Fore! An Intro to Golf Rehabilitation

Golf is a sport enjoyed by millions, from casual games to competitive tournaments being played worldwide.

However, like any sport, golf carries the risk of injury. For physical therapists, understanding the nuances of golf rehabilitation is key for helping patients return to the game they love. This article will look at golf rehabilitation, discussing common injuries and their causes, how to assess them, and strategies to treat them. 

Related: Introduction to Golf Rehabilitation and Performance: 90 Percent Mental, 90 Percent Physical 

Understanding golf-related injuries 

Golf might not seem as physically demanding as sports like hockey or soccer, for example, but it places a lot of stress on many body parts.  

The repetitive nature of swinging a golf club combined with the need for power and precision can lead to several injuries.  

Common injuries in golf 

Some of the most common golf-related injuries include: 

Golfer's Elbow 

Medically known as medial epicondylitis, Golfer’s Elbow happens from overuse of the muscles and tendons in the forearm. This leads to pain and inflammation on the inside of the elbow, which typically flares up with activity. 

Rotator cuff injuries 

The rotator cuff is made up of four muscles that attach around the shoulder, working to stabilize it during movement. Overuse or improper technique can result in tears or tendonitis, causing pain and limited mobility. 

Lower back pain 

Golf swings require strong and fast rotational forces, which can strain the lower back muscles and spine. This often results from poor swing mechanics, overuse, or being too deconditioned. 

Knee pain 

Knee injuries in golf are usually related to the twisting motion of the swing. Things like meniscal tears or ligament injuries can happen, especially in the leading knee, although these tend to be lighter injuries. 

Wrist injuries 

The repetitive action of gripping and swinging the club can lead to tendonitis. The wrist is especially vulnerable during impact with the ball or ground, which can also contribute to Golfer’s Elbow. 

Common causes of golf injuries 

Understanding the root causes of golf injuries is important to treat them properly. Common causes include: 

• Poor swing mechanics: This is one of the most common causes of golf injuries along with overuse. Incorrect form can place excessive stress on the many body parts involved in golfing, causing injuries. 
• Overuse: Repetitive motions can lead to wear and tear, especially for newbie golfers that aren’t yet conditioned to the unique movements of golf. 
• Lack of flexibility: Limited range of motion can increase the risk of injury. 
• Improper warm-up: Skipping warm-ups can make muscles more susceptible to injury if you use them completely cold. 

Like any injury, golf injuries are often multifactorial and require a proper assessment to understand the whole picture.  

Physical therapy assessment and diagnosis for golf rehabilitation 

A proper physical therapy assessment is the cornerstone of effective golf rehabilitation.  Physical therapists should aim to get a deep understanding of the injury and the best path to recovery, including determining when the patient can go back to golfing. 

The key is to understand that golfers are still humans, and they need to be able to make proper “human” movements before they can jump back into golf. It’s all about progression without skipping steps.  

Initial assessment 

The first step involves detailed history-taking where the physical therapist gathers information about the injury, including how it happened, the symptoms, and any previous medical history. 

• Medical history: Understanding past injuries and medical conditions. 
• Physical examination: Assessing range of motion, strength, and flexibility. 
• Functional assessment: Observing the patient's golf swing to identify biomechanical issues. 

Physical examination 

Physical therapists should take their patients through a physical exam that checks the affected area as well as surrounding areas that may influence the injury. This may include checking for pain points, range of motion, strength, and any visible signs of injury. 

Functional assessment 

Functional assessments evaluate how the injury affects the golfer's ability to perform specific movements related to the sport, like swinging or setting up. It also helps identify any compensatory patterns that might have developed. Breaking down the movements that cause pain into small sections (e.g. raise golf club, twist hips, swing, follow through, etc.) can help find hidden issues.  

Imaging and tests 

In some cases, things like X-rays, MRIs, video review, or ultrasound might be needed to get a more detailed view of the injury. These could help diagnose the exact nature and extent of the injury.  

This includes: 

• Imaging: MRI and X-rays can help identify structural issues. 
• Biomechanical analysis: Video analysis of the golf swing can pinpoint areas of improvement or potential concern. 
• Functional movement screening (FMS): Evaluates movement patterns to identify weaknesses and imbalances. 

Goal setting 

Based on the assessment, the therapist and the patient should set realistic goals for recovery. These goals help in creating a personalized golf rehabilitation treatment plan that aligns with the patient's needs and timelines. 

This is also a good time to set expectations with the patient and agree on the treatment plan for adherence. 

Physical therapy treatment for golf injuries 

A physical therapist’s job is to design and implement a treatment plan after assessment. Physical therapy treatment for golf injuries is multifaceted, with the goal to reduce pain, improve function, get the patient back to golfing, and prevent future injuries. 

Pain management 

Initial treatment often focuses on reducing pain and inflammation. Techniques may include: 

• Manual therapy: Hands-on therapy to mobilize joints and soft tissue. 
• Modalities: Use ice, heat, ultrasound, and/or electrical stimulation to reduce pain and swelling. 
• Medication: Over-the-counter pain relievers or prescribed medications as advised by a healthcare provider. 

Restoring mobility and strength 

Once pain is under control, the focus shifts to restoring mobility and strength. This involves: 

• Stretching exercises: To improve flexibility and range of motion in the affected area. 
• Strengthening exercises: Targeted exercises to build strength in the muscles supporting the injured area. 
• Core stability: Strengthening the core muscles to support the spine and improve overall stability, especially during lower body rotation. 

Functional training 

Functional training aims to restore the golfer's ability to do the specific movements required for golfing. This includes: 

• Swing mechanics: Analyzing and correcting swing mechanics to help prevent future injuries. 
• Balance and coordination: Exercises to improve balance and coordination, which are important aspects of a golf swing. 
• Sport-specific drills: Gradual reintroduction to golf-specific activities to ensure a safe return to the sport. 

Education and prevention 

Education plays a very important role in long-term recovery and injury prevention. This involves: 

• Ergonomic advice: Giving patients guidance on proper posture and techniques to minimize stress on the body while golfing, such as club swinging techniques. 
• Warm-up routines: Effective warm-up routines to prepare the body for the physical demands of golf, focusing on the rotational and high velocity movements of swings, for example. 
• Lifestyle modifications: Advice on lifestyle changes that can support recovery and prevent re-injury, like weight management, exercising, and injury management strategies in the case of minor re-injury. 

Final thoughts 

Golf rehabilitation is a specialized area that requires a proper understanding of the sport's physical demands and common injuries. By staying informed about the latest treatment options and continuing education, physical therapists can provide patients with the highest quality of care.  

Both seasoned rehab professionals and new physical therapy students can make a big impact on patients with golf injuries wanting to get back on the course by understanding the details of golf movements and injuries, which enables their patients to return to the game they love with confidence and reduced risk of injury.