Most golfers play through pain day after day after day. Surprising? If you play golf, you know this is true. You have a shoulder problem, your buddy wants to drive the cart because his low back has been bothering him, and your brother-in-law is so lathered in icy-hot that you can’t handle the smell standing next to him.
But, hey I think going and playing 36 holes this weekend sounds like a great idea! As the summer continues to smash us in the face, so do the aches and pains that come with repetitive swings and limited recovery time. For many athletes, this part of the season is where minor tweaks and tightness become more significant injuries.
Many “retired athletes” choose to play golf either for work, leisure, or because of its low impact nature. However, this sport has a shockingly high incidence of injury due to its repetitive nature and swing complexity.
The everyday golfer tends to wait until their pain is impacting their handicap until they seek help… but, the truth is.. sports physical therapy can not only be the answer to a prayer when pain is present, but it can also be the game winning scenario when it’s used before an injury takes place.
But what’s the real question here… it is.. How can sports physical therapy get you back on the course once pain strikes, but also keep you on the course across the years, playing better, and preventing injuries before they even start? In this blog, we will break down the most common golf injuries, why they happen, and most importantly.. how having a physical therapist in your corner can be the difference maker between sitting out weekend after weekend and enjoying schooling your buddies for years on end.
But Real Quick – This is Who We Are & How We Help Golf Athletes
But, first we should answer the question of who we are and why the heck we are qualified to treat the Charlotte golfer. At The Charlotte Athlete (TCA), we are sports performance physical therapists… yes, we are DOCTORS… but think of us as your personal mulligan for aches and pains. We specialize in getting athletes back to peak performance by solving the ROOT CAUSE of their injuries and help mitigate future injuries for long term success. At TCA, our therapists undergo fellowship training to advance their skills in sports and orthopedic manual therapy in order to provide the best treatment for their athletes. The Charlotte Athlete was built by athletes for athletes. We all have played high level sports and know what it’s like to be sidelined with an injury. We understand the frustration, the impatience, and the fear of losing progress. We’ve been there. That’s why having someone in your corner who can relate to where you are as an athlete makes a difference. We know it’s not just about healing, it’s about getting back on the fairways you love with confidence.
Trying to push through the pain might feel tough in the moment .. but continuously playing on top of injuries always backfires .. performance suffers.. compensations creep in.. and the risk of worsening injuries increases dramatically. In golf, overuse injuries are the most common. What does this mean? Typically injuries in golf come about from the repeated stress of the SAME MOTIONS over time combined with pre-existing mobility and strength imbalances within the body. It may go without saying, but let’s break down why this happens in golf:
- Repetitive swing mechanics
- Asymmetry of the swing
- High torque and rotation
The smartest play is to listen to your body early, so you can have longevity on the course and continue beating your son, daughter, son-in-law, and later your grandson as you age. Let’s not normalize the idea that pain is normal. We’ve got your back! At The Charlotte Athlete we not only help you rehab current injuries, but we like to get ahead of things that are holding you back from your game. Golf may be a game of inches, but physical therapy is how you get those extra yards.
If you are in the Charlotte area with pain or injuries, we’d love to help! Let’s dive in..
Demands of The Golf Swing
The golf swing may look smooth and effortless, especially when we watch Scheffler and Mcllory on tv. However, underneath it is one of the most complex and powerful movements in sports. It’s not just about “swinging the club” .. it’s about generating, controlling, and transferring force from the ground up in a matter of seconds. From set up to follow through, the swing requires mobility, stability, strength, and timing working in harmony to create success. When even one link in the chain is limited or off kilter, other areas often pick up the slack, leading to extra stress and increased risk of injury.
Think about the body acting like a “spring” during the golf swing. But, let’s break it down by joint to give you a little more information.
Feet and Ankles
Every powerful golf swing starts from the ground up. Having a stable foot not only creates a strong base and allows you to distribute weight effectively, but it also allows you to transfer force from your back leg to your front leg. This is essential for maximizing clubhead speed and power. On the other hand, limited ankle mobility can disrupt this balance and reduce the ability to generate force cleanly. At a minimum, you need 15-20 degrees of ankle dorsiflexion and functional control of inversion/eversion for a healthy swing.
Knees
We like to think of the knee as the “sandwich joint” between the hips and ankles. If there is an issue here, there is likely something breaking down above or below. The knee is not solely a hinge joint, it does have components of rotation that are essential in the golf swing. Without the dynamic control that the knee provides, golfers may lose power or experience excess stress in the lower back and hips. We often see this with backside collapse on contact.
