It always has baffled me the number of players I’ve played with who experience lower back pain during a round of golf. These people so often know they can be better but have no idea where to start. This is what started my journey to learn why and what can be done about it. Lower back pain is one of the most common complaints among golfers, according to TPI 28.1% of golfers experience back pain during or aftern a round. That is one person in every foursome playing. As someone who has treated golfers of all levels, I’ve seen firsthand how debilitating this pain can be, not only limiting performance but also affecting the enjoyment of the game and life.
But why is it so common in golf? The sport, while seemingly low-impact, requires repetitive rotational movements that put a unique strain on the spine. Unlike other sports, golf combines static posture with high-velocity movement, causing significant pressure on the lower back, especially when swing mechanics or physical limitations come into play.
Let’s break down the reasons why lower back pain is so prevalent in golf.
Physical Reasons for Lower Back Pain in Golfers
There are a few physical and biomechanical reasons why golfers may experience lower back pain, and understanding these can help you reduce the risk of injury.
Addressing Your Body: How Physical Conditions Influence Lower Back Pain
1. Pelvis Alignment and Control
Proper pelvic control is essential for maintaining a neutral spine during your swing. Variations or restrictions through the pelvis will cause the repetative rotational force to transmit somewhere else instead of taking some of the load. This is often sent straight to the lower back.
2. Lead Hip Internal Rotation*
Reduced internal rotation in the lead hip is a significant predictor of lower back pain. If the hip can’t rotate fully during the downswing, your body compensates by rotating the lower back excessively.
3. Core and Hip Stability
Weakness or imbalances in your core muscles can also contribute to lower back pain. TPI presents a great example of this. If your side-bridge endurance test shows that one side is significantly weaker than the other, it can indicate a higher risk of pain. We test for these weaknesses and develop strategies to improve stability.
4. Hip Flexor Flexibility
Tight hip flexors can affect your lower back by restricting the pelvis’s ability to rotate properly during the swing. I have rarely seen a tight back that doesn’t have tight hip flexors associated with it.
Making Physical Changes to Reduce Pain
To reduce the risk of lower back pain, there are several changes you can make to your body that will support your swing and overall golf performance:
1. Strengthening the Core
Your core muscles provide the foundation for a stable, powerful golf swing. Working on exercises like planks, dead bugs and side bridges helps create balance and endurance, which can minimize strain on the lower back.
2. Improving Pelvis and Hip Mobility
Ensuring your pelvis remains neutral throughout the swing and increasing hip mobility (especially lead hip internal rotation) can significantly reduce the load placed on the lower back. We focus on exercises that encourage pelvic stability and improve hip flexibility to help your body move more efficiently. Lead hip rotation issues is a often a big road block for golfers trying to take there game to another level
3. Enhancing Hip Flexor Length
Loosening tight hip flexors can allow your pelvis to move more freely during the swing, reducing the strain on the lower back. Stretching and mobility exercises tailored to your individual needs are crucial here.
4. Addressing Imbalances
We also assess and address muscular imbalances, ensuring that both sides of your body work together. Correcting these imbalances can prevent compensations that lead to back pain. We generally see a stronger side (trail side) but we want to work towards balance.
Some basic Swing Modifications to try that can prevent Lower Back Pain
While improving physical conditions is critical, making the right swing adjustments is equally important in reducing lower back pain. Here are some changes you can make to your swing to alleviate or prevent lower back pain:
Basic setup changes
1. Neutral Pelvis
Begin by maintaining a neutral pelvis throughout your swing. This helps minimize excessive lumbar flexion and extension, reducing strain on the lower back.
2. Reduce Back Extension in the Backswing*
Avoid overextending the back during the backswing. If you feel like you need more range of motion, practice reducing your overswing and maintaining a flat pelvic position. This will increase rotation in the thoracic spine over time, providing the necessary flexibility without overloading the lower back.
3. Open Your Stance
Turn your left foot out. This can decrease the load in the lower back as it helps manage a hip with less rotation. Just be sure to work on alignment if you try this. I like to align my heels to the target rather than my toes.
4. Let Your Lead Heel Lift
Allowing the lead heel to lift during the backswing can ease tension in the lower back by promoting a more natural, fluid motion. This also makes it easier to shift your weight forward on the downswing, avoiding stress on the spine.
5. Ball Position
Adjusting the ball position further forward may also help in reducing the need for compensations that lead to lower back pain, especially when you're struggling with early extension.
Your Coach will help!
1. Reverse Spine Angle
One of the most common culprits of lower back pain in golfers is a reverse spine angle. This occurs when the pelvis begins in a flexed position (around 20 degrees), but the torso extends excessively at the top of the backswing, losing some pelvic control. By the time of impact, the pelvis has lost most of its flexion, creating a high level of strain on the lumbar spine as it compensates to generate power and speed.
2. S Posture
The "S Posture" is another common issue. It involves either standing the torso up too much or allowing the pelvis to arch excessively. Both positions compress the facet joints in the spine, which can cause lower back pain. This position is not stable and forces the body to compensate in other ways, which leads to pain over time.
3. Sway and Early Extension
Sway refers to the excessive lateral movement of the hips during the backswing, which leads to a lack of rotational stability and can cause pain. Early extension, where the hips move towards the ball too soon during the downswing, puts strain on the lower back by disrupting your swing plane, leading to improper movement patterns and compensations.
4. Excessive Sidebend
Over-bending the torso laterally (away from the target) during the downswing can place significant strain on the lumbar spine’s discs and joints, increasing the risk of injury.
At Vitality Golf Performance, my goal is to help golfers improve performance, comfort and movement while minimizing injury risks. By combining physical assessment, body conditioning we give you the foundations you need to minimize the load on the body. We still highly suggest to work with your coach to help you with swing modifications to make the swing changes you need to be able to play this weekend and in 30 years time.
Here is a list of the structures most commonly injured in the lower back:
Lumbar muscles strain, facet joint irritation, herniated disc, degenerative disc disease, Sacroiliac joint dysfunction, Parse stress fracture, lumbar radiculopathy (sciatica), lower crossed syndrome, spinal stenosis and compression fractures. Your prognosis will depend on the structures that you have damaged. Please consult your medical proffessional or us here if you experience lower back pain to determine if these exercises and changes are right for you.
If you’re experiencing lower back pain or want to improve your golf mechanics, feel free to book a session, and we’ll develop a personalized approach to get you back on the course in peak condition.
Dr Matthew Campbell (Osteopath)
Vitality Golf Performance
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