Lower Back Pain, Mobility and the Golf Swing
Updated: Aug 16
In this edition, our fitness specialist, Africa Madueño Alarcón, looks at lower back pain arising from excessive mobility.
Low back pain is unfortunately part of life for most golfers, some 80% of golfers will suffer from low back pain at some point in life and that pain keeps them away from the course and golf.
Low back pain (“LBP”), does not have an easy diagnosis since it can be related to several muscle imbalances and asymmetries, but research has identified some of the known factors contributing to it. These include issues relating to both physical capacity and to deviations in the golf swing technique. According to recent research some types of "swing defects" have a higher probability than others in contributing to low back pain.
In this article, we focus only on a particular group – the deviations in golf swing technique (or "swing defects") that contributes to lower back pain (LBP). Specifically, we look at "reverse spine angle" and "side bending" or "lateral flexion" as the driving factors contributing to the swing defects. We will start with the "reverse spine angle" and its effects on the golf swing and what can be done to improve in this area, then we will move onto "side bending".
As we begin, I like to remember, the Pirelli tire advertisement and its slogan or catch phrase – power is nothing without control and that applies equally to the golf swing.
Reverse Spine Angle
In general, reverse spine angle (RPA) is more prevalent in women than men, but the underlying factors and exercises apply equally to both genders. Women predominantly experience excessive mobility and a lack of stability. This characteristic is typically associated with large amounts of flexibility with little control, which can be a recipe for disaster.
The TPI (Titleist Performance Institute), defines "Reverse Spine Angle" as any excessive upper body backward bend (trunk leaning towards the target) or excessive left lateral upper body bend (for a right-handed player) during the backswing. This swing fault makes it very difficult to start the downswing in the proper sequence, due to the lower body being placed in a position that usually limits its ability to initiate the downswing.
This swing characteristic is also one of the prime causes of lower back pain in golfers. When the lower body can't start the downswing or has a limited ability to initiate the movement, the upper body tends to dominate the swing which will eventually create path problems and limited power output. Reverse spine angle puts excessive tension on the lower back due to a forced inhibition of the abdominal musculature during the backswing, and excessive compressive loads placed on the right side of the spine at impact.
Stability comes from the action of small muscles called stabilizers. These muscles are often overlooked or neglected in training. As the name suggests, these muscles do not produce movement, but act on the joints to keep them firm, allowing the mobilizing muscles to act more efficiently. In effect, these stabilizers act as our body's natural brakes. But, when our natural brake system is defective, whether it is due to lack of strength or because of intramuscular coordination or inactivity, our ability to stop movements and stabilize segments is impaired.
Imagine a car with slow and weak brakes, the ability of car coming to a complete stop from a high speed is impaired and becomes dangerous for the driver. In people with great joint mobility and little stability the same can happen. Wide and poorly controlled movements, uneven acceleration and deceleration end up stressing the structures and causing injuries.
The Technical problems:
One of the big factors that is highly likely to cause low back pain is a swing deviation called "Reverse Spine angle” that occurs in the backswing.
This is a common characteristic and according to TPI (Titleist Performance Institute) 38.5% of the players have a reverse spine angle, affecting mostly women. It happens as the player turns his back on the target while shifting the center of gravity of the torso beyond the center of gravity of the hip towards the left foot.
Most amateur players also have this relative displacement between torso and pelvis, but it is usually to the right. In this case the player deflects the torso to the left. Professional players have very little deviation from the center of gravity (torso / hip) in the backswing.
Usually this swing defect is accompanied by posture with what is termed excessive lordosis with difficulty in performing the pelvic tilt test (lumbar mobility test). Lordosis refers to the normal inward curvature of the lumbar and cervical region of the spine. Excessive lordosis would exaggerate this curvature beyond that which is normally occurring,
This defect can be caused by the lack of stability or an inability to control this region of the body. The problem, though, is not always in the "hardware" (body) but, sometimes in the "software" (brain).
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Excessive Side Bending (Lateral Flexion)
Another factor related to low back pain is excessive "side bending" or excessive lateral flexion at the point of impact. It is a condition that is fairly common with people that have excessive mobility issues.
Every golf swing has lateral flexion movement. In the backswing, for the right-handed player, it is to the left and in through impact the movement is to the right. However, when this movement is exaggerated through impact it results in overloading the lower back.
With this type of swing deviation, it is most pronounced when looking at the player from the front (or "head on" position). The player has bent so much through his swing that the top of the head is much lower at impact than it was in the initial stance, addressing the ball.
Please be mindful that I do not mean to say that I consider these aspects of the golf swing to be “wrong” as my opinion is that the technique used in the swing is generally independent of the style. But, once the technique becomes harmful in that it has contributed to injury, we are left with two choices — either to change the technique (swing), or to better prepare and strengthen the body to be more resilient to the forces that the swing can impose.
Strengthening the Body to Avoid Lower Back Pain:
First of all, let's clarify that lower back pain is a consequence or a result of the injury and not the cause. It is the lack of control of the Core, with the cause usually being gluteal inactivity and deficient motor control. As a result, there is little to no benefit in strengthening the lower back, if the player does not address the hyper-mobility and instability problems. Assessment or evaluation of a qualified professional is essential at this point to assist you in developing a proper response and program.
However, based on professional experience in evaluating athletes for over ten years, it has been my experience that a large part of these problems arise from a unilateral weakness of both postural and gluteal control and difficulty in segmenting the spine, or what we call lumbar intravertebral mobility.
To assist, I have included two exercises below that use no equipment, You can add these to your routine or program to improve lumbar segmental mobility and activation of the glute: exercise video 1.0 – Supported bridge drill and the in video 2.0 – Hip extension, side bend and core strength drill or sometimes called the half kneeling side bend.
Video 1.0 – Supported Bridge
Video 2.0 – The Side Bend
Adding these two drills to your regular program can help you strengthen your core and avoid future lower back pain.
Africa Madueño Alarcón attended the University of Sao Paulo (Brazil), graduating with a degree in physical education. She has been a pioneer in the physical fitness and training field, particularly with professional and amateur golfers since 2005. Prior to becoming a regular contributor for World of Golf, Africa was the physical trainer for the Brazilian Golf Federation. She is a TPI (Titleist Performance Institute) certified Level 3 – Fitness trainer and has completed her TPI level 2 Medical Certification.
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