Winnipeg Free Press - PRINT EDITION

Twist and shout

Playing golf can turn a walk in the park into a sub-par experience with back, elbow and shoulder injuries

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In comparison to other sports, golf is not a game that we think of as being risky or dangerous. It is an activity that you can play whether you are age 7 or 75, and it's popularity is growing, with more than six million Canadians teeing it up every year. However, like any physical activity, golf can lead to sore muscles, joints and tendons, with an estimated 15 injuries for every 100 golfers in a year. Pain in the lower back, elbow and shoulder are the most common trouble areas for golfers.

 

Lower back

The lower back is the most common part of the body to hurt from playing golf. It is responsible for about 20 per cent of all golf injuries. The twisting motion in the golf swing is a repetitive movement that can lead to strain of the back muscles and pressure on the spine. An unnatural golf swing and/or poor back flexibility are believed to contribute to the onset of lower back pain. Back pain is also one of the most common injuries in professional golfers, as well. Consider strengthening your back by doing rowing and pull-down exercises. See a personal trainer, physiotherapist or athletic therapist for a customized program. Try spending some time at the driving range to get your back used to the swing and seek some instruction on your golf swing to perfect your technique. More than 45 per cent of injuries are sustained during the golf swing (both at the point of impact and in the follow-through), so do not hesitate to have a pro look at your swing. Depending on the diagnosis, most back pain will resolve within a few days with the use of ice/heat and a brief break from swinging your clubs. Persistent pain that lasts more than two weeks should be assessed by a physician.

 

Elbow/forearm

Almost as common as back injuries in golf, pain in the area of the elbow and down the forearm can definitely damper your enjoyment of the game. The most common problem on the inside of the elbow is a tendinitis known as "golfer's elbow." It is an overuse injury and is more common in the over-35 age group. The tendons and muscles that bend the wrist and the fingers start at a common point on the inside of the elbow. With repetitive wrist bending and increasing age, this common point can become inflamed and painful. Depending on how much pain you have, treatments vary from a temporary break from golf, anti-inflammatory medication, ultrasound and acupuncture. Once the pain decreases, strengthening exercises for the wrist are important to include in the treatment plan. You can also have a golf pro check your grip. "Tennis elbow" is essentially the same problem as "golfer's elbow," except it occurs on the outside of the elbow and it can also occur with golfing.

 

Shoulder

The rotator cuff is comprised of four muscles located just behind the shoulder (on the front and back of the shoulder-blade bone). These muscles can be overworked with any arm sport, especially if there are overhead movements. The treatment for rotator cuff trouble is similar to the treatment of golfer's elbow, with strengthening exercises required for better recovery. The long head of the biceps can also hurt. The pain is usually in the front and top of the shoulder. Arthritis is also a common problem in the AC (acromioclavicular) joint where the collar bone meets the shoulder bone just above the shoulder.

 

Knees

Knee injuries are not very common in golf, although an awkward turn can sometimes result in a cartilage tear in a susceptible knee. The most common issue with the knee and golf is arthritis. Arthritis of the joint is more common in older adults. Pain, stiffness and swelling can interfere with the your game. The best way to minimize symptoms is to prepare for golf season by strengthening the hip and knee muscles and staying at a healthy weight. Many golfers with knee arthritis will also choose to have a viscosupplementation knee injection before golf season. Viscosupplementation consists of a thickened liquid that can lessen pain and stiffness in the arthritic knee, often for several months.

 

Too much play, you pay

A recent Australian study showed that you are more likely to sustain a golf injury if you play three or more rounds per week compared to less than three rounds per week. Those that play one to two rounds per week have the same risk of injury as those who only play nine or fewer holes per week. Steady and gradual progress in the golf game is the way to go. The "weekend warrior" approach can place you at risk for injury in most sports, and golf is no exception. If you have not been playing and then begin to put a lot of hours on the course over a short period of time, you can expect sore muscles and joints. If you are new to golf, make sure your golf clubs have a large grip and select clubs that will lessen vibration. A conditioning program for the lower back, shoulder and wrist is also a great idea. You can also find some stretching exercises at http://www.fitforegolf.com/public/frameset.cfm.

Be golf wise and enjoy your time tee to green!

 

Readers can ask Dr. Kennedy questions, but due to the volume of requests, replies are not guaranteed. Email: askthedoctor@freepress.mb.ca

Republished from the Winnipeg Free Press print edition May 4, 2010 D3

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About Dr. Maureen Kennedy

Born and raised in The Pas, Dr. Kennedy graduated from the University of Winnipeg Collegiate, earned a BSc and BA from the University of Winnipeg and an MD from the University of Manitoba in 1994. After certifying in family medicine at the University of Manitoba, Dr. Kennedy was awarded a two-year fellowship in primary care sport medicine at the University of Calgary Sport Medicine Centre. She completed this fellowship along with a MSc in Kinesiology at the University of Calgary. Her research focus was exercise counselling by family physicians. Dr. Kennedy further explored the use of exercise in medicine with PhD projects examining aerobic exercise in individuals scheduled for total hip or knee replacement surgery. She holds a diploma in sport medicine from the Canadian Academy of Sport Medicine and has served on numerous provincial and national committees for organizations such as the Alberta Medical Association, Canadian Academy of Sport Medicine, College of Family Physicians of Canada and Canadian Society for Exercise Physiology.

For the past 11 years, Dr. Kennedy has practised as a consultant in primary care sport medicine.

Dr. Kennedy's practice focuses on the diagnosis and treatment of injuries, muscle, bone and joint problems, orthopedic triage, weight management, osteoarthritis and dance medicine. She has served as the head physician for Alberta Ballet for the last nine years and has worked with the national women's hockey team along with many elite and amateur athletes in various sports. She points out that sport medicine physicians provide a tremendous service to the general public and the health-care system by shortening orthopedic waiting lists and providing non-surgical treatment options. "It's great to be back home in Manitoba and Winnipeg is a fantastic city," she adds. Readers can expect coverage on a wide range of fitness and health topics, including insider's tips on how to navigate the health-care system.

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