The short golf backswing: effects on performance and spinal health implications

Golf and Health, More than 18 Holes—A Bibliometric Analysis

Despite golf’s contribution to health, scientific production related to golf and health has been relatively scarce. This work aims to investigate the state of the art on golf and health and to identify existing gaps and the principal and most notable potential future research trends, contributing to connecting the reality of the facilities dedicated to the practice of this sport and its contribution to raising awareness of the importance of sport in maintaining health. A total of 179 articles were analyzed following the steps for systematic reviews and meta-analysis protocols based on the PRISMA 2020 methodology and QUORUM, and a bibliometric analysis was carried out. Research to date has mainly focused on the benefits of golf in improving health, preventing illness, slowing down aging, or as rehabilitation and on exploring the risks and injuries involved in playing golf. The different ways of promoting participation or changing the image of golf by showing its healthy side are outlined as research trends in the coming years. There is a lack of exploration of the use of technology, the effects of the sport on certain disorders related to psychosocial factors, and further knowledge of the relationships between playing intentions and health. This research provides essential information for researchers who plan to work with golf in the future.

Golf Swing Biomechanics: A Systematic Review and Methodological Recommendations for Kinematics

Numerous studies have been conducted to investigate golf swing performance in both preventing injury and injury occurrence. The objective of this review was to describe state-of-the-art golf swing biomechanics, with a specific emphasis on movement kinematics, and when possible, to suggest recommendations for research methodologies. Keywords related to biomechanics and golf swings were used in scientific databases. Only articles that focused on golf-swing kinematics were considered. In this review, 92 articles were considered and categorized into the following domains: X-factor, crunch factor, swing plane and clubhead trajectory, kinematic sequence, and joint angular kinematics. The main subjects of focus were male golfers. Performance parameters were searched for, but the lack of methodological consensus prevented generalization of the results and led to contradictory results. Currently, three-dimensional approaches are commonly used for joint angular kinematic investigations. However, recommendations by the International Society of Biomechanics are rarely considered.

Is Golf a Contact Sport? Protection of the Spine and Return to Play After Lumbar Surgery

STUDY DESIGN

Narrative review.

OBJECTIVE

To address the gap in the literature on specific return to play protocols and rehabilitation regimens for golfers undergoing lumbar spine surgery with a high impact swing.

METHODS

This review did not involve patient care or any clinical prospective or retrospective review of patient information and thus did not warrant institutional review board approval. The available literature of PubMed, Medline, and OVID was utilized to review the existing literature.

RESULTS

Studies have shown that the forces through the lumbar spine in the modern-era golf swing are like other contact sports. Methods of protecting the lumbar spine include proper swing mechanics, abdominal and paraspinal musculature strengthening and flexibility as well as physical fitness. There are a variety of treatment options available to treat lumbar spine pathology each with a different return to play recommendations from doctors in the field.

CONCLUSIONS

With the introduction of a high impact, modern-era swing to the game of golf, the pathology is seen in the lumbar spine of both young, old, professional, and amateur golfers with low back pain are similar to other athletes in contact sports. Surgery is effective in returning athletes to a similar level of play even though no protocols exist for an effective and safe return. There have been many studies conducted to determine appropriate treatment and return to play for these injuries, but there is a gap in the literature on specific return to play protocols and rehabilitation regimens for golfers undergoing lumbar spine surgery with a high impact swing. As return to competitive play is important, especially with professional golfers, studies combining the use of swing mechanics changes, rehabilitation regimens and the type of surgery performed would be able to provide some insight into this topic now that golf may begin to be considered a contact sport.

