Chiropractic and Golf By Dr Nicholas Wall Wall Chiropractic The Golf Swing Setup Posture Training Backswing Loading mechanism Top Downswing Explode Impact Sequence Follow through mimic takeaway ID: 270711
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Slide1
Are you getting the best from your golf game?
Chiropractic and Golf
By: Dr. Nicholas Wall
Wall
ChiropracticSlide2
The Golf Swing
SetupPostureTraining
Backswing = Loading mechanism
Top
Downswing = Explode
Impact = Sequence
Follow through = mimic takeaway
Finish = DecelerationSlide3
Mechanism of a swing
Arm Abduction and Adduction
Shoulder Rotation – Internal/External
Flexion
Knees
Back
Arms
Extension
Back
Arms
Legs
Abdominal CoreSlide4
Swing Styles
Two main styles Classic
ModernSlide5
Modern Swing
Large shoulder rotationMinimal hip rotationSupposed 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 spineSlide6
Classic Swing
Balanced hip and shoulder rotationDecreased separation angleDecreases 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 painSlide7
Posture
Neutral spineHip flexedKnees slightly bentT/S extended with chin tucked
Arms hanging straight down, relaxedSlide8
Posture
MobilityFeetHipsThoracic 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
RehabilitationSlide9
Stabilization
Internal/External ObliquesQuadratus Lumborum
Erector
Spinae
Multifidi
Rectus
Abdominus
Hip
Gluteus
maximusSlide10
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
PujolsSlide11
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.Slide12
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!Slide13
Swing and Impact
Counternutation of Sacrum and hip extension
Supination
of
both
feet
Abdominals eccentrically controlling lumbar spine extensionSlide14
Follow Through
Abdominal Eccentric control of lumbar extensionHip extension
Hip internal rotation
Feet
Supination
Thoracic spine extension and rotation
Left scapula retraction
Right scapula protraction Slide15
Injury
What areas are most commonly injured when playing golf? - Low Back
- Elbows
- Wrists
- Shoulders
- Neck
- Knees (Tiger Woods)
Slide16
Why?
Why do we get injured?Improper biomechanics*RepetitionOveruse*
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 Slide17
Study
Source of data
No. of respondents
Most common injuries
Mechanisms/comment
McCarroll
et al.
Amateur (942 males, 202 females)
1144 (942 males, 202 females)
Males: low
back, elbow, wrist/hand
Females: elbow, low back, shoulder
Excessive
play, poor swing mechanics, hitting the ground, 50% of all injuries occurred at impact
Batt
Amateur
193 (
164 males, 29 females)
Males: wrist, back
Females: elbow
Incorrect swing/miss-hit (affecting wrist), overuse
type injuries
Nicholas
et al.
Amateur
368
47.6% had been struck by a golf ball in lower extremity, followed by trunk and upper extremity injury
sites
Most serious injury being struck by a golf ball,
contusion followed by concussion and fracture were most common
Theriault
et al.
528 (347 males, 181 females)
Upper limb
(42.4%), spine (39.7%), lower limb (17.9%)
Technical
injury (53.9%),
overextertion
of trunk during swing (30.8), overuse (14.1%)
Burdorf
et al.
Back pain in beginner males
196
Baseline survey: life-long
cumulative incidence of back pain was 63%, 28% had a history or back pain within 1 month prior to answering the survey
Those that were athletes had increased
odds ratio of 2.1:1 to previous back pain compared with non-athletes
Gosheger
et al
Amateur and professionals
643 amateurs
(70.9% males), 60 professionals (90% males)
Professionals:
back, wrist, shoulder
Amateurs: elbow, back, shoulder
More than
80% of injuries were attributed to overuse in the back, shoulder, knee and elbow
McCarroll
and
Gioe
Professional
226 (127
males, 99 females)
Male:
low back, wrist, shoulder
Females: wrist, low back, hand
Sugaya
et al.
Low back pain among
elite/professional
283
(115 regular tour males, 55 senior tour males, 113 tour females
Low back, followed by neck/high
back and elbow and shoulder
equaly
72% experienced injuries that caused them to miss a tournament or perform at a lower level, mostly
due to back and upper extremity injuries
McNicholas
et al.
Sports medicine clinics data collection
286
Most common site was reported as upper limb,
followed by trunk and knee
Nearly 90%
were recreational golfers. Of the upper limb injuries, lateral
epicondylitis
was most common, followed by shoulder impingement and medial
epicondylitis
Finch
et al.
Sports medicine clinics
and emergency
depts
34
Lower
back, elbow and knee
Overuse, a twist or rotational component
of the swing, poor swing mechanics, aggravation of previous injury. Elbow injury due to overuse (2/3) and missed hits (1/3)Slide18
Incidence of Injury
Area
Amateur %
Professional %
Male
%
Female %
Low back
15-34
22-24
25-36
22-27
Wrist
13-20
20-27
18-28
12-36
Elbow
25-33
7-10
8-33
6-50Slide19
Professionals
WristLow BackMechanismRepetition
Hitting something other than golf ballSlide20
Amateurs
Elbows ****Low backWristShouldersMechanism
Poor mechanics ****
Overuse
Hitting the groundSlide21
Low Back
Most common injured areaMechanism of injury:Setup: Extension or flexion? Too much rotation? Combination?
Reverse pivot swing fault
Early extension swing fault
Sedentary lifestyleSlide22
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 functionSlide23
Elbows
Amateurs/ProfessionalsGolfer’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.Slide24
Wrists
Cartilage weakness/Hook of Hamate
fx
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
.Slide25
How do you prevent injury?
Know your weakness areasGolf swingLoss 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!Slide26
Injury Prevention
Go see your chiropractor!!!!EducationPre-game Stretching
TrainingSlide27
Low Back
Chiropractic adjustingCore MusculatureExercisesBridge
Side Bridge
Cat-Camel
Bird Dog
Glut Musculature
Exercises
Glut Bridge
Bird Dog
Wobble BoardSlide28
Thoracic Spine
Adjust for extension
Exercise ball mobilization
Bruegger’s
posture
Stretch tight muscles - Pecs,
latsSlide29
Elbow/Shoulder
ElbowChiropractic AdjustmentsExercise ball throwsThera
-band
Hip and T/S mobility
Shoulder
Chiropractic Adjustments
Hip and T/S mobility
Thera
-band
Lawnmower pullsSlide30
Wrist
Chiropractic AdjustmentsStrengtheningThera-band
Broccoli stretching
All ROM
Stabilization
Thera
-band
Wood chops
Bracing
Training hips and T/SSlide31
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.