Low Back Pain and Your Golf Game
Low back pain can be limiting your golf game and an aggravating injury. Even worse when it keeps you in the clubhouse. While back pain can be caused by a wide variety of factors, here are three movement screens to assess your movement efficiency. Inability to perform these can lead to swing compensations, shot inconsistency, and an increased risk for injury. Let’s get you moving and back on the golf course!
Screens developed by the Titleist Performance Institute are great starting blocks to begin looking at a golfer’s movement and relating it to their swing. We will go over three of the movement screens below and discuss how they will influence your golf swing. Check out our free ebook, “Unlocking Your Golf Swing”, by clicking here. Each screen below is accompanied by some corrective exercises with picture and descriptions.
Hip Strength and Core Stability
Stability is likely the single most important factor in our swing. Without hip and core stability, you lose the ability to access the power you can generate because you have no stable base to push from. Without stability it would be like trying to fire a cannon from a canoe. You’re not going to have much luck.
During our swing, our pelvis and core initiate the swing. Each phase of the swing following the initiation builds from this stable base generating more and more speed as you progress from pelvis, to torso, to arms, and finally to the club head.
Begin by laying on your back in a supine position with your knees bent, feet flat on the floor. Lift your pelvis off the floor and maintain a neutral pelvic position (no rotation). Keep the hands up towards the ceiling to eliminate the upper body from helping compensate. You will want to monitor pelvic rotation throughout the screen. To assess the left glute and core, lift the right leg as showing in the picture. Hold this position for 10 seconds.
Throughout the hold, monitor to see if the left side of the pelvis drops down towards the floor, you begin shaking in the right leg or core, or you start to get cramping in the right leg. You will test the other side in the same fashion.
If any of the prior mentioned pelvic drop, shaking, or cramping occur in the legs, you will need to address hip and core strength/stability to improve this screen.
Without strength and stability there can be no mobility. Trouble performing this test?Cramping in your hamstrings while performing this test? Get ready for the truth. You are at a high risk for all 12 swing faults identified by Titleist Performance Institute. S-Posture, C-Posture, loss of posture, flat shoulder plane, early extension, over-the-top, sway, slide, reverse spine angle, hanging back, early release, and chicken winging. Yikes!
Hip flexor/core strengthening – While lying on your back, keep the low back pressed into the floor and slowly extend one leg as far as you can bringing it as close to the floor as you can without touching the floor. During this, the low back should remain flattened and not arch. Too difficult or easy? Click here for a simple core progression.
Reverse Lunge with Press – Begin by holding a kettlebell or weight in your hands. You will hold the weight at chest height and perform reverse lunge by stepping back with one leg while bending the lead leg. When you bend the lead knee, you should drop your chest slightly forward as well so most of your weight stays in the lead leg. For an added challenge press the weight forward as you step back.
Trunk Rotation with Wall Facilitation – This can be a challenging exercise especially if you have difficulty with balance. I would not recommend it for those that have difficulty performing the reverse lunge with press or have difficulty with single leg stance balance. To perform this exercise, grab a kettlebell and stand near a wall. You are going to get into a lunge position with one foot forward and the other on the wall behind you. Press both feet hard into the surface they are against to engage and stabilize the lower extremities. Hold the kettlebell in the hand opposite the forward leg. Rotate through your thoracic spine.
This is a complex exercise, I highly recommend watching the video to get a good feel for this one first.
The name says it all. This is another straightforward screen, but you need to be honest with yourself when completing the screen. While it is very straight forward, some people like to embellish their ability to touch their toes so we will make this as basic and fool (cheat) proof as possible.
For this screen, and for the sake of consistency, you want to remove your shoes and place your feet and ankles together. To perform the screen, bend forward reaching for your toes without letting the knees bend. You touch the toes, you pass. You don’t touch your toes, you don’t.