Injury risk-factor differences between two golf swing styles: a biomechanical analysis of the lumbar spine, hip and knee

The golf swing has been associated with mechanical injury risk factors at many joints. One swing, the Minimalist Golf Swing, was hypothesised to reduce lumbar spine, lead hip, and lead knee ranges of motion and peak net joint moments, while affecting swing performance, compared to golfers' existing swings. Existing and MGS swings of 15 golfers with handicaps ranging from +2 to -20 were compared. During MGS downswing, golfers had 18.3% less lumbar spine transverse plane ROM, 40.7 and 41.8% less lead hip sagittal and frontal plane ROM, and 39.2% less lead knee sagittal plane ROM. MGS reduced lead hip extensor, abductor, and internal rotator moments by 17.8, 19.7 and 43%, while lead knee extensor, abductor, adductor and external rotator moments were reduced by 24.1, 26.6, 37 and 68.8% respectively. With MGS, club approach was 2° shallower, path 4° more in-to-out and speed 2 m/s slower. MGS reduced certain joint ROM and moments that are linked to injury risk factors, while influencing club impact factors with varying effect. Most golf injuries are from overuse, so reduced loads per cycle with MGS may extend the healthy life of joints, and permit golfers to play injury-free for more years.

Low back pain and golf: A review of biomechanical risk factors

Golf is an international sport played by a variety of age groups and fitness levels, and although golf has a low to moderate aerobic intensity level, injuries are common among professional and amateur golfers. High amounts of force experienced during the golf swing can lead to injury when golfers lack appropriate strength or technique with the lower back most commonly injured. Research has indicated that trunk muscle activation, hip strength and mobility, and pelvis and trunk rotation are associated with low back pain (LBP). Based on anecdotal evidence, golf practitioners specifically address issues in weight shift, lumbar positioning, and pelvis sequencing for golfers with LBP. This review aims to elucidate the effects of proper and improper golf swing technique on LBP and to help golf practitioners understand how to approach the alleviation of LBP in their clientele.

Bilateral differences in the trunk muscle volume of skilled golfers

Repetitive mechanical load applied to a body part may lead to hypertrophy of its muscles. If a movement requires asymmetric activation of bilateral muscles, this may result in differences in muscle size between the sides. This study aimed to investigate the degree of bilateral differences in the trunk muscle volume of golfers by comparing with non-golfers. Seventeen male right-handed golfers and eleven (nine right- and two left-handed) non-golfers participated. Trunk muscle volume was determined using magnetic resonance imaging, and the degree of asymmetry was calculated as the ratio of trunk muscle volume on the left to trunk muscle volume on the right side in right-handers and vice-versa in left-handers. Golfers had significantly larger lateral abdominal wall (LA) muscle volume than non-golfers: 12.36 ± 1.12 vs. 9.96 ± 0.94 cm3/kg; erector spinae: 9.12 ± 1.16 vs. 7.88 ± 0.84 cm3/kg; psoas major (PM): 6.27 ± 0.88 vs. 5.51 ± 0.98 cm3/kg; rectus abdominis (RA): 4.15 ± 0.54 vs. 3.50 ± 0.64 cm3/kg; and multifidus: 3.61 ± 0.41 vs. 3.05 ± 0.40 cm3/kg (p < 0.05). The degree of bilateral asymmetry of the LA, PM, and RA volume was significantly greater in golfers than in non-golfers (LA: -8.63 ± 7.40% vs. 1.94 ± 2.76%; PM: -9.10 ± 5.25% vs. -0.48 ± 5.96%; RA: 6.36 ± 6.50% vs. -2.12 ± 9.64%, respectively, p < 0.05). Right-handed golfers had greater left LA and PM volume compared to the right (LA: 5.89 ± 0.55 vs. 6.48 ± 0.65 cm3/kg; PM: 3.00 ± 0.42 vs. 3.27 ± 0.47 cm3/kg; p < 0.05) and had greater right RA volume compared to the left (2.15 ± 0.32 vs. 2.00 ± 0.24 cm3/kg, p < 0.05). These findings suggest that skilled, long-term golfers develop large volume and bilateral asymmetry of their trunk muscles.