Hips
Welcome to the ultimate powerhouse of your swing! They rotate against the stable lower body during the backswing, building torque like the coiled spring we mentioned earlier. This torque is unleashed on the downswing creating explosivity. Appropriate rotation at the hips is the foundation of power transfer in your swing … let’s put it this way .. this is the difference between a 270 yard driver and 200 yard driver. But what does this look like? In order to get the most primed and smooth swing that you are looking for, 45 degrees of lead hip internal rotation and 45 degrees of trail hip external rotation are key. Limitations here can also force compensations at the lower back or knees.
Spine/Core
Let’s slow down for this one. The number one thing that is extremely important to understand is that THE LOW BACK IS NOT MEANT TO ROTATE. What?! The lumbar facet joints are built to provide motion in the sagittal plan, efficient in bending you forward and backward, not rotationally. The midback aka the thoracic spine and hips provide the rotational mobility that we are looking for, while the lumbar spine aka the lower back should remain more stable. With this being the case, a strong, efficient core allows the most appropriate energy transfer from the hips upward. When core stability or spinal mobility is lacking, injury risk increases, and performance and accuracy decreases. During your backswing, the goal is a “90-degree” shoulder turn. Well.. what does that mean? At the top of your backswing, we are looking for your front shoulder to reach the top of the ball.
Shoulders
Keep it simple stupid. The shoulders create a wide arc for the club as the trail shoulder externally rotates and the lead shoulder internally rotates at the top of the backswing. But, how much are we talking? For a right handed golfer, the backside shoulder needs to move back and behind the golfer .. ideally requiring at least 90 degrees of external rotation for the most optimal back swing. Proper shoulder blade control allows for smooth motion without impingement or strain through the shoulder joint. More specifically, your scapula needs to upwardly rotate 60 degrees, and posteriorly tip efficiently for a minimally compensatory swing.
Elbows and Wrists
The final energy transfer! How much of a WHIP can you create? This whip-like motion is what adds the finishing touch to your club head speed. At impact, the stored force from the ground all the way up the chain is released through the wrists into the club, generating not only speed but also distance. However, this “whip-like” motion puts the finishing stress on the smaller joints, which is why wrists and elbows are frequent sites of overuse injuries. But, why does this happen? It is not solely because of the repetitive nature of the swing. Limitations in the midback, shoulders, and even hips can lead to increased demand on the wrists and elbows.
So where does that leave us? All of that force that you just generated from the ground up through the body and explodes through the clubhead into the ball. The efficiency of this transfer depends on how well each joint along the chain contributes without breaking down. The golf swing isn’t just about technique.. It’s a WHOLE BODY movement where EVERY JOINT MATTERS. Sure you can compensate to get the job done .. we are athletes. BUT, if one link in the chain is weak, stiff, or painful, the energy transfer is less efficient, performance suffers, and other joints are forced to pick up the slack.. Ie. compensation. This is where injuries occur.
Common Injuries and Root Cause
If you have made it this far .. CONGRATS! You are taking all the right steps to learn about how golf affects your body, how to ensure peak performance, and how to mitigate injury! You are already a step ahead of your bros!
Now, I know we have talked about the inherent repetitive nature of the sport, so I don’t want to be a dead horse here. But, ultimately, if an athlete has faulty movement patterns in their swing, or mobility / strength limitations throughout the kinematic chain, this can predispose them to injuries down the road. At TCA, we like to draw our focus to solving THE ROOT CAUSE of pain. What does that mean? It means looking past the quick “fixes” like ice, ibuprofen, or stretching for five minutes before you tee off. We take pride in really digging into the bigger picture. Are you getting enough sleep to allow your body to recover? Are you sleeping in positions conducive to healing? Are you fueling with solid nutrition, or surviving on energy drinks, protein bars, and gas station snacks? Are you sitting at a desk for 8-10 hours a day in the same posture? Getting to the root cause means we don’t just patch up a sore spot.. We identify and address the habits, weaknesses, and stressors that are feeding your issues in the first place. Think of us less like the “duct tape fix” and more like the pit crew that makes sure every part of your system is tuned up and firing properly.
