SHOULDER

Shoulder injury for both the amateur and pro golfer is relatively low

• Having shoulder pain when playing golf?
• Starts off just an ache, but gradually becomes more painful by the end of your game?
• Difficulty putting on your seatbelt or finding a comfortable sleeping position?
• Taking painkillers to get round the golf course?

Your shoulder joint is a complex structure made up of a series of several joints working in unison.

Even although shoulder injuries in golf tend to be less common than injuries in other parts of the body, swinging a club still places a significant amount of stress on the shoulder.
A perfectly executed and painless golf swing requires the cooperation and synchronisation of all the 17 muscles and 4 joints that make up your shoulder.
If any of these muscles or joints are dysfunctional, a painful swing can result.

Contributing Factors

• Overuse
• Poor swing technique
• Inadequate warm up
• Poor strength and flexibility of the shoulder, arm, back and legs
• Advancing age

Professional

Poor conditioning and flexibility are not normally the issues for the professional golfer. Overuse is usually the main cause of shoulder issues. The average professional can put the shoulder through 2,000 revolutions a week.
With each swing comes some degree of micro trauma to the shoulder complex and surrounding soft tissue. Soft tissue thickening and inflammation may occur, resulting in shoulder pain and stiffness and with continued play, further injury and muscle weakness occurs. A repetitive cycle ensues; the weakened and painful muscles are unable to do their part, which results in even more strain where the whole structure is unable to function correctly.

It is important to address any shoulder issues to help minimise future injury risk.

First of all it is important to examine the neck and mid back to see if there are any restrictions that could be affecting the movement of the shoulder.

Swinging a golf club places a significant amount of stress on the shoulder. A good executed and painless golf swing requires the cooperation and synchronisation of the entire shoulder complex. If even one part of the shoulder complex is dysfunctional, a painful swing may occur.

Shoulder pain, weakness and loss of mobility are all signs of an overuse injury. Do not ignore these warning signs by continuing to ‘play through the pain’. Treatment, rest and correction of the body biomechanics, together with a slow return to golf, is usually enough to resolve many shoulder issues.

If you are having any issues with your shoulders then avoid future injury and book your consultation at the Golf Injury Clinic today on 07469 205041

ELBOW

Do you suffer from:

• Pain in the inside or outside of your elbow?
• Pain that radiates into your forearm?
• Pain that increases with activity/movement?
• If you touch it you can hit a hot spot of pain?
• You often can feel numbness or tingling into your fingers?
• Pain is usually worse at the top of your backswing and at impact with the ball (or ground)?

If you are saying yes to any of the above, then chances are you may be suffering from Tennis or Golfer’s elbow.

But you play golf, not tennis?

• Tennis Elbow – If you have pain and tenderness on the outside of your elbow.
• Golfers Elbow – If you have pain on the inside of your elbow.

Just to confuse matters, tennis elbow is the most common elbow injury for golfers.

4 main causes of Elbow Pain:

1. Age
2. Poor conditioning
3. Poor/lack warm up
4. Excessive play/practice.

The primary cause of elbow pain is joint hyper-extension at impact

During the backswing you will reach the end range (elastic barrier) of your shoulder blade and socket of the forward arm, you then bend your elbow to compensate for any tightness in order to keep the club head speed farther behind your body. During the downswing, your bent elbow snaps into hyper extension (bends too far back) at impact with the ball.

Have your elbow examined to help rule out other causes such as arthritis, ligament injury, nerve irritation or neck issues call Golf Injury Today on 07469 205041

WRISTS

Are you suffering:

• Constant bruised feeling in your palm near your index finger?
• Pain when gripping your thumb?
• Index finger feeling ‘stuck’?
• Swelling?
• Clicking at wrist or thumb?
• Clumsy poor grip?

Fractures, tendonitis and nerve injuries are a few issues caused by overuse/ excessive play, poor swing technique or a hit involving hard surface.

Anatomy

Your wrist is made up of 2 larger bones of the forearm, your ulnar and radius bones. You then have 8 carpal bones made up in two rows (like mini pebbles.) Your wrist is a complex of many small joints that interlock with their neighbour just like a jigsaw. Ligaments and other soft tissue keep these bones together providing stability for your wrist.

Wrist pain is a common occurrence among golfers.

There two general types of upper extremity injuries:

• Striking injuries
• Repetitive strain injuries

Striking Injury

This can occur when hitting the ball from the deep rough. As the club face meets the resistance of the thick grass it will decelerate rapidly relative to your arms. In other words, the club face has all but stopped and the arms and hands keep moving at a high rate of speed. The result is a potential sprain/strain of the muscles, tendons and ligaments of the wrist and/or elbows.

Repetitive Strain

This syndrome will have two root causes:

• Incorrect grip on the club.
• Failure to keep the club shaft on the correct incline plane during the swing.

Either way, these faults have the potential to create extreme mechanical strain on the connective tissues of the upper extremities.

This is the root cause of a repetitive strain syndrome: being out of positional alignment, then repeatedly swinging the golf club.

Remember, your average swing of the club can build up to 90 mph. When you are playing a round of golf or go to the driving range you will swing the club hundreds of times. If your body is out of sync, it is easy to be injured.
When your hands are placed on the club, your wrist pain will have everything to do with how the wrists hinge and the right elbow folds (for the right-handed golfer) when swinging the club.
When your hands are incorrectly placed on the grip, it becomes difficult to get the club shaft into the correct upward position as the club head moves behind the body.