Visual dependency and postural control on swing performance in golf players

Individuals have to reweight the respective contribution of the different sources of sensorial information for regulating posture and balance, especially during fine task execution. Given the evidences indicating strategy during swing performance as associated with prioritization of task-relevant visuospatial information for skill execution, the aim of the present work is to assess differences in visual dependency (VD) and postural control in a population of expert (EXP) and non-expert (NEXP) golfers when compared with healthy subjects (HC) and to discover possible relationships between these outcomes and swing performance. Thus, 15 golfers (EXP = 7; NEXP = 8) and 32 matched HC underwent otoneurological testing including video Head Impulse Test, posturography and Rod and Disk Test (RDT). Golf players also underwent a swing session procedure, which performance was measured by means of the Flightscope X2 Doppler-radar launch monitor system. EXP subjects demonstrated significant (p < 0.05) lower values in i) counter-clockwise (CCW) and clockwise (CW) dynamic conditions when compared with both NEXP and HC subjects RDT outcome measures and ii) surface and length posturography values as compared with HC subjects. When treating golf players outcomes as 'a continuum', CCW and CW scores were found to positively correlate with both lateral distance and horizontal launch angle and to negatively correlate with spin rpm. In conclusion, the present study suggests that the high-level of visual-independency demonstrated by EXP subjects may be functionally related in expert golfers to an effective motor strategy preferentially not referring to an inappropriate reliance on visual input.

Mechanical lower back pain and sacroiliac joint dysfunction in golfers at two golf clubs in Durban, South Africa

Background

Mechanical lower back pain (MLBP) and sacroiliac joint dysfunction (SIJD) are common problems among golfers. There are currently few studies on golfers regarding the relationship between MLBP and SIJD.

Objective

The objective of this study was to determine the prevalence of MLBP and SIJD and their association in golfers at two golf clubs in Durban, South Africa.

Method

A correlation design included convenience sampling. The Standardised Nordic Questionnaire for the analysis of musculoskeletal symptoms determined the prevalence of MLBP. Sacroiliac joint pain provocative tests determined the prevalence of SIJD. Institutional ethical clearance was granted and consent from participants was obtained. Data were collected over 3 weeks and SPSS was used to calculate descriptive and inferential statistics.

Results

There were 271 participants dominated by males (86.7%) aged between 39 and 47 years (33.2%). A total of 123 (45%) of the participants presented with MLBP and 62 (23%) with SIJD. The MLBP prevalence was moderately associated with age (χ² = 71.22, p = 0.004) and years of experience (χ² = 69.93, p = 0.001). The SIJD prevalence was moderately associated with age (χ² = 55.49, p = 0.003) and poorly associated with years of experience (χ² = 44.93, p = 0.005). Twenty-two per cent (60) had both MLBP and SIJD and 54% (146) had neither. A strong association (χ² = 88.234, p = 0.000) between MLBP and SIJD was observed.

Conclusion

There was a high prevalence of MLBP and SIJD and a strong association between them. A comprehensive management approach is recommended for golfers with MLBP and SIJD.

Clinical Implications

This study will provide valuable knowledge that will assist clinicians, especially physiotherapists, in their clinical management of golfers with MLBP and SIJD. Intervention studies are needed to address lower back and sacroiliac joint problems reported in this study.

Effects of nine weeks isokinetic training on power, golf kinematics, and driver performance in pre-elite golfers

Background

It has previously been shown that isotonic strength training can improve driver performance among golfers, though few studies have investigated effects of strength training on swing kinematics together with driver performance. In this study we investigated whether isokinetic rotational training could improve driver performance and swing kinematic variables amongst elite golfers.

Methods

Twenty competitive pre-elite golfers (handicap better than -3.0), 13 men and 7 women, were split into two groups, one group received the isokinetic power training (IK) alongside their normal isotonic pre-season strength-training and the other group continued with their normal isotonic pre-season strength-training regime (IT). The IK group completed 12 sessions of isokinetic power training on a standing rotation exercise (10% body weight at 1 m/s) and barbell squat (25 kg plus 10% body weight at 0.5 m/s). The IT group continued with their normal isotonic pre-season strength-training regime. Participants were tested for rotational power, lower body power, golf swing kinematics, and driver performance before and after a nine-week training period.

