One thing about living in the Southern California South Bay is that a lot of people in this area play golf. Ever since Tiger Woods became a household name, the game has exploded in popularity. Personally, I’ve never been a really big fan of it. Sometimes when I go home to visit some of my friends its kinda fun to head out to the golf course and play nine holes or so, but it’s not something that holds my attention for long.
For a growing number of people though, golf is quickly becoming a passion. People from their early teens well into their 80s are taking up this game. I think it has become more popular in certain segments of the population because it is considered to be a safer when compared to other highly recognized sports. There are, however, some inherent dangers in the practice of golf as well as other sports that utilize a high degree of rotation that I feel are important to address.
Among golf practitioners, lower back injuries are the most common type of injury reported. A survey of golf related injuries published in 2007 noted that lower back injuries among amateur golfers ranged from 15 to 34 percent and 22 to 24 percent in professionals. The instance of lower back pain in male golfers is 25 to 36 percent and 22 to 27 percent in females. This is not too surprising. Particularly in an amateur population which is probably not working with trainers or strength coaches, there are most likely limitations in both hip and thoracic spine mobility which can force the lumbar spine to compensate. The lumbar spine is not meant to rotate and forcing it to do so can result in both pain and eventual injury.
Let’s look at rotational mobility for a moment. Certain joints in the body are meant to be mobile while others are meant to stabilize and have little range of motion. If our mobility joints are not working properly, we’re more likely to put the rotational stresses on the stabilizing joints. Our stabilizing joints are not meant to move much but are designed to provide a stable base. When we force these joints to move, the potential for injury goes way up.
As an example, let’s look at the relationship between the hip joint, lumbar spine and thoracic spine. The hip is a mobility joint and is meant to be able to move freely and openly from front to back, side to side and rotationally. The lumbar spine is a stability joint and is not meant to move much. Forcing the lumbar spine to flex, extend or rotate can result in damage to the spinal discs between the lumbar vertebrae which can lead to even more serious spinal injuries. The thoracic spine, on the other hand, is a mobility joint and is meant to move freely and openly in all planes of motion. When we talk about rotational mobility in golf, the thoracic spine and the hip is where it should be coming from.
Hip mobility itself is probably one of the most important aspects of any athletic activity. Most people don’t realize this, but the hips and the lumbar spine are linked. This is why hip mobility is so important. Any lack of mobility in the hips is transferred to the lumbar spine. If you cannot fully extend your hips, you will extend your lower back. If you cannot flex your hips effectively, you will flex the spine. As you can see, it is important to maintain range of motion in this area.
There are several things we need to be doing to improve our hip mobility: foam rolling or soft tissue work to relax the muscles, stretching to improve flexibility, and strength training exercises to develop strength and stability.
is essentially massage work. By taking a foam roller and performing about 10-20 rolls up and down the length of the tight muscle, pausing on the tender areas, it will relax the tissue, relieve some discomfort associated with muscle tightness and make the tissue easier to stretch. Important areas to foam roll include the glutes and piriformis, the IT Band (outside of the thigh between the hip bone and the knee joint), the tensor fascia latae and the short and long adductors on the inside of the thigh.
Stretching is the second element that needs to be addressed. Static stretching—or stretching held for time—helps to further relax the muscle fibers while improving flexibility. Stretching should be done in increments of 30-45 seconds and should be repeated 2-4 times per muscle group.
Strength training can be done with a variety of exercises and loads. If you are performing exercises such as lunges, split squats, side lunges as well as dead lifts, Romanian dead lifts and kettlebell swings, you are headed in the right direction. It is highly important to properly warm up beforehand though. Among other things, I always take my clients through a series of bodyweight lunging exercises to warm up the body and open up range of motion. These include split squats, side lunges and rotational lunges. I normally have them do two sets of between 10-15 reps.
Hip mobility is only one aspect that needs to be addressed though. The other is thoracic mobililty. The thoracic spine consists of the 12 vertebrae that exist between the base of the neck and the top of the lumbar spine. Unlike the lumbar spine, however, the thoracic spine is meant to be mobile and is the area of the back that is meant to absorb rotation when the hips are not involved. The thoracic spine should be able to rotate 30 degrees in each direction and should be able to flex (crunch forward) up to about 60 degrees. Insuring good mobility through the thoracic spine will definitely help to reduce injury.
There are several exercises that I normally do with my clients who participate in rotational sports to keep thoracic mobility optimal. These are listed below:
Thoracic Windmill: Lying on your side, keep the bottom leg straight and in alignment with the rest of the body. The top leg bends so that the knee is even with the hip and the knee itself is bent at 90 degrees. You can place a foam roller underneath your top knee to provide support. Both hands should be together at arm’s length directly in front of your chest. While the bottom arm remains stationary, slowly begin to rotate your top arm up over your head, imitating the motion of a clock hand. As you do this attempt to rotate your top shoulder to the ground behind you, looking in that direction with your head. Keep the moving hand in contact with the ground as long as possible and once you have completed a rotation of 180 degrees, bring the hand back over the top of your body, placing both hands together and repeating.
Thoracic Crunch: Lie back on either a foam roller or a pair of tennis balls placed together to either side of your spine. The foam roller or tennis balls should be placed directly opposite of the base of your chest. Place your hands behind the back of your head and pinch your shoulder blades to pull the elbows back. Do not pull on the back of your head. From here, without involving the lower back, roll your shoulder up as high as you can, performing a crunch and then return to starting position and repeat.
Sit, Rotate and Flex: Assume a seated position on a chair that is low enough to allow your knees to be at hip height. You may also sit cross-legged on the floor. This is to prevent lumbar rotation. While maintaining a straight back, place your hands behind the back of the head and pinch your shoulder blades to bring your elbows back. From here, rotate from the base of your chest up to the side as far as you can comfortably. Once you have reached your comfortable limit, slowly bend your body to the side as far as you can comfortably then return to an upright position. Rotate a little further and repeat. Perform this 3-4 times to each side.
I normally recommend performing a circuit of the above exercises for thoracic mobility and with the exception of the sit, rotate and flex, performing 10 reps per side.
While mobility is without a doubt one of the most important aspects of rotational sports, it is important to keep in mind that proper conditioning for any sport is a valid and wise idea. This doesn’t mean a person has to embark on a hard core conditioning program if they decide they want to head out to the course with their buddies on a Sunday afternoon for a couple rounds. But a sound program involving mobility work, proper core training and some basic strength training are important things to consider… and relatively easy to justify when you consider the pain and long rehabilitation process of a spinal injury.