Today's News

Thursday, March 19, 1998

Spinal motion determines incidence of low back pain in golfers

The way golfers move their spine during a swing may be the cause of their aching back, according to a study on display at scientific exhibit 86.

"Low back pain is one of the most frequent and occasionally disabling problems in amateur and professional golfers," said study co-author Scott A. Banks, PhD, Orthopaedic Research Laboratory, Good Samaritan Medical Center, West Palm Beach, Fla. "Poor swing mechanics, excessive practice and poor physical conditioning can cause low back pain in recreational golfers. In professional golfers, whose swing is established, overuse is believed to be the cause of the injury."

A three-part study on how golfers' spinal movements relate to low back pain was conducted by Hiroyuki Sugaya, MD, department of orthopaedic surgery and sports medicine, Kawatetsu Hospital, Chiba, Japan, and researchers from the Orthopaedic Research Laboratory, Good Samaritan Medical Center.

Questionnaires were distributed to 283 professional golfers participating in major Japanese golf tournaments (115 male tour golfers; 55 men's senior tour golfers; and 113 female tour golfers).

All of the golfers were right-handed except for one player who was left-handed. "The left-handed player was excluded from the study," Dr. Banks said.

The golfers answered questions about demographic information (age, weight, height and golf experience) and described the incidence and location of their pain. The golfers' swings were divided into seven segmentsóaddress; ball address to top of back swing; top of back swing; top of back swing to ball impact; impact and follow-through; finish; and putting.

Fifty-five percent of the golfers reported having a history of low back pain; neck and high back, 33 percent; elbow, 16 percent; wrist, 15 percent; and knee, 9 percent. "The golfers with low back pain missed at least one tour event due to their injury," Dr. Banks said.

Most of the golfers experiencing low back pain reported having pain on their right-side, low back (51 percent). Other golfers experienced pain on the left-side (28 percent) and central (21 percent) portion of their spines.

"Golfers with the right-side, low back pain experienced aggravation of their symptoms during the impact of the golf ball through the follow-through phase of their swings," Dr. Banks said.

In the study's second part, radiographic assessments of the lumbar spine were analyzed. Ten male elite amateur golfers and 16 professional golfers (14 males, 2 females) with low back symptoms were compared to a control group of 105 randomly-selected, non-golfing patients who also had low back pain.

"We found the golfers exhibited a significantly higher rate of right-side osteophyte formation and degenerative changes at the facet joints on their X-rays," Dr. Banks said.

The final portion of the study involved the use of a three-dimensional motion analysis system to analyze golfers' movements during their swings. Six high-speed cameras aided by 29 body markers were used by the researchers.

Markers were placed on the shoulder, elbow, wrist, thigh, knee, ankle, toes, calf and heel of 43 male, right-handed, experienced golfers.

"We hypothesized that a golfer's lateral or sideways bending combined with an increase in twisting speed contribute to degeneration and injury," Dr. Banks said. "We call the combination of these measurements the ëcrunch factor' and plan to use it as the basis of comparison between healthy and injury-prone golf swings in future studies."

The study's principal author is Hiroyuki Sugaya, MD, department of orthopaedic surgery and sports medicine, Kawatetsu Hospital. Co-authors of the study are Hideshige Moriya, MD, department of orthopaedic surgery, Chiba University, Chiba, Japan; and Frank F. Cook, MD, and David A. Morgan, Orthopaedic Research Laboratory, Good Samaritan Medical Center.

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Last modified 02/March/1998