
By: Jason Brumitt

Introduction
Golf is a sport played by millions of people of all skill levels worldwide. While most of us do not share Tiger Woods' perfect swing, amateurs and professionals do share one thing in common-injuries.
Golf is often assumed to be a sport free from injury. Although golfers do not traditionally experience traumatic injuries (such as those seen in football), injury can occur due to the repetitive nature of the golf swing. Low back injuries are common in both professional and amateur golfers4.

Forces on the Spine
The lumbar spine experiences significant forces during the golf swing that may contribute to injury. Pro and amateur golfers experience compressive loads 8 times one's bodyweight, whereas the loads experienced during running are only 3 times body weight2. Amateur golfers experience shearing forces nearly equivalent to those experienced during squatting2.
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With professional golfers performing up to 2000 swings a week (during both practice and competition), it can be appreciated the potential for injury from repetitive overuse3.

Injury Prevention Strategies
Professional and amateur golfers can reduce their risk of low back injury by improving their swing mechanics and participating in a strength-training program.
Addressing technique errors with a golf professional will decrease the forces upon the spine2 and reduce incorrect muscle compensation patterns.

Strength Training Program
The trunk muscles serve dual roles of stabilization and torso rotation5. Stabilization is key to minimizing potentially injurious forces on the spine. Trunk rotation contributes to the movement of the club from the initial ball address position through the entire swing.
As a golfer, your strength and conditioning program should include specific training for the upper body, trunk, and lower body. Cardiovascular conditioning must also be included to maintain endurance for an 18 hole round.
The following exercise program details a sport specific trunk program (table 1).
| Table 1. Core Program For Golfers |
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Note:
An abdominal bracing maneuver should be performed with each exercise. Contract both your abdominals and lower back muscles, making the muscles stiff without creating any movement of the abdominal wall.
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Hang Twist
Grip a pull up bar or the top of a squat rack with a supinated grip bilaterally. Raise the knees towards the right shoulder until thighs are parallel with the floor. Hold for 1 to 2 counts, then lower and repeat to the opposite side.
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Figure 1: Hang Twist.
Lunge Twist
While performing the classic lunge exercise, rotate your trunk toward the side of your rear leg. Return to the start position and repeat to the opposite side. A stick can be used to help balance.
Click To Enlarge.
Figure 2: Lunge Twist.
Prone Twist
Start with both feet supported on a bench and both hands positioned on the floor, shoulder width apart. Bend one knee to waist height and then rotate the trunk toward the opposite side. Hold up to 5 seconds. Switch legs and repeat to the opposite side.
Click To Enlarge.
Figure 3: Prone Twist.
Roman Twist
Incorporating a twisting motion with a roman chair exercise will increase the challenge to the oblique muscles improving trunk stabilization capacity.
Click To Enlarge.
Figures 4 & 5: Roman Twist.
Russian Twist
Position yourself on the roman chair as shown. While maintaining the abdominal bracing contraction, slowly rotate your trunk and arms to the side. Hold for up to 5 seconds. Return to the start position and repeat to the opposite side. To increase the intensity, hold a medicine ball out with straight arms.
Click To Enlarge.
Figures 6 & 7: Russian Twist.
Lat Pulldown
The latissimus dorsi provides power during the forward swing and acceleration phases of the golf swing. Since this muscle is used to provide power, it should be trained with low repetitions and heavy weights.
Figure8: Lat Pulldown.

Conclusion
Performing a strength-training program will help to reduce the incidence of lower back injuries and may even improve your driving distance.
This article originally appeared in NSCA's Performance Training Journal, a publication of the National Strength and Conditioning Association.
For a free subscription to the journal, browse to www.nsca-lift.org/perform.
About the Author
Jason Brumitt is a board-certified sports physical therapist working for Willamette Falls Hospital in Oregon City, Oregon. His clientele include both orthopedic and sports injury patients. To contact the author email him at jbrumitt@elitesportandfitness.com.
References
- Brumitt, J. (2004). The Missing
Component to Core Training: Endurance.
Performance Training Journal, 3(6):16 - 18.
- Hosea TM, Gatt CJ. (1996). Back
Pain In Golf. Clinics in Sports Medicine,
15 (1):37 - 53.
- Hovis WD, Dean MT, Mallon WJ,
Hawkins RJ. (2002). Posterior instability
of the shoulder with secondary impingement
in elite golfers. American Journal of
Sports Medicine, 30(6):886 - 890.
- McCarroll JR. (1996). The Frequency
of Golf Injuries. Clinics in Sports Medicine,
15(1):1 - 7.
- Pink M, Perry J, Jobe FW. (1993).
Electromyographic analysis of the trunk
in golfers. American Journal of Sports
Medicine, 21(3):385 - 388.
Jason Brumitt
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