I was having a discussion with my client the other day who happens to be an avid golfer and is constantly trying to improve his performance in his game. He mentioned that his golf pro has suggested that he try to develop better upper body rotation to help correct his habit of leading with his hands in his downswing too much. He then came to me and simply said ‘ Jean, we need more rotation, upper body, what do I do?” Of course I proceeded to show him some mobility and flexibility exercises that tuned-up his upper body (thoracic spine) rotation in about 20 minutes. ” Will this really help my swing” he asked? My reply to him was simple and to the point, ” you will swing far better if you’re not injured or dealing with pain somewhere else in your body”. “Having uninhibited range of motion in your thoracic spine during your golf swing will take the added pressure off of other muscles and joints to make up for what your thoracic spine isn’t doing during your swing”. My client’s perplexed look softened as he raised his left eyebrow and said “Now I get it!” He was also motivated to hear that the corrective exercises to correct the mobility in his upper back were fairly easy to do.
Clinically, I use a joint-by-joint approach when it comes to analyzing golf and tennis-related injuries which offers an intuitive and systematic look at how golf and tennis injuries are created. Our treatment procedures go beyond mere pain relief and restoration of normal everyday function. Many of the conditions listed below are by-products of golfers not having the requisite flexibility or mobility in the thoracic spine or hips to achieve optimal swing mechanics. The golfer with the more chronic injuries will usually exhibit compensations in their swing mechanics for these movement deficits. After an assessment, I can then discern where the key movement deficit lie and implement the necessary interventions to correct this for the patient. Many times a few progressions in some corrective exercises will be enough to correct mobility issues for rotation in the thoracic spine, along hip flexibility for hip pivoting during the swing.
Common injuries affecting leisure golfers are:
- lower back pain (due to poor thoracic and hip rotation)
- sacro-iliac joint pain and dysfunction
- wrist joint pain and dysfunction from casting the club
- tennis elbow (tendonitis)
- shoulder rotator cuff strains and micro-tears
- neck pain and associated dysfunctions
Tennis players on the other hand can experience similar injuries, although the “moments of injury” in tennis tend to occur more at the musculo-tendinous junction (MTJ -where the tendon and muscle meet) within the athlete who may possess a muscle imbalance that potentiates the condition of elbow tendinitis. Although the genesis of these injuries differ for each sport, it is the repetitive nature and biomechanical stress from the countless repetitions to the MTJ that weakens the elbow and results in injury. This moment of injury is particularly accentuated when the elbow is fully extended making contact with a powerful, opposing ground stroke.
This means that in treating your particular injury, we not only address the symptoms of the injury—relieving pain
and rehabilitating associated muscle weakness—but also attempt to restore proper function to the “weak link in the chain” which has suffered most of the biomechanical stress and also treat the rest of the “myofascial chain” in which your injury resides. The myofascial chain is a continuance of muscles and fascia that includes the joints and connects all the muscles in a movement pattern. It is the “kinks” in the myofascial chain and micro-tearing at the MTJ that is of concern and usually the common site of pain.
The golf swing is a particularly unnatural coordinated movement of the arms, torso and knees, placing tremendous forces on the spinal joints. Performing a good swing in good physical condition and with proper biomechanic form is stressful enough on the tendons, joints, and spine.
Performing it with poor form (as above) posture and body conditioning can lead to very painful and undesirable chronic consequences.
The challenges of tennis are similar but different in that the rate and frequency of repetitive movements are much greater during the same play time, with repetitive stresses multiplied on the dominant elbow joint and frequency of impact on the knee and ankle joints. Although tennis elbow is one of the more common injuries seen in our clinic, it is not the only debilitating condition that can plague the tennis pro or amateur. Knee injuries can also occur should the tennis player be weak and imbalanced in the hip musculature.
At Spectrum, once we have treated the pain, inflammation, associated muscle weakness, and pain-free range of motion, we can then use a well established and innovative assessment protocol, called Functional Movement Screening, to give us an accurate picture of how well you move in seven different movement patterns. These patterns translate into your golf or tennis swing mechanics and provide us with a blueprint of your personal movement attributes. The movement patterns reveal mobility/flexibility deficits as well as stabilizer deficits.
With the biomechanic origin of your injury in mind, devising and implementing a plan to correct your movement deficits and swing performance is never easier. Mobility and stability exercises have spoken volumes in demonstrating success in optimizing performance and reducing propensity for injury. This may also include educating and re-programming your movements to produce more efficient and productive movement quality, something that may even improve your game.
If you have any questions as to getting help with your golfer’s or tennis body, feel free to go to our website, view our contact information and connect with me personally to have your assessment reveal your weaknesses.
Yours in Sport,