Health & Wellness | Modern golf swing can hurt your back. Here’s how to prevent injuries.

Cory Zacker practices his golf swing at Piedmont Park on Sunday, May 30, 2021. (Photo: Steve Schaefer for The Atlanta Journal-Constitution)

Credit: Steve Schaefer

Combined ShapeCaption
Cory Zacker practices his golf swing at Piedmont Park on Sunday, May 30, 2021. (Photo: Steve Schaefer for The Atlanta Journal-Constitution)

Credit: Steve Schaefer

Credit: Steve Schaefer

During your next golf foursome, eyeball your three companions. One of you may be about to hurt your back, if you haven’t already. More than a quarter of recreational golfers develop back pain associated with the sport, according to some estimates.

That percentage can rise to above 40% among elite and professional players, studies indicate, numbers that are believed to dwarf those from generations past.

A few rounds of golf don’t have to end with wincing and sore spines, though, experts say. Simple changes to your golf routine could help keep both your back and handicap in good shape.

Changes in the golf swing

“Golf never used to hurt the back like it does in more recent times,” said David Lindsay, who recently retired after more than 20 years as head physical therapist at the University of Calgary Sport Medicine Center in Canada. He’s treated many golfers and avidly plays the sport himself.

“A lot of that has to do with the evolution of the swing,” he continued.

Decades ago, in the era of World Golf Hall of Famer Ben Hogan and his contemporaries, the golf swing was gentler than it is today, Lindsay said. A golfer would typically rotate his trunk, shoulders and hips almost in unison as he raised his club into a backswing.

Tiger Woods and other professionals have popularized a more explosive version of the golf swing, now seen in variations at all levels of the sport. The golfer’s hips remain almost stationary, facing the ball during the backswing, while the torso and shoulders forcefully twist through the ball.

This intense screwing motion coils the body’s core muscles, building up stored energy, like a rubber band being twisted and pulled tight.

Then, slashing through the downswing at velocities that may exceed 100 mph, a golfer generates enormous power as they strike the ball, sending it winging far down the green.

Players’ long games have improved with this swing when done well, Lindsay said.

But the performance gains have “consequences,” he added, especially for the spine.

The crunch factor

Today’s version of golf has become a “very spine-intense activity because of all the twisting that you’re doing,” said Andrew Hecht, the chief of spine surgery at Mount Sinai Hospital in New York City.

In biomechanics studies, male golfers who whipped through a modern-style golf swing generated forces equal to at least six times their body weight.

These forces, especially during the downswing, converged on vertebrae in the golfers’ lower backs, most notably on the right side of the spine for right-handed players, compressing the vertebrae to such an extent that orthopedists call the effect the “crunch factor.” (Virtually all golf-injury studies have included only male golfers, so it’s uncertain if female golfers’ swings and backs respond in the same way.)

In comparison, runners’ spines typically absorb forces equal to only about twice their body weight with each stride, Lindsay said.

During the follow-through, spines then torque again, in the opposite direction, as many golfers twist their trunks sideways more forcefully than they might feel comfortable - or even capable of - doing away from the green, Lindsay said.

All of this twisting and curling results in a fundamentally “unnatural motion,” said Vijay B. Vad, a physician and sports medicine specialist at the Hospital for Special Surgery in New York City and co-author of the 2007 book “Golf Rx.”

“It’s rotation with high velocity,” he said, a way of moving that occurs in few other sports or everyday activities.

How to protect your back

Golfing and healthy backs can coexist, most experts who work with or study the players said, if golfers follow a few precautions.

Interestingly, altering your swing may not be one of them, said Dan Coughlan, a physical therapist and the head of strength and conditioning with the European Tour Performance Institute. Large-scale studies haven’t yet found links between changing swing mechanics and avoiding or recovering quicker from back problems.

“There’s not enough evidence to say to a golfer, ‘If you reduce the amount of side bend in your golf swing,’” or otherwise tweak how you move, “‘you are less likely to have back pain,’” Coughlan said.

Any change might also ding your scores. “It’s a bit like telling a 100-meter sprinter to run slower,” he said. “They might get hurt less, but they won’t win anything.”

Other fixes, though, seem more likely to be effective without reducing performance. Here are some of them.

Try these stretches

A few basic stretches can help prepare your body and spine for the demands of the golf swing, said Demarkis Cooper, a PGA-certified instructor at CitySwing, an indoor golf studio in Washington.

Forward stretch for golf prep

Credit: William Neff/The Washington Post

Credit: William Neff/The Washington Post

Side stretch for golf prep

Credit: William Neff/The Washington Post

Credit: William Neff/The Washington Post

Reduce practice swings

Cut down on practice swings. A majority of back-related problems in golf are because of overuse, not sudden, acute injuries, Coughlan and others pointed out. In one of the few large epidemiological studies of injuries in the sport, almost 83% were attributed to overuse.

“Every swing you take puts a little micro-trauma on your spine,” said Scott Lynn, a professor of kinesiology and biomechanics at California State University at Fullerton, who studies golf swing mechanics. (He is also the director of research for Swing Catalyst, a for-profit company that sells equipment designed to analyze strokes.)

Over multiple rounds of play and practice, the micro-traumas can begin to accumulate into small, aggregate damage to the spine and surrounding soft tissues.

“Build up your game sensibly,” Coughlan said. Take 50 practice swings, instead of 70 or 100, especially with harder swings and heavier clubs.

Strength train

Strength train with a focus on the core and shoulder muscles, Lindsay said, to help stabilize the spine as you swing.

Warm up before swinging

Warm up before you play – something too many golfers neglect, the experts said.

A warm-up can be as simple as walking around the course near your tee for at least 15 minutes, Vad said, which will help raise your body temperature, stimulate muscles in your lower back and legs, and increase blood and oxygen circulation to tissues. (American courses often encourage golfers to use carts, instead of walking from one hole to the next, to speed up play. But you should be able to stroll in the vicinity of your tee.)

Should your back pain after golf linger for more than about a week or cause you acute discomfort, talk with your doctor, Vad said. But for most golfers, back aches tend to be relatively minor and will often resolve over time.

With a little care, common sense and a 15-minute walk beforehand, golf can be “one of those sports that people play for their whole lives,” Hecht said.

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