When you are out of position at the top of the backswing, it puts a mechanical strain on the right elbow and wrists when they try to find the downward path back to the ball with the club head travelling at 90 mph.

HIPS

Having hip pain when playing golf?

• Pain in the very base of your back?
• Pain in your groin region?
• Do your thighs ache?
• Feeling stiff if sitting for too long?

Golf injuries vary in severity; minor muscle strain, tendonitis, bursitis or joint pain can be the cause of your hip pain

When the pelvis becomes dysfunctional, most golfers can not position their back foot correctly. If this sounds like you, when you try to do this, you will more than likely experience pain in the sacroiliac joint (area just below your back) as your hips rotate during the backswing.
For relief, you will ‘open’ your back foot to be able to rotate with less pain. Unfortunately, an ‘open’ back foot will result in loss of power and an inconsistent direction of ball flight.

Without correct lumbar (low back) curvature you will be at a mechanical disadvantage when you try to swing the club. The lumbar curve is an essential source of mechanical leverage for rotating your hips when swinging at a golf ball.
For the right-handed golfer, if your sacro-illiac joint (base of back that looks like a half moon either side of your spine) is dysfunctional, the transfer of your body weight onto your right side during the backswing will require more effort, as you attempt to coil into a ‘longer’ functional leg.
In addition, the coil will be restricted and painful for you, since the right ilium will have a problem releasing in order to receive the transfer of weight into that right hip.

• The main cause of hip pain from golf is the high amount of pressure placed on the joint and surrounding muscles during the swing.
• The external rotation of your hips during your swing can put significant strain on the joint with repetitive practise; think how many times you do this motion when playing 18 holes of golf.
• The speed at which you swing the club around your body can also place unwanted stress on your hips if your swing is not controlled or smooth.
• Golfers with strong hip muscles have lower handicaps and longer driving distances than those with weak hip muscles

Playing good golf requires the muscles of your hip complex to be conditioned in order to help provide better trunk stability that may in turn be related to better golf performance. An overall strength and conditioning programme is an important part of preventing musculoskeletal injuries.

If you are suffering from hip pain then call today to arrange your Golf Specific examination on

07469 205041 or email [email protected]

KNEE PAIN

Knee pain is a common cause with golfers who position there back foot outward at the address position.

The knee must be able to maintain it’s postural alignment above the ankle during the backswing. The most common reason why golfers avoid positioning their knee like this is because they do not have the flexibility to have their back foot straight. Without this flexability, you lose the ability to rotate your hips, therefore lose the rotation needed for a powerful swing.

Repeated stresses placed on the knee joint will, over time, result in ‘wear and tear’ of the knee including its ligaments, shock absorbers and the joint itself.

Here at Golf Injury Clinic we look at the whole picture and consider your low back, hip and ankle/foot to rule out these areas as the root cause of your knee pain.

HEEL PAIN

• Feeling pain first thing in the morning or after periods of rest?
• Does your foot or heel start to ache as you make your way around the course?

Some golfers develop chronic ankle instability from previous ankle sprains that failed to heal properly, which causes a weakness in your balance. The achilles tendonitis can also contribute to balance instability during your golf swing. Any restrictions in any of the bones of your foot and ankle can cause compromise to other surrounding structures. Ill fitting golf shoes may cause corns and calluses that make standing uncomfortable. Inflammation of the tendon that runs along the arch region is a common golfing injury as the foot can be placed under excessive pressure during the golf swing (plantar fascitits)

Common Conditions Causing You Pain And Affecting Your Game

• Arthritic inflammation and/or ‘wear and tear’ of the joints in your foot and ankle. Ankle arthritis or ankle instability can affect the weight shift during the golf swing.
• Neuroma (nerve) – A nerve may become thickened, enlarged and painful because it has been compressed or irritated. A neuroma in the ball of your foot can cause significant pain as your body transfers its weight from one foot to the other while swinging the club. Inflammation of the nerve between your toes may occur. This can be very painful for golfers while walking round the course.
• Joints in your foot or ankle may become restricted and dysfunctional.

Good footwork is essential to playing better golf – but what is good footwork?

• Good footwork begins with feet that are fit, functional and mechanically sound.
• The feet are designed to point straight ahead; each foot is designed to be directly beneath the knee.
• When the feet are out of positional alignment, unwanted movement occurs in our gait muscles, beginning in the hips. In this scenario, the body must introduce compensating motion with every step. With every step, rather than a smooth swish swish motion, we end up with more of a clunk clunk motion.

Stability, Power and Balance

The Arches
You have 3 arches in your feet:

1. One on the outside of your foot
2. One on the inside of your foot
3. One that goes across your foot

If any of these 3 crucial arches are not stable, over time, this instability will place the ankle, the knee and the hip of the back leg at risk of injury. If our feet tilt either inwards or outwards when addressing the ball, this will influence the stability of the pivot during the backswing. 75% of the body weight transfers directly into the muscles of the back leg at the top of the backswing. The back foot must be able to support this weight transfer and then push the weight to the front foot during the downswing.

Any instability in your foot is going to make this very difficult to achieve.

Additionally, a golfer, on average, will walk three to five miles over a period of four to five hours while completing 18 holes of golf.
With poor foot stability, bunions, corns or hammer toes, the golfer risks chronic instability when attempting to transfer the weight during the golf swing or walk without compromise.

When your feet are not in top condition, your golf swing will not be either. Why delay, call today on 07469 20504 or email [email protected]  for your golf specific assessment