Fix Your Golfing Back Pain - Step 2: Early Stage Rehab

This article is co-written with Marnus Marais. Since 2011, Marnus has worked with some of the world’s best players on both the PGA Tour and European Tour, helping them to maintain optimal health and peak physical performance. His current stable of players includes Dustin Johnson, Patrick Cantlay, and Louis Oosthuizen, amongst others. 

You can find more information on Marnus and his work at marnusmarais.com

This article is No. 2 in a 4 part series:

Step 1 - The Importance of Assessment

Step 2 - Early Stage Rehab

Step 3 - Essential Strength and Golf Movement Patterns

Step 4 - Building global strength for prevention of future injury

Introduction

Now that we have identified the source of the back issue through assessment, it’s time to start working on the underlying causes, in order to reduce pain and decrease the likelihood of re-injury further down the track. 

In our experience, mechanical back pain in golfers caused by physical issues is most often caused by one or more of the the following 4 issues, with many amateur players displaying the entire collection!

- Lack of Mobility at the Hips and Mid / Upper Back

- Poor Posture

- Misalignment and Muscle Imbalances

- Weak Core Muscles

Because pain is likely still a factor at this stage, we need to proceed with caution and focus on rehab work that is low intensity and has a low risk of causing a pain flare up.

With that in mind, in ‘Step 2: Early Stage Rehab’ we are going to address Mobility, Posture and Misalignment / Muscle Imbalances. These 3 areas can be improved upon, and should have a positive impact on pain reduction, even if back discomfort is still restricting larger, more global movements.

Step 2.1 - Improving Mobility in Hips and Mid / Upper back

Certain areas in the body need to be more stable, and others need to be more mobile. The lumbar spine (lower back) falls into the stable category, partly due to its limited capacity for rotation and lateral flexion (side bending). We know the unnatural golf swing movement imparts both rotational and side bending forces on the spine, so it’s an area we need to keep stable and protected. 

In order to avoid excessive low back rotation forces in life and especially in the golf swing, it’s very important that we try to maximize the range of movement in other areas, most notably the joints above and below the low back, where the majority of rotation in the golf swing should take place:

Hips

We need sufficient range of movement to turn into, and out of, both hips. For example, if we can’t turn and load into our lead hip due to a lack of internal rotation mobility, we tend to compensate with excessive rotation and side-bending in the lower back.

Suggested Exercise Circuit – Hip Mobility

1) Self Massage Glutes - 45 secs each side

2) Cross Leg Glute Stretch - 30 secs each side

3) Prone Glute Stretch - 30 secs each side

4) 90 90 Hip Mobility - 5 reps each side

Thoracic Spine (mid to upper back)

Having sufficient rotation in our thoracic spine to both left and the right is extremely important. The thoracic spine has significantly greater rotational capabilities compared to the lumbar spine (low back). If we maximise our mobility here, we can help protect the lower back, along with the cervical spine (neck).

Suggested Exercises – Thoracic Mobility

1) Self Massage Mid / Upper back - 60 seconds

2) Upper Back Extension - 30 seconds

3) All Fours Rotation - 5 reps each side

Step 2.2 - Improving Posture

Posture can be described as the proper alignment of the spine, with the aim of establishing three natural curves (low back, mid/upper back and neck).

 The 3 major spinal curves: 1 - Cervical, 2 – Thoracic, 3 – Lumbar

Modern lifestyles and the associated muscle imbalances have pushed and pulled our spines away from those three natural curves, and this has had a damaging effect on our spinal health. Our backs are designed to function optimally from the neutral illustrated above, and the further we get away from it, the more stress we put on our protective spinal structures. 

Aside from promotion of pain, poor posture also does terrible things for our golf swings; reducing range of motion in key areas (hips, mid back and shoulders) and creating inefficiencies in our swing action, to give us a double whammy of back pain causes.

The muscles responsible for holding your posture are located deep in the body and close to the spine. Strengthening them can be tricky, as we don’t really have a lot of conscious control over their activation. Hence posture being such a difficult thing to remember! The combination of the 4 exercises featured below help provide the stimulus to those deep muscles that, if trained often enough, will automatically hold your posture in a good position.

Suggested Exercises – Strengthening posture muscles

1) Wall Posture Check - 30 secs

2) Posture Cue - 60 secs

3) Posture Cue Knee Lifts - 10 reps each side

4) Arm Press - 15 reps

Step 2.3 – Fixing Alignment Issues and Muscle Imbalances

Imagine a car with wheel alignment issues; front wheels facing to the right, back wheels facing to the left. Not only will the tires wear out unevenly and quickly, but other areas of the car will experience more torque, load or strain and would have to work harder. The same thing happens to the lower back when we have body alignment issues above and / or below.

For example, if we have short / tight / overactive hip flexors (muscles at the front of the hips that bend our knees to our chest) on one side of the body; very common amongst golfers with low back pain, then this would rotate the pelvis forward on one side, which can create a knock-on effect of imbalance throughout the body.

If the pelvis rotates in one direction, the shoulders naturally have to rotate in the opposite direction in order to maintain balance. Our low back is subsequently caught in the middle, and placed under more load, stress and strain. This imbalance can cause the low back to bend and rotate further, and more unevenly, especially in the already complex rotation and side bending context of the golf swing!

Below is a pelvic alignment technique that can help those with the afore mentioned imbalance.

In the next article; Step 3: Essential Strength and Golf Movement Patterns, we will show you the progression of exercises and key technique principles to build up the strength and movement patterns to return to regular exercise and golf. 

If you would like to see how Marnus can help with your golfing back pain, then check out the resources below:

Marnus Marais – marnusmarais.com 

If you would like to access training programs designed for elite and recreational players, then check out the following resources and services from Nick at Golf Fit Pro: