Why do golfers lack spine?

Why do golfers lack spine?

Pardon the pun, but golfers appear to lack spine.

Why? They appear to not only be damaging that body part with greater regularity in recent years but, with no thought, mindlessly following the golf swing developed intuitively, centuries ago, by mere shepherds in Scotland! It is surely high time to rethink the golf swing in a more scientific manner, in order to aid both the vertebral damage that golfers are suffering and to give them the courage of their (swing) convictions!

As regards the injury involved, a 2016 New York Times column mentions that the who’s who of professional golfers are suffering from back injury, many of them chronically – Tiger Woods, Rory McIlroy (since age 19), Jason Day (since age 13), among others. Another article states that, according to experts, the lower back is one of the three most commonly injured areas of an elite golfer’s body.

Of course amateur golfers suffer back pain too – 15-34 percent of their population, according to one article (McHardy & Pollard, 2005), compared to 22-24 percent of professional golfers.

So is lower-back pain inevitable and should golfers resign themselves to it? Not at all – there are several cures possible. Different professionals have differing opinions (McGill, 2008), based on their backgrounds. A physical therapist’s diagnosis may be based around manual therapy, a surgeon’s around surgery and a chiropractor’s around a chiropractic adjustment.

Of course, a cure is never as effective as prevention. With regard to prevention, too many “authorities” will recommend different solutions. Fitness folks will recommend a set of life-long exercises. In fact, Rory McIlroy states that his back pain from his teenage years is what caused him to become such a "fitness buff." Golf instructors, often those whose students continue to have back injury, will suggest swing poses which should be made and which should be avoided.

The best idea for a golfer who practices and/or plays a lot is to have his or her own understanding of what causes back injury and understand what to do to prevent it. Once injury occurs, it’s not in one’s hands anymore but in those of a range of healthcare professionals, all with differing viewpoints. The only scientific way to understand injury is from a loading perspective, because it is this simple formula that makes all the difference:

Applied load > tissue strength = injury

What is tissue and what is applied load? Human tissues prone to injury in sports are mainly bones, the muscles that move them and the structures that support them, such as tendons, ligaments and cartilage. According to Dr. Stuart McGill, not merely professor of spine biomechanics at Waterloo University, Canada but virtually the godfather of spinal injury, to understand back pain and injury, the only correct approach is through an understanding of the mechanics of tissue damage, and then following a tissue-based approach to assessing any problems that may arise.

What then is “load”? There are three main types of load (and several combinations of them). A compressive load is one when two parts, such as bones, are pushed closer together. A tensile load exists when something, such as a ligament, is stretched. A shear load is one which is applied parallel to a surface, as when two touching bones are being pushed and pulled respectively, in opposite directions.

Having understood what tissue is and what loads are, the next thing a golfer should know more about is which positions of the golf swing are likely to be causative factors. What, so far, are the opinions of some of the experts?

Leading professional golfer Jason Day, who had a herniated disc issue during a major part of 2016, said at a recent press conference that his plan to prevent future injury is to take a shorter backswing as he feels he crunches down on his right side more with a longer one, which brings on his back problems.

According to the Titleist Performance Institute, there are three main swing faults that cause low back pain (Finn, 2013): early extension of the hips moving forwards towards the target line during the downswing, a reverse spine angle (or arching of the spine) during the backswing and a reverse-C finish (or arching of the spine) during the follow through.

Despite so much more research in recent years and so many leading golfers having access to the most well-known fitness trainers and instructors, back injuries continue unabated. Perhaps the correct correlations between golf swing positions causing injury have not been assessed in adequate detail? Perhaps some outside-the-box thinking will lead to better explanations?

Dr. McGill’s book "Low Back Disorders," is based on his many years of research, as well as much experience. According to the book, back injuries result from repeated loading, and a good example by McGill is that of lightly hitting one’s thumb with a hammer over a long period – ultimately even the slightest touch will cause pain as the tissues concerned become hypersensitized. The only solution is to stop using the hammer, but first a golfer needs to understand where in his or her back the “hammer” is being applied. As leading researchers such as McGill have not directly looked at the golf swing, a look at positions that replicate golf movements to a good extent might be a good starting point.

The spine is capable of twisting, side bending and forward-and-backward bending. Which of these movements create maximum loading on the various structures of the spine? One study by McGill shows muscle activity, which is an indication of muscle force, in normal standing as compared to side bending. While the numbers that indicate muscle force in four important core muscles are 3, 5, 4 and 5 in quiet standing, they become 18, 18, 25 and 14 in a right-sided side-bend. Also, many studies in McGill’s lab have shown that too many cycles of movement, when leading to full forward bend, will cause disc herniation.

As regards twisting, McGill points out that there is a big difference in twisting with low twist “moment” (i.e., rotary force) and that which has high moment which places large compressive loads on the spine. Try this drill to understand the difference: cross your hands over your chest, stand upright and rotate everything from your head to your ankles together to the right. Then, with the hands still crossed over the chest, try keeping the pelvis locked in place and rotating merely the shoulders to the right, to the maximum possible extent. Which “twist” is easier and seems effortless, and which cause a tight feel, and would place larger loads on the back? If you feel the latter was a tougher move, note that it represents the much vaunted “X factor,” which some research has shown does not relate to greater club speed anyway!

Let us look at other research to develop more perspective. One study (Marras et al., 1993) looking at occupational tasks associated with lower-back disorders found that the velocity of a movement is the single biggest predictive factor of back injury risk. As the velocity of a movement increases, more trunk muscles become active and increase the loads they place on the spine as they contract forcefully. The directions of the velocities that exert larger loads are during side bending (lateral trunk movement) and twisting. Together with these, the larger the forward bending angle of the spine, the greater the loads imposed. The paper concluded by stating that changing the loads which they found appeared to be the main causative factors could reduce risk in a “high-risk” group by up to 11 times.

So, putting together all of the above, would it not appear that the movement to watch out for is the one made when there is a lot of speed as well as a lot of side-bend, twisting and forward-bend in the swing? Perhaps we can, based on research, agree that most injury to the spine is likely to be caused as a golfer is swinging at great speed, during the downswing and early follow-through, with a lot of lateral flexion and forward flexion, as well as rapid trunk rotation? This latter spinal rotation would involve the type of twist with the large compressive loads, if a golfer were to twist one part of the spine (thoracic) against another (lumbar), not with it. Given all this information, what might be a viable solution? It is not a problem that will go away with a mere shortening of the backswing.

Might reverting to the classic swing which so many insist is less injurious to the spine than the modern one be beneficial?

Let us examine the difference. The classic swing allows the entire trunk to rotate, not just the thorax against a fixed pelvis. A point in its favor. However, it permits the lead foot to come off the ground, so that that foot must be planted back before forward-directed weight shift can begin, as the lead foot needs firm purchase against the ground before the rest of the body can be pulled forward, towards target. This weight shift is important for starting momentum, after which body rotation takes over to supply the main contribution of club speed. Body rotation comprises a pelvis-before-shoulders movement, so that the lower body-segment passes speed up the chain to the higher segment. The classic swing is not so good for developing maximal speed then.

Of course classic swing fans might ask, “How come so many long drivers produce speed with this method?” The reply would be: they produce speed despite the method, simply by being so strong and fast that they can plant the lead foot, pull the rest of the body along very quickly and do it all before the inevitable rotation created by the contraction of stretched, powerful core muscles begins.

The modern swing, while torqueing one part of the spine against the other and putting excessive loads on it, has much more opportunity for the creation of early speed, as the planted lead foot can quickly generate some starting momentum through weight-shift, after which body rotation can take over. Two videos on baseball pitching and batting beautifully break up those movements into an early weight shift followed by a later rotation and explain how the opportunity for the former can be missed if not performed early enough in the downswing.

So what should a golfer do: make a less powerful swing or risk injury by making a more forceful one? Neither. Instead, any dedicated golfer should understand what the two methods both lack. Every golf swing allows the trail shoulder to be higher (to some extent or the other) than the lead one, at the top of the backswing. This creates a major problem. The trail shoulder must now move a long way down to deliver the club back to the ground. The more-skilled golfers start an early pelvis rotation during which the raised upper body can “reconnect” with the lower body. The-less skilled golfers simply drop the trail shoulder forward and down. And down….

Both result in the positions Day dubbed a side-crunch. Why does any golf swing require a raising of the trail shoulder during the backswing, anyway? After all, at both address and impact, it must be lower, because the trail hand is always lower on the club’s handle! Not only does the raised trail side require excessive distance for the trunk to drop down through, but it also changes the line-of-action of important core muscles into an excessively downward one. And this whole movement cannot even give a golfer enough speed, on a consistent basis, to be justified.

What should happen then, is for a minimal amount of weight shift to take place for some starting momentum, followed very quickly by powerful core rotation. Such a rotation should keep all parts of the spine aligned at all times - from the neck (cervical spine) to the upper thighs (to include the thoracic and lumbar spines as well as the pelvis), not twist one part of the vertebral column against another. Although some weight shift followed by quick core rotation are both vital, neither should happen at the risk of lifting the trail shoulder during the backswing, which then forces it to have to drop a long way down, causing an excessive side-bend-forward-bend situation during that part of the golf swing which also involves maximal speed and rotation. So, dear reader, simply understand what matters and then either device your own solutions to the problem, or use the only golf swing in the world that is already programmed for more speed and less injury and has, what one might term, spine!

Kiran Kanwar has been a full-time graduate student for over six years for the specific purpose of studying human movement and researching the golf swing, in the hope of unraveling, with irrefutable science, the many mysteries surrounding it.

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Kiran Kanwar