When it comes to golf, there are a handful of injuries that we see pop up over and over again in the clinic:
- Shoulder
- Rotator cuff injuries and tendinosis
- Labral tears
- Gleno-humeral Instability
- Elbow
- Medial epicondylosis (aka golfer’s elbow)
- Tendon sprains or tears
- Low back
- Muscle strains
- Facet dysfunctions
- Stress fractures
- Radiculopathy / nerve tension
- Hip
- Impingement
- Labral tears
- Wrist
- Ligament sprains
- Tendinosis
So what’s the bottom line? Many people make the argument that golf is a low impact sport, which is technically true .. but it is a physically demanding sport on the body. By paying attention to your body both on and off the course, you can keep yourself strong, avoid being sidelined, and swing pain free, while your buddies are over there icing their backs.
If any of these sound familiar to you or you have been experiencing pain with your swing .. GET YOUR LOCAL CHARLOTTE PHYSICAL THERAPIST FROM THE CHARLOTTE ATHLETE IN YOUR CORNER!
What Physical Therapy Looks Like At Our Clinic
If you are anything like me, I’m sure you want a sports physical therapy assessment and plan that is geared to not only your sport, but also the demands of your swing. At The Charlotte Athlete, all of our athletes are considered family from the moment they walk through the door. We will let you tell YOUR STORY. One of things that we value at TCA is TIME. Our clinic was established on the grounds of THE PATIENT COMES FIRST.
What does this look like?
All of our physical therapy sessions at 1-on-1 with a Doctor of Physical Therapy. You will not be bounced around from therapist to therapist, and you will not be tossed off to an assistant at any point during your care. We value your time, just as much as you value ours. After you tell us your story, we will ask you a wide range of additional questions to give us more detailed information and fill in the gaps to help us ensure the best possible treatment. But.. you’re an athlete right? So, WE HAVE TO SEE YOU MOVE. Yes, this includes taking you through range of motion, strength, neuromuscular screenings, etc; however, it doesn’t stop there. We will take you through some overall functional movements to see how you move, and we are going to take you through a sports assessment that helps us analyze the movement patterns and demands of your swing.
Wow… I mean that sounds great.. I think?? But, what does all of that mean? If you are having pain swinging, we are going to take time to analyze your swing. If you are having pain chipping, I want to see what that looks like. These are the tasks you have to get back to in order to perform on the course! And if you have videos of your swing from screwing around at the driving range or a golf lesson, even better! These are things that absolutely NEED to be looked at!
But, not only is this something that we will look at in detail, it is also something that we will explain to you in a manner you can understand. How often do you walk out of a doctor’s office with a new treatment plan or prescription, but don’t even know what the problem truly is? This is the big thing we want to avoid. This is YOUR body and YOUR golf game, so we want you to be part of YOUR care. If you walk out of our office confused, we did not do our job. Our goal is for you to be confident in your treatment plan and add some tools to your tool box to continue helping yourself down the road.
Ultimately, we know you need an individualized rehab and training plan that fits your needs, addresses your concerns, and helps you crush your goals in the tee box, on the fairway, on the green, and even in the bunker and rough if it’s been a tough day.
Don’t let little aches and pains linger.. We’ve got you covered!
Manual Therapy
At The Charlotte Athlete, our therapists’ programs are precisely designed to meet the specific needs of each golfer, certifying personalized and effective treatment. We all have experience with fellowship training in sports and orthopedic manual therapy, which not only help us to assess you in a hands on and functional manner, but it allows us to provide you with the best possible treatment to get your body ready to perform. At The Charlotte Athlete, we don’t settle for “standard of care”, we pride ourselves on going above and beyond for our patients and that starts with our education. PT school just wasn’t enough to provide us with the tools we needed to be elite level therapists. Our fellowship training sets us apart in our hands on skills and clinical reasoning in order to best treat our athletes.
The cool part about our treatment approach is that it will look different for every athlete that walks through our doors. Our treatments are geared specifically towards your individual needs to get you back to finally being able to blame a bad shot on clubs instead of the body. Our goal with manual therapy is to set the stage for strengthening and mobility.
Got shoulder pain? Remember.. We are looking to get 70 degrees of backside shoulder external rotation in order to achieve the smoothest backside. So … not only will we do some soft tissue work, joint mobilizations, and dry needling to decrease your pain and help your shoulder blade move more efficiently with your backswing, but we will also do some hands on joint mobility to improve your external rotation. But, it doesn’t stop there, because the real gains are solidified in the gym.
Got lower back pain? We are going to look at joint restrictions around the lower back to help decrease some of the demand that is being forced through this area during your swing. We can’t settle for a 45 degree front shoulder turn on your back swing. Not only is this going to lead to your lower back overworking, but it will also drastically decrease your power and whip.
