Back Pain Is the Most Common Golfing Injury: Here’s What to Do About It

Is golf bad for your back? Not as much as you’d think, with the help of these tips from a neurosurgeon.

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You’ve been looking forward to your golf game all week. You put your ball on the tee and swing: Fore! But as you watch your ball sail toward the green, you feel it. No, not now, you think, but it’s too late; pain shoots through your back, threatening to cut your game short.

Man golfing without back painBack pain doesn't have to spoil your afternoon on the links.

You’re far from alone in experiencing this pain. According to one 2014 study in Asian Journal of Sports Medicine, lower back pain from golf accounts for between 18% and 54% of all documented ailments, which makes LBP the most common golf injury, much more than golf upper back pain. In fact, even pros the likes of Tiger Woods and Jack Nicklaus have been sidelined with golf back pain

Last year, the National Golf Foundation (NGF) reported that 36.9 million Americans over the age of six played golf, which adds up to a lot of back pain.

If you seem to always have back pain after a game or if you’re dealing with a golf back injury, don’t relegate your clubs to the back of the closet just yet. Neurosurgeon and SpineUniverse Editorial Board member Lali Sekhon, MD, PhD, MBA of the Reno Orthopedic Center shares his tips and tricks for hitting the links with less pain, or even playing pain-free. 

Common Back Injuries Associated with Golf

While generally low back pain tops the list of back ailments that result from golf, Dr. Sekhon explains that golf-related back injuries typically fall into four categories. These include:

  • Lumbar strains, which is another way to describe low back pain. Specifically, Dr. Sekhon calls these “myofascial injuries,” or tight, injured muscles that result from excessive strain.
  • Disc herniations, painful injuries that involve the vertebrae and the cushioned pads that move out of position between the vertebrae.
  • Exacerbated facet arthritis, also known as spondylosis (osteoarthritis of the spine), when the cartilage in one’s spine breaks down over time.
  • Accidents, or as Dr. Sekhon calls them, “the weird stuff that happens when alcohol is combined with physical activity, like falls and golf cart accidents.”

Dr. Sekhon goes on to say, “Muscle strains are the most common injuries, and thankfully, they’re usually self-limiting, responding to rest, ice, and over-the-counter medications. They typically only last a few days and have no sciatica.”

He adds, “Disc herniations can occur. They may just start out as back pain with sciatica happening a few days later.” Dr. Sekhon says that Tiger Woods is “probably the poster child for disc problems, allegedly having had at least four and possibly six back surgeries for disc problems.”

Shearing Force and Back Injuries

So, why are back injuries so prevalent in the golf world? Are they primarily caused by twisting forces in golf swings?

“In general, tissues don’t like shear,” Dr. Sekhon says, describing the tears that connective fibers can experience. “Most tissues are resistant to forces in one direction or another. Shear forces combine those forces and are particularly injurious.”  

Shearing force means a force pushing your body (your spine, your vertebrae) in one direction and another force pushing it in the opposite direction. When they’re aligned—when they’re pushing directly against each other—it’s called compression force, but when the alignment is off, it’s shearing force. Think about wringing out a wet towel: You separate your hands when you grab the towel, then you twist one hand toward you and one away from you. That’s shear.

“Disc herniations can occur with the twisting. The facet joints are also made to resist shear in the spine. Over-50 golfers usually already have a degree of arthritis in these joints and risk irritating these joints with twisting. The combination of a bend and twist are the worst,” Dr. Sekhon cautions.

Dealing With and Preventing Back Injuries in Golf

When it comes to achieving a reduced-pain or even pain-free golf game, you can turn to some nonsurgical treatment methods and preventive measures, which Dr. Sekhon lists:

“Get some core strengthening. Try not to use 100% power on long shots, like tee-offs. Try and avoid 18 holes three times a week. Lose some weight. Get some lessons to improve form.”

For those core-strengthening back exercises for golf, think planks, dead bugs, Russian twists, and bird dogs, which are detailed in this article by the Professional Golfers Association (PGA).

If you are dealing with a strain, Dr. Sekhon recommends tried-and-true treatments, like rest, ice, and simple over-the-counter anti-inflammatory medications. Physical therapy is also an option, along with prescription muscle relaxants.

“If there is pain down the leg or back pain is uncontrolled, you should seek medical advice,” Dr. Sekhon advises.

He adds that you could also turn to a TENS unit, a battery-operated device that uses electrodes attached to the injured area to reduce pain through electrical stimulation.

Lastly, it’s key to avoid what Dr. Sekhon calls the “BLTs”: bending, lifting, and twisting.

You should know that if your golf-related back pain has gotten so severe that you’re finding it difficult to function, or if you’re dealing with a specific back condition that warrants further measures, surgery is an option. In fact, it is possible to return to golf after surgery.

Dr. Sekhon says that although generally low back pain is managed non-surgically, if there is sciatica and it does not settle, a review by a physician is warranted.

He says, “Surgery is used for recalcitrant sciatica or leg weakness.”

Golf Swing Modifications

A high-quality golf swing for a bad back is possible with modifications, along with other tweaks you can make.

“Turn down the power on tee-offs,” Dr. Sekhon says. “They really are the most violent movement. Instead, use 70% power.”

He also recommends taking lessons, thinking about how often you play (“9 holes is better than 18, and once a week is better than three,” Dr. Sekhon adds), and losing weight, since “the belly flap weakens the abdominals, which support the game,” he says.

Keep Teeing Off

Your regular golf games don’t need to come to a screeching halt from your back pain. With some tweaks and caring for your body, you could be playing golf for years to come.

If you’re a serious golfer who doesn’t love the idea of changing your game in any way or scaling things back, keep this point in mind from Dr. Sekhon:

“Enjoy the game for what it means to you. It’s often not about the scorecard, but the exercise, outdoor experience, and camaraderie. The key to life is moderation. Be kind to yourself and know that wonderful machine that is your body does wear out in time, but if you look after it, you can get the best mileage possible out of it.”

Updated on: 07/29/21
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Lali Sekhon, MD, PhD, FAANS, FRACS, FACS
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