Results

After the nine-week training period both the IK and the IT groups increased their dominant side rotational force and power (effect sizes between 0.50-0.96) and magnitude based inference indicated that IK had a likely (> 80%) more beneficial increase in dominant side rotational force and power. For swing kinematics, IK had a likely (> 80%) more beneficial improvement in lead arm speed and acceleration compared to the IT group. For driver performance, IK had a possible (65%) beneficial effect on ball speed and likely (78%) beneficial effect on carry distance when compared to IT, whereas neither of the groups improved club head speed.

Conclusion

In the present study on pre-elite golfers we found that 9 weeks of isokinetic training increased seated rotational force and power, peak arm speed and arm acceleration, ball speed, and carry distance more compared to isotonic training. Even though isokinetic training did not increase CHS, it did result in greater carry distance.

Electromyographic analyses of the erector spinae muscles during golf swings using four different clubs

The purpose of this study was to compare the electromyography (EMG) patterns of the thoracic and lumbar regions of the erector spinae (ES) muscle during the golf swing whilst using four different golf clubs. Fifteen right-handed male golfers performed a total of twenty swings in random order using the driver, 4-iron, 7-iron and pitching-wedge. Surface EMG was recorded from the lead and trail sides of the thoracic and lumbar regions of the ES muscle (T8, L1 and L5 lateral to the spinous-process). Three-dimensional high-speed video analysis was used to identify the backswing, forward swing, acceleration, early and late follow-through phases of the golf swing. No significant differences in muscle-activation levels from the lead and trail sides of the thoracic and lumbar regions of the ES muscle were displayed between the driver, 4-iron, 7-iron and pitching-wedge (P > 0.05). The highest mean thoracic and lumbar ES muscle-activation levels were displayed in the forward swing (67-99% MVC) and acceleration (83-106% MVC) phases of the swing for all clubs tested. The findings from this study show that there were no significant statistical differences between the driver, 4-iron, 7-iron and pitching-wedge when examining muscle activity from the thoracic and lumbar regions of the ES muscle.

The Biomechanics of the Modern Golf Swing: Implications for Lower Back Injuries

The modern golf swing is a complex and asymmetrical movement that places an emphasis on restricting pelvic turn while increasing thorax rotation during the backswing to generate higher clubhead speeds at impact. Increasing thorax rotation relative to pelvic rotation preloads the trunk muscles by accentuating their length and allowing them to use the energy stored in their elastic elements to produce more power. As the thorax and pelvis turn back towards the ball during the downswing, more skilled golfers are known to laterally slide their pelvis toward the target, which further contributes to final clubhead speed. However, despite the apparent performance benefits associated with these sequences, it has been argued that the lumbar spine is incapable of safely accommodating the forces they produce. This notion supports a link between the repeated performance of the golf swing and the development of golf-related low back injuries. Of the complaints reported by golfers, low back injuries continue to be the most prevalent, but the mechanism of these injuries is still poorly understood. This review highlights that there is a paucity of research directly evaluating the apparent link between the modern golf swing and golf-related low back pain. Furthermore, there has been a general lack of consensus within the literature with respect to the methods used to objectively assess the golf swing and the methods used to derived common outcome measures. Future research would benefit from a clear set of guidelines to help reduce the variability between studies.

Spine biomechanics associated with the shortened, modern one-plane golf swing

The purpose of this study was to compare kinetic, kinematic, and performance variables associated with full and shortened modern backswings in a skilled group of modern swing (one-plane) golfers. Shortening the modern golf backswing is proposed to reduce vertebral spine stress, but supporting evidence is lacking and performance implications are unknown. Thirteen male golfers performed ten swings of each swing type using their own 7-iron club. Biomechanical-dependent variables included the X-Factor kinematic data and spine kinetics. Performance-related dependent variables included club head velocity (CHV), shot distance, and accuracy (distance from the target line). Data were analysed with repeated measures ANOVA with an a priori alpha of 0.05 (SPSS 22.0, IBM, Armonk, NY, USA). We found significant reductions for the X-Factor (p < 0.05) between the full and shortened swings. The shortened swing condition ameliorated vertebral compression force from 7.6 ± 1.4 to 7.0 ± 1.7 N (normalised to body weight, p = 0.01) and significantly reduced CHV (p < 0.05) by ~2 m/s with concomitant shot distance diminution by ~10 m (p < 0.05). Further research is necessary to examine the applicability of a shortened swing for golfers with low back pain.