In case you were wondering – dry needling is also an additional tool we hold in our toolbox that we utilize quite frequently! Dry needling causes a localized twitch response in the directed muscle, which can help release tension, improve blood flow, and ultimately reduce pain and restore normal muscle function. It is also just a great tool for performance RECOVERY in golfers due to the repetitive nature of the sport!
But… as you can imagine… none of this stuff matters without a top notch exercise regimen to help strengthen these tissues and enhance your overall swing performance.
Sport Specific Exercises
If you are looking to take your golf game to the next level, find yourself a physical therapist with the knowledge and training to develop you a strength program geared towards your needs. This is the difference between a good golfer and a great golfer. Generic rehab or training plans may help you improve your general strength; however, they typically miss the mark when it comes to golf specific performance. Strength and mobility is extremely important, and while these are building blocks to a great foundation and it is a place that we may start, it is not the answer to your prayer. Finding a physical therapist with the knowledge to train your body in the way that your golf swing demands is critical.
As we mentioned before, this is not your GRANDMA’S CLINIC. At The Charlotte Athlete, our therapists are trained to analyze your movement patterns from the ground up. General rehab may focus on muscle groups in isolation and utilize general mobility routines, but the truth is… a golf swing does not use parts of the body in isolation. It is a complex rotational movement that follows something we like to call a “kinetic chain.” But, what does that mean? To put it simply, it means that the body does not move parts independently. If any link in the chain is isolated or out of sync, power output decreases, stiffness and tension become notable in your swing analysis, accuracy suffers, and performance becomes less than ideal. This is why elite golfers often describe their swing as a “rhythm” or “flow”.
With this being the case, our Doctors target the specific movement patterns that affect your swing mechanics. If you are experiencing pain in the low back, it is important to first ensure that each part of the spine is doing its job. As we discussed above, the thoracic spine is the prime rotator of the spine, while the lumbar spine is built to mainly flex and extend. Creating stability of this lower back with core exercises geared towards anti-extension and anti-rotation first and foremost is key. During this time, we can also work to improve the mobility of the thoracic spine into rotation to take this demand off the lower back during your swing.
If you are experiencing shoulder pain, we already know that golf has a high occurrence of overuse injuries in the shoulders such as rotator cuff tendinopathies and shoulder impingement. What we have not taken as deep of a dive into is how much the shoulder blade plays a role to keep your shoulders healthy. With the golf swing being a super high torque movement, we obviously need to get mobility through the midback… as we discussed above… but the shoulder is an interesting joint due to its ability to move SO MUCH. However, shoulder movement is actually affected by MANY different joints. If one of those areas is not moving well then another area will pick up the slack and overwork. This is why we focus so heavily on the shoulder blade! If athletes are NOT getting adequate mobility from the shoulder blade, this can lead to compensations such as: increased mobility of glenohumeral joint,. which is where these injuries arise. So, don’t expect to grab a band and do shoulder external rotations all day long… because news flash this is not the answer. Once we get the shoulder blade moving appropriately with exercises like wall slides, overhead carries, and landmine presses.. Get ready to have some fun with upper body plyometrics!
Force Plate Testing
But, it doesn’t stop there! Have you ever wondered what it was like to be treated like a professional athlete? Not only do you get advanced 1-on-1 care with manual therapy, exercise prescription, and potential dry needling… but let’s break down how you really move and also PUT A NUMBER ON IT! At The Charlotte Athlete, we utilize VALD force plates to measure the way your body produces, absorbs, balances, and transfers force. This gives us real time data on strength, power, and imbalances that could be holding you back in your golf game. These are the same tools trusted by professional athletes around the country, and now they are at your feet .. literally. Whether we’re evaluating your swing mechanics, tailoring your rehab, or building a program to maximize performance, the VALD force plates are an added tool to ensure your treatment is precise, personalized, and designed to unlock your full potential on and off the course. But… come ready to sweat!
Closing/ Benefits of a having a PT in your corner
Ready to take your golf game to the next level? Don’t do it without a PT in your corner. A full evaluation with our Doctors at The Charlotte Athlete goes beyond traditional physical therapy. It combines expert movement assessment with deep understanding of the demands of the golf swing, in addition to top notch knowledge in manual therapy to best address your imbalances. By identifying the areas of your body that need more mobility, stability, and/or strength, our PTs will create a customized plan designed to sharpen your mechanics, increase power, and most importantly keep you pain free on the course. Don’t let nagging aches or movement inefficiencies hold you back from lowering your handicap or beating your buddies. Schedule your evaluation today because your swing deserves more power than your excuses. Then you can just worry about your short game 😉
Thanks for reading,
Dr. Leah