Golf Injuries: An Overview
Guest: Dr. David Geier – Orthopedic Surgery, MUSC
Host: Dr. Linda Austin – College of Medicine - Dean’s Office, MUSC
Dr. Linda Austin: I’m Dr. Linda Austin. I’m talking with Dr. David Geier, who is Assistant Professor of Orthopedics and Director of the MUSC Sports Medicine Clinic. Dr. Geier, here in South Carolina, there are a lot of very avid golfers and lots of people who come here on vacation to play golf. What are some of the common injuries that golfers experience?
Dr. David Geier: It’s actually surprising. There are a number of injuries. Most people associate golf with this leisure activity that’s fun and anybody can play it. And that’s absolutely true. But given time, and it can cause its share of aches and pains; some very minor, some that can progress to be more severe. One of the surprising things, actually, if you look at the literature on golf injuries, is the high incidence of muscular and bony back injuries, back pain; neck and back pain, I think, a lot due to the posture that the player is in with the swing and the very rapid rotational forces on the spine as you go through the swing. So, clearly, the spine is one. There are also a number of shoulder and elbow injuries, or aches and pains, with respect to golf, as well as knee, foot and ankle problems.
Dr. Linda Austin: When you talk about spine injuries, it makes me wonder if yoga wouldn’t be a good exercise for golfers.
Dr. David Geier: It’s interesting. With golf, typically, especially at the recreation level, not to be rude, you’re not looking at high-level athletes. I mean, this is a sport that, literally, everybody can play. You don’t need to be a big muscular person. So, a lot of times, you have people that aren’t in the best cardiovascular shape, or don’t have great muscular strength. They don’t have good abdominal strength. That’s why, in our program, when we deal with a lot golf injuries, spine or otherwise, we emphasize core strengthening, abdominal strengthening, hip and pelvis strengthening, hamstring stretching, that kind of thing, to try to cut down on this. And yoga, you’re absolutely right. Yoga and Pilates, maybe there is a role for that in a sport like this.
Dr. Linda Austin: Are there any examples of core strengthening exercises that you could describe?
Dr. David Geier: Absolutely. It may be a little difficult in an audio format. But I think most of us are familiar, through TV or through gyms, with these Swiss balls, these large flexible balls that you can do abdominal strengthening with, abdominal crunches and oblique training, and things like that. A good abdominal routine to strengthen the abdominal muscles is critical for preventing lower backaches and pains, and injuries. So, good abdominal strengthening, oblique strengthening, and the muscles of the anterior and posterior thigh, and the around the hips, is very important. And a good strength and conditioning trainer at your local gym should be able to describe and demonstrate core strengthening exercises, most of which can be done at home. They’re not things that require fancy equipment.
Dr. Linda Austin: The upper extremity, arm, wrist, elbow, and shoulder, I’m sure, can also have injuries.
Dr. David Geier: Absolutely.
Dr. Linda Austin: What are some common injuries for golfers?
Dr. David Geier: It’s interesting. People hear the term tennis elbow and think that it’s related to tennis players, that only tennis players get that. And, certainly, tennis players do get that. But it’s a very common injury in golfers. In the muscle groups and tendons just below the elbow, on either the inside of outside, you can get, at first, kind of a nagging achy discomfort in that area; soreness, related mainly to the swing. But you start noticing, more and more frequently, having it at rest, with normal activity.
And there’s a variant of that, golfer’s elbow, along the inside, just like tennis elbow on the outside of the elbow. The rotator cuff either tears or, more importantly, there’s shoulder impingement, which is very common in golf. If you think of it, it’s an overhead activity with high rotational forces coming through the backswing. It’s very common to get shoulder problems, not through any one swing, but over time, repetitively swinging the golf club. Not just through 18 holes, but over the course of three of four times a week, through the course of a season, and years, the result is a lot of wear and tear.
Dr. Linda Austin: What sorts of problems there?
Dr. David Geier: The problem that older golfers get into with, say, knee injuries, and hip, and that kind of thing, is that it gets much easier, as you twist through a golf shot, or you squat, to get a tear of the meniscus, which is the shock-absorbing cartilage in the center of the knee. It can get twisted and pinched and cause a tear, and sometimes that’s even surgical. And there are arthritic problems. People talk about knee and hip replacements. Certainly, the milder forms of that, the wear and tear through walking 18 holes can start to build up on the knee and ankle, and hip.
Dr. Linda Austin: So, what sort of preventive message could you provide us with?
Dr. David Geier: First and foremost, we have to remember that this is, really, a sport, or at least a form of exercise, and we need to treat it that way. We talk a lot, in our team sports, about the importance of warming up and stretching. It’s just as important in golf as it is in some of these other sports to warm up the muscles for a few minutes, as well as to stretch. And in this case, not just the shoulder and upper extremities, but some lower back strengthening, some trunk rotational stretching, in addition to warming up for three to five minutes, to get blood flowing to the muscles.
Stretch the muscles of the lower back, the abdominal muscles, and the muscles on the side; the obliques, the hip muscles, and do some simple exercises for shoulder and elbow stretching. And again, a good physical therapist or athletic trainer, or strength and conditioning expert can teach that.
Also, as you start to get into these aches and pains with the shoulder and the elbow, it helps to learn some exercises with, say, a physical therapist, not just to rehab these injuries, but also to prevent them from recurring.
Dr. Linda Austin: If someone starts getting an injury, let’s say golf elbow, should they back off from playing so frequently for awhile?
Dr. David Geier: That’s a good question. I think that’s a very good initial step to take. If it’s really uncomfortable while you’re playing, you’re really not doing yourself any favors trying to play through it.
Now, muscle soreness isn’t inherently bad, but certainly a sharp stabling pain and really unusual discomfort are signs that maybe, even only for a day or two, you should back off. The question is, how long do you give it before you need to have it looked at? And there’s no rule of thumb, other than; what I’d say, if it’s limiting your ability to play, that’s a good reason to be seen. Along with that is, not just if you can’t play at all, if your swing isn’t as good or you’re unable to control your accuracy due to shoulder or elbow pain, you may be able to play, but if it’s affecting your quality of play, that’s another good reason to have that injury examined by someone that treats a lot of sports injuries.
Dr. Linda Austin: Dr. Geier, thank you so much.
Dr. David Geier: Thank you.
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