Golf-related low back pain: a review of causative factors and prevention strategies

Golf is a popular sport with both perceived and real health benefits. However, certain injury risks are also prevalent, particularly to the lower back. Epidemiological studies have shown that lower back pain (LBP) from golf account for between 18% and 54% of all documented ailments, leading many researchers to regard the condition as the most common golf injury.

The purpose of this review was to examine the scientific literature to ascertain the risk factors associated with the development of LBP from playing golf and suggest methods to modify or limit these factors. Results of the review indicate that the high frequency of LBP appears multi-factorial although the asymmetrical and forceful nature of the swing along with excessive play and practice, particularly amongst elite players, appear to be common factors. Other factors include swing flaws leading to excessive side-bend and over-rotation of the spine, abnormal muscle recruitment, poor trunk endurance, restricted lead hip internal rotation and the use of unnecessarily stressful club transportation methods. Methods to help control or eliminate excessive stress on the lower back would include reducing the amount spent playing or practicing, seeking professional assistance to assess and adjust swing mechanics, improve trunk and hip flexibility, increase the strength and endurance of the trunk musculature, consider different footwear options and avoid carrying the golf bag. Adopting some or all of these recommendations should allow players to continue to enjoy the sport of golf well into their senior years.

Rehabilitation of low back pain in golfers: from diagnosis to return to sport

Context:

Low back injuries are the most common injury in golf. Best practice guidelines for rehabilitation and prevention of these injuries are helpful for health care professionals and all golfers.

Objective:

To establish a best practice clinical model for low back pain in golfers from diagnosis through treatment and rehabilitation to return to golf.

Evidence Acquisition:

The PubMed database and Google Scholar were searched from 1993 to 2012 with the following keywords: golf and low back injury, low back injury, golf and low back pain, golf injury prevention, golf modern swing, muscles in golf swing, low back rehabilitation, diaphragm, and core stability. All studies addressed in some manner the rehabilitation, prevention, or return to sport from low back injury, preferably in direct relation to golf, as well as muscle firing patterns used during the golf swing.

Results:

Best practice for rehabilitation and prevention of low back injury in golf appears to be through a multidisciplinary approach.

Conclusion:

Movement patterns, muscle imbalances, and type of swing utilized all have a direct effect on the forces applied to the spine during the golf swing and need to be assessed to prevent or rehabilitate injury. Understanding the golf swing and how the body works during the swing is necessary.

Lower back pain in golfers: a review of the literature

OBJECTIVE

To review the epidemiological literature on low back pain in golfers and to review the golf swing and relate the literature on the mechanics of the swing to the lower back.

METHODS

A computer search was conducted of Index Medicus (1966 to 2004), MANTIS (1880 to present) and CINAHL (1982 to 2004) for literature on the following key words: low back, golf, injury. A manual search for relevant references in review papers on the subject was also conducted. The results were collated and literature fitting the criteria were collected and evaluated for suitability.

RESULTS

The lower back is a common site of golf-related injury and has resulted in much research being conducted on the forces produced by the 'modern' swing in the low back. An analysis of the 'modern' swing when compared to the 'classic' golf swing, demonstrates lower rotational forces on the low back in the 'classic' swing. However, no studies exist to compare the different types of swing.

CONCLUSION

The back is an area of the body that undergoes significant movement and muscular activity during the golf swing. It is likely that the significant activity and repetitive nature of the swing are associated with the high rate of injury in golfers. Modification of the golf swing has been hypothesized to reduce the incidence of low back injury in golf. Further research needs to be conducted on the various golf swings to evaluate if different swings change low back injury rates in golfers.

