APRIL FOCUS – GOLF

Golf is an enjoyable and sociable way to exercise. The gentle walking activity, often over a reasonable distance, is great for us.
Sometimes golf can cause problems too. Research shows that 15 to 20% of golfers suffer injury each year. Injury is more common in recreational golfers, and more common in older golfers. As we age, unfortunately our tissues don’t respond so well to the repetitive stress placed on the body. Also ‘wear and tear’ changes in the joints don’t allow us to accommodate so easily.
The sorts of injuries seen in golfers are mainly overuse-type problems. Some are more traumatic, in relation to the large amount of force required to drive the ball forward in the golf swing.
Injuries from previous events, or other activities may also be highlighted by golf. So proper attention to any issue as it arises is ideal.
Common golf injuries are:
Lower back pain
Research has highlighted lower back problems form 20% of all golf injuries. The repetitive golf swing, and hunched stance have the potential to cause problems.
Injury could occur in any structure of your lower back. Perhaps depending on the mode of injury, posture and any underlying weakness. So it may cause problems to discs, joints, muscles, tendons and ligaments.
Golfers Elbow
Golfers Elbow is a strain of the muscle tendon on the inside of your elbow. Also Tennis Elbow can be a problem too for golfers! This is a tendon strain on the outside of the elbow. Either way, they are both caused by repetitive stress through the forearm and wrist.
Plantar Fasciitis
This is an irritation of the tough tissue called fascia on the underside of your foot.
It can be caused by repetitive stress going through the feet.  It is more likely to happen if there are changes in weightbearing, this may be related to a problem elsewhere. Changes in or problematic/inappropriate footwear may also cause this issue.
Knee Pain
Of course the golf swing places places pressure on many areas of our body. There may be similar causative factors, as with plantar fasciitis. The rotation element of the golf swing at the knee may cause problems too. Problems local to the knee could relate to the joint, muscles, tendons or ligaments.
Shoulder Pain
Shoulders are equally susceptible to injury, and can receive too much pressure in the golf swing. Problems can relate again to any of the joints that form the shoulder complex, muscles, tendons and ligaments.  More specific diagnoses you may have heard about relating to the shoulder are impingement syndromes, muscle/tendon tears, and rotator cuff strains/tears.
As an Osteopath my role is in helping people when they do struggle with such issues, and also to offer advice on prevention and management.
If you do experience a problem. Here are some treatment options:
·      *Manual Therapies. Clearly my bias is towards Osteopathy! I would aim to treat the local area where the problem is. Also, address the body overall, and identify other factors that might be maintaining or predisposing to the problem.

·      *Supports can be purchased online, at sports retailer and pharmacies. A wide variety is available for shoulders, backs, elbows, knees…..Sometimes guidance will be necessary in choosing the correct one.

·      *If you suddenly injure yourself. An ice pack is generally a good option. A proper ice pack, or frozen vegetables do the trick. Make sure nothing frosty rests on your skin, so wrap up what you’re using. Then apply to the area for 10 minutes. You can repeat this process hourly.

·      *Cold treatment creams and sprays are available. These are more portable if you’re on the move.

·      *Anti-inflammatory medication can be purchased over the counter in pharmacies. These can be useful to settle any acute reactions. You should check that this medication is appropriate for you, and doesn’t interfere with any other medication taken.

·      *If you do injure yourself. It is generally best to try and stay gently mobile.
Prevention is clearly ideal, here are some things to think about:
·     * Look after your posture as best you can. A body that is in as balanced position as possible is less likely to be injured.

·      *Look after your general health. Good nutrition and hydration are important to maintain good tissue health.

·      *If you have had a break from your golf practice. Ease yourself back in gently, and slowly increase your length and intensity of play.

·      *Golf lessons are going to be invaluable. Your golf pro can assess and address any issues with you. This should help prevent injury and improve your game.

·     * Running through a series of gentle exercises before and after your golf session should be useful to prevent injury. 

These exercises shouldn’t cause pain, if you experience a problem, stop the exercise and consult your Osteopath or other medical practitioner. If you have an existing complaint, it would be wise to consult your practitioner to check these exercises are appropriate for you.

Getting into habits of warming up, and cooling down your body with gentle exercises either side of a golf game should help ward off any potential problems. Golf combines so many forces and strains through the body. It is important to consider stability and mobility first. The following exercises will help get you started. These would be good to do regularly outside of the golf club.

Cat Stretch

This opens out the joints of the spine, stretches some of the adjacent muscles and soft tissues, and activates your core muscles. Start on your hands and knees, hands under shoulders, and knees under hips. Try and start from a neutral position in the lower back and pelvis (so not too arched through the lower back, but equally not too tucked.) Have a straight neck, with your gaze to the floor.
Begin by tucking your pelvis under, and then continuing the movement up through your lower back, then to your upper back, and then to your neck. So you are arching up like an ‘angry cat’. 
Then to return to the start position. Bring your pelvis back to neutral, followed by your lower back, then upper back, and finally your neck.
Repeat 5 to 10 times.






The Plank

Start on all-fours. Extend your upper body forward so your forearms and elbows rest on the floor, clasp your hands together if you prefer. If you’re used to working your core muscles go straight for this version. With a straight body, so legs straight out, rest on your extended toes. Use your core muscles to maintain your position (raise your pelvic floor and pull your navel back towards your spine). Practice holding for a little longer each time you give it a go.
If this feels too difficult, still have your legs extended behind you, but rest on your knees instead of your toes. Build up your strength and then try the other version. You are trying to maintain a neutral/aligned spinal position by engaging the core muscles.




Lumbar Rotation

From the start position and with knees and ankles together, bring both knees down to one side. To start, just go as far as you can whilst keeping both shoulder blades in contact with the floor. Use this exercise as a mobilization, so once you have reached the lower part of the movement, return to the centre and perform the exercise to the other side. Repeat with control 5 to 10 times on each side. This exercise gives a gentle stretch to the hip and lower back, and helps to keep the waist area mobile.