Golf requires a lot of time and effort, not to mention a great deal of skill, mental fortitude, and perseverance to excel at it. The explosive nature of the swing can put a tremendous amount of stress on the body, and most professional golfers have experienced some sort of nagging injury at one time or another in their careers. But you do not have to be a professional to experience some of the most common injuries in golf. Even casual golfers can sustain injuries. Many injuries can be prevented. Experts in sports medicine note a number of factors that contribute to common golf swing injuries: • Overuse and over-practice • Poor swing mechanics • Over-swinging • Not warming up the muscles properly • Rotational stresses placed on the spine • Incorrect grip and setup • Traumatic force to the body resulting from a poorly executed swing These factors can lead to the most common injuries: 1. Back Pain – An estimated 75 to 85 percent of all Americans will experience some form of back pain during their lifetime, and the numbers may be higher among golfers. The rotational stresses of the swing can place considerable pressure on the spine and muscles. Compound that with the fact that golfers spend four to five hours in a bent-over stance, repeating the same motion hundreds of times, it is no wonder that playing golf can cause minor strains in the back that can easily lead to severe injuries. To keep your back healthy for golf, add exercises that stretch and strengthen your back. 2. Tendinitis in the Elbows– Tendinitis (irritation and inflammation of the tendon tissue) is the most common condition affecting the elbow. It is frequently referred to as “tennis elbow” when there is an injury to the outer tendon, and “golfer’s elbow” when there is an injury to the inner tendon. Interestingly enough, most golfers suffer more from “tennis elbow” than “golfer’s elbow.” The risk of getting tendinitis increases with age and is higher in people who routinely perform activities that require repetitive movements that increase stress on susceptible tendons, such as hitting golf balls. In addition, these types of injuries can be aggravated by an improper swing motion. Treatment focuses on resting the injured tendon to allow healing, decreasing inflammation, promoting muscle strength, and improving improper swing mechanics. In most patients, tendinitis readily resolves with treatment. 3. Knee Pain – Knee pain can occur from the strain placed on a weak knee to stabilize the rotation of the hip axis at the beginning of the swing. Extreme force placed on the knee can result in torn ligaments. Arthritis sufferers may experience more knee problems because the degenerative nature of the disease, which results in a gradual wearing away of joint cartilage. Treatment of knee pain depends entirely on the cause of the problem. So, if you are experiencing symptoms, you must see a doctor. Stretching, rest and icing to bring down inflammation can all help alleviate symptoms. 4. Rotator Cuff– Pain may be felt in the shoulder or upper arm at various phases of the golf swing, or following play, often during the night and when extending arms overhead. Injuries to the rotator cuff can be sustained through traumatic force resulting from a poorly executed golf swing, hitting a root or rock, taking a deep divot, and from overuse. Golfers can develop tendinitis, bursitis, and tears in the rotator cuff due to the repetitive motion of the golf swing. Rotator cuff injuries are usually treated with anti-inflammatory drugs. In some instances, surgical repair becomes necessary. In these cases, modifications to the golf swing, combined with strength conditioning could alleviate symptoms and prevent further injury. 5. Wrist Injuries – The repetitive motions of golf and the high speed of the typical swing can place wrists at high risk for injury. Pain and tenderness on the top of the wrist, experienced at the top of the backswing and at impact, are common. The most common golf-related wrist injury is tendinitis or swelling of the tendons responsible for wrist movement. Many wrist injuries, as well as other golf-related injuries, can be prevented by a pre-season and year-round golf-specific conditioning program. 6. Hand and Finger Injuries – Much as with wrist injuries, the repetitive motions of golf, and the high speed of the typical swing can place the hands and fingers at high risk for injury. Repetitive blunt trauma or single severe trauma to the fingers can lead to numerous conditions such as tendinitis, broken or deformed bones and a condition called hypothenar hammer syndrome, or HHS. Learning the proper grip, avoiding long periods of ball bashing, and not hitting balls off of artificial mats can prevent all these injuries. 7. Neck Injuries – Neck injuries are common in new golfers who are not used to twisting their bodies so much. After a few hours of swinging the club and hitting balls, the neck muscles may shorten in spasm and freeze the neck into a painful position. Again, like most injuries, neck injuries can be prevented by first warming up the muscles, taking frequent breaks while playing or practicing, and slowly working up to longer periods of practice and play. The primary goal of an exercise program for your neck is to strengthen and stretch the shoulders and upper back. 8. Foot and Ankle Injuries – Throughout the golf swing, the body acts as a whip; power production starts with the feet pushing against the ground. Each foot moves differently during a golf swing. The back foot must allow for more pronation during the follow-through of the golf swing than the front foot. Injuries can occur when the golfer loses his or her footing or balance during the swing while performing the swing with the improper swing mechanics, and when hitting a ball off an uneven surface. Sprains in the ankles, tendinitis in the ankle and foot bones, and inflammation and blisters are common injuries that can be sustained while playing golf. Wearing properly fitted golf shoes and improving swing mechanics are the best ways to prevent foot and ankle injuries. 9. Hip Injuries – The hip joint is usually very mobile and able to withstand large amounts of loading stresses, but is particularly vulnerable to injury during golf since the swing involves a tremendous amount of pivoting and twisting movements. During the golf swing, the hip is subjected to repeated adduction and flexion/extension forces. This requires a great deal of control throughout the gluteal muscles and the adductor muscle complex. It is these rotational and shear forces that cause injuries such as groin strains and low back injuries. The hip joint is very similar to the shoulder joint or rotator cuff, so the injuries sustained to the hip are very similar to the tears that occur to the rotator cuff. Again, warming up muscles before play is imperative to preventing injury, as is adding flexibility and strength to the muscles that surround the hip joint and socket. (Jack Nicklaus and Peter Jacobsen had hip replacements.) 10. Sunburn – Skin is the largest organ of the body, and the most vulnerable to damage while playing golf. Repeated exposure to the sun can lead to skin damage and even skin cancer. Since golfers typically spend four to five hours exposed to the sun – often during the hottest part of the day – they are most likely to injure their skin through sunburns. Prevention is the best defense against the sun. Always apply sunscreen with an SPF of 15 or higher and reapply often during the round. Wear a hat, sunglasses, and protective clothing if you are going to spend long periods of time out in the sun. Preventing the most common golf injuries can be done by working on improving swing mechanics, participating in golf-specific conditioning programs, buying properly fitted equipment, avoiding long practice sessions, always performing a warm-up routine before practice and play, and (golf-specific) stretching frequently. By Karen Palacios-Jansen