A Most Dangerous Game: Golf Injuries

Why are golfers always getting hurt?

Curt Pesmen

Fact is, there is nothing inherently natural about the golf swing. It’s a beautiful thing when uncorked smoothly and effortlessly, and even more so at times in ultra-slow motion on Sunday last round championships. All fluid arcs and loads and torques and uncorks… and yet it’s hell on an un-prepped or under-prepared body. The mighty swing, don’t we know, can create musculoskeletal havoc without warning—even when performed perfectly, rhythmically, by a low-handicapper who’s done his or her proper warm-ups. Here are a few reasons why that’s so.

The following injuries were below 5%: neck, hip, ribs, ankle, foot, head, thigh, face, abdomen, calf and forearm.

1) LOWER BACK (35% of injuries reported): The first and most common source of complaint and injury among pros and amateurs is low back pain, of several varieties and causes. Overuse and excessive rotation are key reasons for the high count (see chart, opposite). Also, the average amateur swing packs 50 percent more torque than a pro’s. Perhaps surprisingly, thinner golfers tend to report low back pain more often than those with higher (on average) Body Mass Index (or BMI). One reason for the thin player disadvantage, offers Maurie Steinley, a physical therapist who trained at the Rocky Mountain University of Health Professions in Utah, may be that excess torque is distributed unevenly—in more of an “S” shape—upon the spines of those who weigh less. 

ALERT: Epidural steroid injections, while quite popular, can over time weaken bone tissue and increase the risk of fractures along the spine, according to pain specialist Christopher Centeno, M.D., of Centeno Schultz Clinic of Broomfield/Denver. 

2) ELBOW (33%): Even if they never set foot on the court between rounds, painful recurrent “tennis elbow” can afflict golfers of all skill levels due to overuse, or simply from hitting too many balls on the range just once a week or even less frequently. (There are reasons touring pros often limit pre-round practice to between 30 and 45 swings.) Then too, slight imperfections in mechanics, or seemingly obvious corkscrew mechanics that cause swing faults, can also impinge the joint that’s critical for proper swings—and for mighty fist-pumps after elusive birdies or eagles.

3) HAND/WRIST (20%): Unfortunately, the most glorious of rescue shots sometimes result in hand or wrist traumas that “reverb” with every swing that follows the round. Or for even longer. (While “normal” fractures often take six weeks to heal, scaphoid or wrist fractures can take nine to 12 weeks to heal.) What may look like an easy “pick” from behind that veiny tree root can and will stop a rescue club in its tracks—and send shudders into your grip and wrist and hand joints and tendons. All of which are finely tuned and often sinewy, but not built for unexpected shock led by an extra-forceful, TV-worthy attempt that goes askew in an instant.

ALERT: Hero shots are felt first and foremost in the hands and wrist.

4) SHOULDER (12%): Set-up and posture can go a long way toward protecting your shoulders, especially your lead (left if you’re a righty) shoulder, from impingement or injury. Even absent a proper lesson with a pro, a quick smartphone video shot by your partner on the practice tee, can let you instantly see whether you are starting your backswing from a straight, vector-like address.

If not, you may witness your posture as somewhat C-like in shape, from feet through core, and curving up over a bent spine into slightly slumped shoulders. The shoulder cap and rotator cuff are amazingly resilient ball joint components, to be sure, but they don’t handle excess stress and undue golfing forces very well without proper alignment, Dr. Centeno tells his golf clients. The four (vulnerable) muscles of the rotator cuff are the supraspinatus, infraspinatus, teres minor and subscapularis. They need—and appreciate—proper support.

5) KNEE: (9%): While many golf fans remember Tiger Woods’ limping-left-knee victory at the ’08 U.S. Open, fewer recall that he had surgery just eight days later for a torn anterior cruciate ligament (ACL). And far fewer remember that he had undergone three surgeries already on that same knee: in 1992, in 2002 and earlier in 2008.

This is one way to say that in golf, especially high-level golf, where swing speed accelerates through the ball-strike and follow-through, knees never forget what’s done to them.  Especially the lead knee (in Tiger’s case his left). You lock in, press down, press ahead, press through; you drive all your body’s power from core through quad and into and through the strappy architecture of the knee joint. Knees remember like elephants. And far too often they feel as if that’s exactly what’s just stepped on them.

ALERT: In the seven years since Woods’ wobbly win, platelet-rich plasma (drawn from the patient) and stem cell injection procedures into knee (and other) joints have led to celebrated, pain-free, nonsurgical solutions and new legions of related success stories.

[Sources: Maurie Steinley, PT, PhysicalTherapy.com; Centeno-Schulz Clinic, Broomfield, Colo.]

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