Potential benefits of warm-up for neuromuscular performance of older athletes

Demographic trends project increasing numbers of older people to engage in exercise programs and sports. Sustained participation depends on both perceived health outcomes and avoidance of debilitating injuries. This review explores the potential benefits of physiologically based warm-up strategies to alleviate some key age-related decreases in the biomechanical capacity for skilled sport movements.

A comparison of physical characteristics and swing mechanics between golfers with and without a history of low back pain

STUDY DESIGN

Controlled laboratory study using a cross-sectional design.

OBJECTIVES

To examine the kinematics and kinetics of the trunk and the physical characteristics of trunk and hip in golfers with and without a history of low back pain (LBP).

BACKGROUND

Modified swing patterns and general exercises have been suggested for golfers with back pain. Yet we do not know what contributes to LBP in golfers. To create and validate a low back-specific exercise program to help prevent and improve back injuries in golfers, it may be valuable to understand the differences in biomechanical and physical characteristics of golfers with and without a history of LBP.

METHODS

Sixteen male golfers with a history of LBP were matched by age and handicap with 16 male golfers without a history of LBP. All golfers underwent a biomechanical swing analysis, trunk and hip strength and flexibility assessment, spinal proprioception testing, and postural stability testing.

RESULTS

The group with a history of LBP demonstrated significantly less trunk extension strength at 60 degrees/s and left hip adduction strength, as well as limited trunk rotation angle toward the nonlead side. No significant differences were found in postural stability, trunk kinematics, and maximum spinal moments during the golf swing.

CONCLUSION

Deficits observed in this study may affect a golfer's ability to overcome the spinal loads generated during the golf swing over time. Exercises for improving these physical deficits can be considered, although the cause-effect of LBP in golfers still cannot be determined.

Effect of spinal manipulative therapy with stretching compared with stretching alone on full-swing performance of golf players: a randomized pilot trial

OBJECTIVE

There has been a steady growth of chiropractic treatment using spinal manipulative therapy (SMT) that aims to increase the performance of athletes in various sports. This study evaluates the effect of SMT by chiropractors on the performance of golf players.

METHODS

Golfers of 2 golf clubs in São Paulo, Brazil, participated in this study. They were randomized to 1 of 2 groups: Group I received a stretch program, and group II received a stretch program in addition to SMT. Participants in both groups performed the same standardized stretching program. Spinal manipulative therapy to dysfunctional spinal segments was performed on group II only. All golfers performed 3 full-swing maneuvers. Ball range was considered as the average distance for the 3 shots. Treatment was performed after the initial measurement, and the same maneuvers were performed afterward. Each participant repeated these procedures for a 4-week period. Student t test, Mann-Whitney nonparametric test, and 1-way analysis of variance for repeated measures with significance level of 5% were used to analyze the study.

RESULTS

Forty-three golfers completed the protocol. Twenty participants were allocated to group I and 23 to group II. Average age, handicap, and initial swing were comparable. No improvement of full-swing performance was observed during the 4 sessions on group I (stretch only). An improvement was observed at the fourth session of group II (P = .005); when comparing the posttreatment, group II had statistical significance at all phases (P = .003).

CONCLUSIONS

Chiropractic SMT in association with muscle stretching may be associated with an improvement of full-swing performance when compared with muscle stretching alone.

The lumbar spine and low back pain in golf: a literature review of swing biomechanics and injury prevention

BACKGROUND CONTEXT

The golf swing imparts significant stress on the lumbar spine. Not surprisingly, low back pain (LBP) is one of the most common musculoskeletal complaints among golfers.

PURPOSE

This article provides a review of lumbar spine forces during the golf swing and other research available on swing biomechanics and muscle activity during trunk rotation.

STUDY DESIGN

The role of "modern" and "classic" swing styles in golf-associated LBP, as well as LBP causation theories, treatment, and prevention strategies, are reviewed.

