creating motion (mobility) at the level of that segment. A series of these crunches can be done all the way to the top of the shoulder blades. The end result is often a large increase in shoulder turn. Another possibility is to foam roll the thoracic spine. Make sure the elbows are together to separate the shoulder blades and get pressure on the thoracic spine.

If you are bothered by low back pain, neck pain or want more shoulder turn try the attached mobility exercises. Just remember, it’s not always where it hurts that needs the attention. Often times it’s the joint above or below.