Swinging Through The Pain: Understanding Golfers and Low Back Pain

In 2022, avid golfers Mark (85 years old) and Ryan (25 years old) both suffered significant back injuries while playing golf, impacting their daily lives and enjoyment of the game. Mark plays golf for socializing with friends and family, while Ryan uses it for networking and gaining clients as a realtor.

Both found me, a Maple Grove Chiropractor and certified Titleist Performance Institute professional, through word of mouth. They reached out and we were able to conduct a comprehensive low back evaluation on the same day.

Here are the top 5 things that I look to differentiate when a patient has a low back injury.

The following has been taken and revised from MyTPI.com the full article can be read here:

http://www.mytpi.com/articles/health/the_golfer's_guide_to_lower_back_pain_part_1  

1.  Muscle Strain or Ligament Sprain: A muscle strain or “pulled muscle” as well as an injured ligament will usually resolve in 2-4 weeks with expert care. An acute injury causes significant muscle stiffness, fascial restrictions, joint fixations, or movement alterations that need to be addressed. Sprains or strains are the most common form of lower back injury we see. Symptoms may range from a minor ache to a sharp debilitating pain. Most sprains and strains are localized in the lower back region, meaning pain does not radiate into the butt or leg. The chemical inflammation around the injury is usually sore to the touch. My office can help with this.
   
   
2. Disc Injury: The low back discs act as a spacer between the neighboring vertebrae to protect the bone above from the bone below and create enough space for the spinal nerves to exit the spine. Imagine the disc as a jelly filled donut. If excessive or abnormal stressors are placed on the disc, tears can occur. When this happens, the force of the jelly against that tear can cause a bulge in a portion of the donut leading to a “bulged disc.” In more severe cases, the jelly exits through the donut wall leading to a “ruptured disc.” The discs are also susceptible to degenerative changes over time. To continue the analogy, imagine the jelly inside of the donut drying up. Any of these disc problems can leave the spinal nerves vulnerable to irritation or compression resulting in dysfunction and pain. Most disc injuries create radiating pain into the buttocks or the leg (sciatica) due to the irritation of spinal nerves. Sitting for prolonged periods of time, bending forward into a slouched position, or lifting heavy objects can all exacerbate symptoms associated with a disc injury. My office can help with this.
   
   
3. Altered Joint Mechanics or Motor Control: Interestingly, the brain can completely change the spine’s ability to move just by changing which muscles are firing and altering the sequence of when muscles fire. These altered joint mechanics can lead to chronic problems over time. Most experts believe over 80% of all chronic lower back problems begin this way. My office can help with this.
   
   
4. Degenerative Arthritis: Just like all large joints (hips, knees, and shoulders) spinal joints can become arthritic. Bone spurs may form and can encroach on the opening for the spinal nerves. With time, these bony outgrowths can fuse, irritate nerves and create inflammation in the area. Spinal stenosis, the narrowing of the canal is a very common problem with arthritic changes. Most arthritic problems in the spine create sharp pain with certain movements. The resulting inflammation can then cause chronic dull pain over time. My office can help with this.
   
   
5. Bone Fracture: Stress fractures and pedicle fractures (spondylolysis) are common problems seen in the lumbar spines of rotational athletes. This occurs due to the extension and rotation of the spine, causing neighboring vertebrae to collide into each other. This action places stress on the back portion of the spine and can lead to these types of fractures. Injuries of this sort can lead to deep dull pain and instability in the spine. My office can help with stable injuries, instability of the spine requires a referral to the orthopedic and spine specialist.

Mark’s evaluation revealed:

• Mark complained of sciatic nerve pain going through the back of his left glute and down the back of the left leg stopping at the knee.
• His posture has forward rounding shoulders and limited mobility in his mid-back.
• Difficulty standing up straight, rising from a chair, and difficulty bending backward without pain.
• Full strength in all extremities, but significant pain when assessing the left side of his low back muscles.
• Muscle spasms on both sides of his low back, left worse than right.
• X-Ray images taken in my office revealed spinal stenosis of the 5th lumbar vertebrae (L5) and severe disc degeneration of L5.

Ryan's evaluation showed:

• Pain and limited rotation to the right, with restricted rotation to the left.
• No signs of neurological issues or disc injuries.
• Full strength in all extremities.
• Muscle spasms on the left side of his low back and below the right shoulder blade.
• Severe inhibition of the left and right glute muscles, and excessive activity in the lumbar paraspinals and hamstring muscle groups.
• Mild curve, not to the level of scoliosis, and postural alterations to the lumbar spine.
• Occult, stable, stress fracture of the L5 vertebrae (Happened 10 years ago). Otherwise structurally within normal X-ray images. 

After evaluating Mark and Ryan, we discussed their conditions and their desire to return to golf as soon as possible. 

Here are 3 easy screening tests that can be done from home to determine if there is an imbalance or restriction in the hips or mid back. This may relate to golfers and athletes who have complaints of low back pain. Try these safe and easy tests today. https://youtube.com/shorts/ubXvneQavKM

Both Mark and Ryan were presented with a treatment plan involving chiropractic care and specific rehab exercises for their unique low back issues. We set a goal to return to golf with limited discomfort in 1 week and be pain-free in 2 weeks. Then to continue care as their bodies proper joint mechanics are restored, strengthened, and stabilized. They were given at-home exercises and a golf-specific warm-up to prevent future injuries. By following the plan, both Mark and Ryan were back on the golf course, enjoying their favorite activity without the need for other specialists or medications.

Dr. Greg Beenken is a Maple Grove Chiropractor and owner of Northwood Chiropractic and Wellness. His passion is working with people who are active and engaged in sports and activities that are lifelong. Results matter and getting people out of pain, functioning properly, and enjoying life again is why Dr. Greg is committed to serving others. Contact us today 763-432-3932