METHODS

A PubMed literature search was performed using various permutations of the following keywords: lumbar, spine, low, back, therapy, pain, prevention, injuries, golf, swing, trunk, rotation, and biomechanics. Articles were screened and selected for relevance to injuries in golf, swing mechanics, and biomechanics of the trunk and lumbar spine. Articles addressing treatment of LBP with discussions on trunk rotation or golf were also selected. Primary references were included from the initial selection of articles where appropriate. General web searches were performed to identify articles for background information on the sport of golf and postsurgical return to play.

RESULTS

Prospective, randomized studies have shown that focus on the transversus abdominus (TA) and multifidi (MF) muscles is a necessary part of physical therapy for LBP. Some studies also suggest that the coaching of a "classic" golf swing and increasing trunk flexibility may provide additional benefit.

CONCLUSIONS

There is a notable lack of studies separating the effects of swing modification from physical rehabilitation, and controlled trials are necessary to identify the true effectiveness of specific swing modifications for reducing LBP in golf. Although the establishment of a commonly used regimen to address all golf-associated LBP would be ideal, it may be more practical to apply basic principles mentioned in this article to the tailoring of a unique regimen for the patient. Guidelines for returning to golf after spine surgery are also discussed.

Practice behaviors, attitudes, musculoskeletal complaints, and previous exposure to chiropractic care in a group of recreational golfers

OBJECTIVE

This study investigates the practice behaviors, attitudes, musculoskeletal complaints, and previous exposure to chiropractic care in a group of recreational golfers.

METHODS

A survey study was conducted on recreational golfers who were attending an annual golf show at the Hubert H. Humphrey Metrodome in Minneapolis, Minn. Northwestern Health Sciences University established a booth at the annual golf show and recruited subjects from this site. Four hundred two subjects completed the survey form. Of the 402 subjects, 4 of 5 respondents were male and 90% are of working age, with 19 subjects younger than 20 years and 26 subjects older than 60 years.

RESULTS

For almost 90% of subjects surveyed, golf is played at least 3 times per week, mostly for social interaction. Most subjects transport their own golf bags under their own power, and almost 90% wear spike golf shoes, most of the metal variety. Approximately half of the subjects reported having received chiropractic care in the past, and virtually all reported having positive experiences with the care they received. Many subjects reported musculoskeletal complaints that they commonly experienced, and 1 in 8 reported having been previously injured on the golf course. Half of the subjects exercise regularly to maintain a level of conditioning, and half expressed an interest in attending a specific golf fitness program.

CONCLUSION

This study provides the health care provider with more knowledge about this group of golfers. Knowledge of the most common musculoskeletal complaints provides an opportunity to identify and subsequently address the associated risk factors.

Muscle activity during the golf swing

In the right hands, the golf swing is a motion that inspires looks of awe from the public. It is a complex movement of the whole body to generate power to a golf ball to propel the ball great distances with accuracy. This movement relies on the coordinated sequence of muscle activation to produce a fluid and reproducible movement. This paper reviews the literature on golf swing related muscle activity. The phases of this activity are discussed with a view to assisting the practitioner in understanding the swing. Such understanding may help in the management of the injured golfer.

Golf and upper limb injuries: a summary and review of the literature

BACKGROUND

Golf is a popular past time that provides exercise with social interaction. However, as with all sports and activities, injury may occur. Many golf-related injuries occur in the upper limb, yet little research on the potential mechanisms of these injuries has been conducted.

OBJECTIVE

To review the current literature on golf-related upper limb injuries and report on potential causes of injury as it relates to the golf swing.

DISCUSSION

An overview of the golf swing is described in terms of its potential to cause the frequently noted injuries. Most injuries occur at impact when the golf club hits the ball. This paper concludes that more research into golf-related upper limb injuries is required to develop a thorough understanding of how injuries occur. Types of research include epidemiology studies, kinematic swing analysis and electromyographic studies of the upper limb during golf. By conducting such research, preventative measures maybe developed to reduce golf related injury.