If you are unable to touch your toes with both legs straight, you can see if you have one lower extremity that is tighter than the other. To screen out a more involved limb, place a slight bend in one knee and reach forward then repeat with the other knee bent. If you can bend further forward when the right knee is bent and left knee straight, for example, you know the right leg is more limited. If you bend forward with the left knee bent and right knee straight and notice more mobility, the left leg is more limited.
While the ability to bend forward and touch your toes may not seem like a necessary motion to perform an efficient swing. The inability to perform this motion can lead to C-posture, early extension, excessive knee flexion (bending), loss of posture and can take away a great deal of power from your swing. Beside the swing, you want to be able to gracefully get the ball out of the cup after sinking that long putt. Don’t you???
Plantar Fascia Rollout – Place a ball such as a lacrosse ball or tennis ball under your foot and place a moderate amount of pressure on the ball. Roll your foot forward and back. You can make it more specific by finding the areas along the foot that feel tighter or more tender and hang out in the spot a little longer.
Walk the dog – I like calling this one walk the dog. You get into a “downward dog” yoga position and pedal your feet. Be sure when you are in the position, you are pressing your hands into the floor, shoulders away from you and shifting your weight back towards your heels. If you are unable to get into this position, it can be modified by leaning against a countertop or wall.
Bottoms up – Place your forearms and elbows on your thighs and assume a slight squatted position. And, like a center in football looking back to snap the ball to his quarterback, lift your butt up towards the sky, press your knees back and attempt to look between your legs.
Lower quarter rotation, specifically rotation at the hip, may be one of the biggest limiting factors that is hurting your golf game. For a right-handed golfer, the right hip must be able to internally rotate during the backswing and externally rotate during the follow through. The left hip must be able to externally rotation during the backswing and internally rotate during the follow through.
There can be come common compensations made for loss of internal rotation by turning the foot outward, but this can cause some issues during set and may cause some inconsistency with ball contact. Why not get this fixed!?
For this test you will need to remove your shoes to ensure your toes of the testing leg always remain forward. First, select the leg you will be testing first. Keep this leg straight and put a slight bend in the opposite knee with toes touching for balance. Turn your body as far as you can in each direction while keeping your hands on your hips. This will assess hip rotation, knee health, and foot/ankle health and mobility.
You will want to make sure you compare side to side when you rotate into internal and external rotation. An efficient movement during this screen is the ability to rotate at least 60 degrees. As a cheat, you can place the elbow of a 5 iron in front of your foot and rotate towards the club shaft. If you get your pelvis equal to that of the shaft, this will be about 60 degrees. Internal rotation is assessed by rotating towards the straight leg and external rotation is assessed by rotating away from the straight leg. This test should not be painful and you should be able to maintain a tall, upright posture with your rotation. See below for pictures.
As you are doing the screen, it is easy to see why this is such an effective screen for the lower extremity. You are essentially isolating each leg through the backswing and follow through. The inability to perform the movements into your back swing, for a right-handed golfer this is right lower extremity internal rotation and left lower extremity external rotation, can lead to sway and vice versa for slide for the follow through. Other swing characteristics can include reverse spine angle, hanging back, and early extension.
The fix for this section is primarily focused on improving hip internal and external rotation. For full benefit, you should include exercises that emphasize total LE mobilization and stability.
Single Leg Stance with Rotation – Assume a single leg stance position. While balancing on one leg, rotate your body to the left and right pausing at the end range of motion for a few seconds then rotating back to the other direction. If you have trouble with balance, perform the exercise as if you were performing the screen by keeping on leg in a toe touch position.
Switchbacks – In a seated position assume the position below by bringing one hip into external rotation and one hip into internal rotation. Hold this stretch and breath. While maintaining a sitting position, switch the position of the hips bringing the hip that was in external rotation into internal rotation and vice versa. Be sure to maintain a tall, upright trunk position to emphasize the hip mobility. If you are unable to get the legs down to the ground while in this position, use a pillow or yoga block under the knee as support.