Are you getting the best from your golf game?

1. Are you getting the best from your golf game? Chiropractic and Golf By: Dr. Nicholas Wall Wall Chiropractic

2. The Golf Swing • Setup • Posture • Training • Backswing = Loading mechanism • Top • Downswing = Explode • Impact = Sequence • Follow through = mimic takeaway • Finish = Deceleration

3. Mechanism of a swing • Arm Abduction and Adduction • Shoulder Rotation – Internal/External • Flexion • Knees • Back • Arms • Extension • Back • Arms • Legs • Abdominal Core

4. Swing Styles • Two main styles • Classic • Modern

5. Modern Swing • Large shoulder rotation • Minimal hip rotation • Supposed to increase chance of striking ball with a square club face • ↑ Power • ↑ Distance • Increased separation angle – shoulder/hip separation • Causes increased lateral bend (crunching) • Overextension of spine

6. Classic Swing • Balanced hip and shoulder rotation • Decreased separation angle • Decreases lateral bending (↓ crunching) • Lowers amount of torque on lumbar spine • Balanced, upright form on finish • Studies have shown this swing can reduce incidence of low back pain

7. Posture • Neutral spine • Hip flexed • Knees slightly bent • T/S extended with chin tucked • Arms hanging straight down, relaxed

8. Posture • Mobility • Feet • Hips • Thoracic Spine • These three are the key areas of the body that must be mobile and controlled, or problems arise • Many injuries can be traced back to poor posture • Training the body • Rehabilitation

9. Stabilization • Internal/External Obliques • QuadratusLumborum • Erector Spinae • Multifidi • Rectus Abdominus • Hip • Gluteus maximus

10. The Feet • Dorsiflexion- 8 inch step down • Pronation- Talus must adduct and internally rotate • Calcaneal (Heel) eversion • Golf is one of the only sports that generates an explosive force with both feet on the ground at all times • This requires very mobile feet since they are locked onto the ground • Albert Pujols

11. The Hips • During the Back Swing, both hips internally rotate • The Femur moves faster than the pelvis on the front leg, giving relative internal rotation • Hip internal rotation turns on our most powerful force producers, our anterior and posterior muscle slings • Internal rotation of the hips loads our gluteal and abdominal muscles • This activates the anterior and posterior oblique sling muscles, producing a concentric moment of force, the explosion or downswing. • If the calcaneus doesn’t evert, we will not be able to internally rotate our hips, causing a slide or sway, which makes it near impossible to get back to our original setup position.

12. Thoracic Spine • To end range load our Anterior sling muscles, we must EXTEND and rotate through our T/S. • T/S extension is necessary to retract our scapula, stabilizing it • This “sets” the club at the top of the back swing • At this point, the T/S is extended, rotated and laterally flexed • Separate our arms from our body, POWER!

13. Swing and Impact • Counternutation of Sacrum and hip extension • Supination of both feet • Abdominals eccentrically controlling lumbar spine extension

14. Follow Through • Abdominal Eccentric control of lumbar extension • Hip extension • Hip internal rotation • Feet Supination • Thoracic spine extension and rotation • Left scapula retraction • Right scapula protraction

15. Injury • What areas are most commonly injured when playing golf? - Low Back - Elbows - Wrists - Shoulders - Neck - Knees (Tiger Woods)

16. Why? • Why do we get injured? • Improper biomechanics* • Repetition • Overuse* • Bad luck • Most golf injuries are repetitive microtrauma injuries, joints and muscles become overloaded by excessive forces and motions and symptoms present • Look for the areas not moving enough and find out why they are not moving. • The most common locations for these dysfunctions are the HIPS, FEET, and T/S! • The body must work together as a whole to avoid injury. • Chiropractic!!! • Acute trauma can occur, as in the classic “fat” shot and wrist injury

18. Incidence of Injury

19. Professionals • Wrist • Low Back • Mechanism • Repetition • Hitting something other than golf ball

20. Amateurs • Elbows **** • Low back • Wrist • Shoulders • Mechanism • Poor mechanics **** • Overuse • Hitting the ground

21. Low Back • Most common injured area • Mechanism of injury: • Setup: Extension or flexion? Too much rotation? Combination? • Reverse pivot swing fault • Early extension swing fault • Sedentary lifestyle

22. Low Back • Why is it getting injured? • Compensations: • Tight hips: poor loading during backswing, poor glut max and med function • Tight t/s: must be able to extend and rotate • Stiff ankles: poor dorsiflexion and subtalar joint eversion • Muscle Imbalance • Abdominals: stabilize the spine, rotate around a stable L/S • Gluts Max: control weight shift to back leg, control femur internal rotation, proper loading for power and control • Scapular stabilizers: serratus anterior, middle and lower trap • ADLs and function

23. Elbows • Amateurs/Professionals • Golfer’s elbow (medial epicondylitis) • Tennis elbow (lateral epicondylitis) • Mechanism of Injury: • Overuse of the wrist extensors eccentrically slowing down wrist flexion and pronation. • Casting swing fault. • Scooping motion at impact. • Slicing shot pattern.

24. Wrists • Cartilage weakness/Hook of Hamatefx • Swing faults of Casting or Over the Top (compression of cartilage during ulnar deviation) • Hitting a fat shot, causing fx • Lack of: • Spine extension • Hip internal rotation • Hip extension • Tight pecs/lats.

25. How do you prevent injury? • Know your weakness areas • Golf swing • Loss of function • Correcting weaknesses • Lessons • Chiropractor • Exercise/Rehabilitation • Keys to successful rehab: • Are you working on the key link? • Does your rehab mimic golf? • You must know golf biomechanics to understand how injuries occur!

26. Injury Prevention • Go see your chiropractor!!!! • Education • Pre-game Stretching • Training

27. Low Back • Chiropractic adjusting • Core Musculature • Exercises • Bridge • Side Bridge • Cat-Camel • Bird Dog • Glut Musculature • Exercises • Glut Bridge • Bird Dog • Wobble Board

28. Thoracic Spine • Adjust for extension • Exercise ball mobilization • Bruegger’s posture • Stretch tight muscles - Pecs, lats

29. Elbow/Shoulder • Elbow • Chiropractic Adjustments • Exercise ball throws • Thera-band • Hip and T/S mobility • Shoulder • Chiropractic Adjustments • Hip and T/S mobility • Thera-band • Lawnmower pulls

30. Wrist • Chiropractic Adjustments • Strengthening • Thera-band • Broccoli stretching • All ROM • Stabilization • Thera-band • Wood chops • Bracing • Training hips and T/S

31. References • McHardy A, Pollard H, Luo K. Golf Injuries – A Review of the Literature. Sports Med 2006; 36 (2): 171-187 • Lehman G. Resistance training for performance and injury prevention in golf. JCCA 2006; 50(1):27–42. • Gluck GS, Bendo JA, Spivak JM. The Lumbar Spine and Low Back Pain in Golf: A Literature Review of Swing Mechanics and Injury Prevention.The Spine Journal 2008; 8 (5): 778-88.