The Biomechanical Link between Low Back Pain and Golf

  • February 26, 2016
  • /
  • Sports
  • /
  • Dr. Anthony Deluise

The golf swing is a highly integrated sport requiring tri-planar (three directions) mobility and strength, especially across the hips and pelvis. There are approximately 23 ranges of motion in the body that are essential for an efficient swing and none more important than the acetabular-femoral joint- also known as the hip joint.

Research has shown a positive correlation between decreased lead hip rotation and lumbar range of motion with a history of low back pain in professional golfers. Studies have shown that range of motion deficits in the lead hip rotation and lumbar spine extension correlate with history of low back pain in golfers. 

There is an asymmetry across the lower extremities which occur to some degree in all humans, more specifically on the left side. This is due in part to internal anatomical differences and a dominant right side motor pattern that we develop throughout our life. As a result predictable patterns evolve causing structural compensations throughout our entire body.

This asymmetry tends to affect the pelvic girdle and its corresponding joints. The left pelvic innominate is more anteriorly tilted and forwardly rotated in relationship to the right. This causes the left femur to externally rotate with compensation causing the posterior left capsule to tighten and the left external rotators to over work.

During the downswing, the internal rotation of the hip is key for transfer of energy and acceleration through the impact of the golf ball. As weight is being transferred to the lead hip, the pelvis rotates over the femur producing internal rotation. This torque is created in the lower body and transferred up through the body and through the club. The majority of torque in the swing is generated by the lower body muscle groups of the glutes, hamstrings, quads and core region (low back, abdominal, obliques).

When a golfer presents with hypertonicity of left external rotators and/or posterior (left) capsule tightness, the internal rotators of the hip and obliques are positionally weak and cannot properly achieve adequate internal rotation on the down swing.

The inability to rotate the acetabulum over the femur creates compensatory shearing forces in the SI joints and lumbar spine, where anatomical rotation is minimal and not desired. This can eventually lead to sacroiliac (SI) joint  dysfunction and mechanical low back pain.

At Ortho Rhode Island - Foundry Sports Medicine we have helped many golfers overcome these asymmetries through recognition of and addressing these imbalances. The specific exercises used address realignment of the pelvis and opening of the left posterior capsule which allows a more fluid transfer of weight from right to left.

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  • hip