Jonas Blixt Case Study: From Back Pain to PGA Tour Win
This is a case study on professional golfer Jonas Blixt and his eight-month journey from severe and persistent back pain to a PGA Tour win in 2017. It was written to offer insight into the work that a dedicated professional put into his body and his game after a setback due to a significant injury. The case study also serves to highlight the importance of training for posture, spinal strength, and shoulder girdle stability: three areas of training that are often misunderstood and under-appreciated.
The majority of Jonas’ rehab and progression forward was performed using GravityFit exercise techniques and products. GravityFit is an Australian-based company that specializes in a science-based approach to training the body for spinal strength, injury prevention, posture, and golf movement patterns.
Background: Jonas, 32, and is in his sixth season on the PGA Tour. He’s won three times in his career (2012 Frys.com Open, 2013 Greenbrier Classic, 2017 Zurich Classic), and his best finish in a major came in 2012 when he finished T2 at the Masters.
Strengths: Putting, Around the Green. Career-average rank of 33rd in Strokes Gained Putting. Career-average rank of 36th in Strokes Gained Around the Green.
Weaknesses: Off the Tee, Iron Play. Career-average rank of 143rd Strokes Gained Off the Tee. Career-average rank of 158th in Strokes Gained Approach the Green.
Physical Training History: College program at Florida State University. Exposure to various different methods of training stability, mobility, strength, and power since turning professional.
Jonas came to see me with after having received two cortisone shots for back pain resulting from herniated discs leading to nerve compression in his lower back. He also received another shot for pain referring into his left glute/hip, suspected at the time to be caused by facet joint inflammation. His desire was initially to return to a pain-free state, and then to improve his long game by hitting more fairways and greens, thereby gaining strokes on the field in the Strokes Gained Off the Tee and Strokes Gained Approach the Green categories. If that outcome could be accompanied by an increase in distance, then that would be a bonus.
After conducting the initial screening and assessment, I highlighted the following areas as priorities for improvement:
- Lumbar and cervical spine posture (lower back and neck).
- Core awareness, stability, and control.
- Arm and body connection movement pattern in rotation.
- Quality of rotation movement pattern from thoracic spine (mid and upper back).
- Mobility in right shoulder (external rotation), thoracic spine (rotation and extension), ankle (dorsi flexion), and quad tightness.
I believed that improving these areas would not only help Jonas move better in his golf swing, but more importantly at that stage, help take strain away from his lower back.
Of particular interest was how Jonas performed in a series of tests for awareness control and stability of the lumbar core (think core muscles and lower back). This seven-stage series of tests is called the Core Body Benchmark. It was developed by GravityFit to provide a more objective measure of core control that could be easily administered in any setting.
Jonas failed the last four tests in the series:
- Hinge Forward
- Hinge Forward with Rotation
- Single Leg Hinge Forward
- Single Leg Rotation
Despite a history of core training, Jonas was unable to use his core muscles effectively in the movements that he repeated up to a thousand times per week: hinging forward, balancing, and rotating (the key components of the golf swing).
Initial Program: These assessment findings, combined with the recent back injury, immediately lead me to write Jonas’ first program using predominantly GravityFit tools and techniques, which are specifically designed for strengthening the spine and improving posture. Luckily, we had a few weeks before the first tournament of the 2017 season, so it was time to go work. Below is a snapshot of the initial program, including a few photos of Jonas and myself demonstrating the exercises.
A very basic daily program that focused on establishing good posture, as well as training basic spinal stability and quality of rotation. This program also included a 20-minute walk in the soft sand (Jonas lives near the beach) and a range of self-massage and stretching exercises. The exercises are below and were performed using the Gravity Cap and GravityFit TPro.
- 1A: Posture Cue Walk
- 1B: Posture Cue Knee Lifts
- 1C: Set Up Posture Drill
- 1D: Split-Stance Turn
1: Beach Walk
Program 1 Exercise Examples
Posture Cue Knee Lifts: This exercise establishes a solid upright posture, stretching tall against the resistance provided by the Gravity Cap.
Set Up Posture Drill: Here I’m training golf posture using the TPro for postural feedback and scapula/shoulder stability and control.
Split-Stance Turn: Training dynamic rotation using the TPro while working on balance and control with the split stance.
After two weeks of the initial program, we progressed into more traditional exercises (squat, lunge, push, pull) with the addition of the GravityFit TPro and Core Awareness Belt (CAB) to give audio and kinaesthetic feedback on quality of movement and postural control. We also advanced the specific posture and rotation exercises to add some more complexity and challenge. As you can see in the video below, at this stage even a simple bodyweight squat was a challenge for Jonas.
- 1A: Body-Weight Squat
- 1B: Push Up
- 1C: BW Backward Lunge
- 1D: Cable 1-Arm Row
- 1E: Mini Mountain Climber
- 1F: Pallof Press
- 1A: Gravity Cap Hurdle Walk
- 1B: Split-Squat Rotate
- 1C: Jonas Backswing Drill
Jonas Backswing Drill: Jonas is using the TPro and the Core Awareness Belt (CAB). Notice the hand position: right palm up, left palm down. This was a custom feel for Jonas that he wanted to train in his backswing.
Body-Weight Squat: Jonas initially struggled to squat while maintaining his posture. A combination of ankle mobility restriction and lack of core control made it very difficult for him.
About 5 weeks after our initial session, the fall series events came around Jonas decided to play. We continued to gradually increase the complexity of the exercises, each program requiring a little more from the perspective of stability and postural control. The majority was still only using bodyweight and some light band resistance.
Programs 3 and 4
At this point, Jonas was really starting to improve his movement quality and balance.
Split-Hand, One-Foot Push Up: An advanced version of a push up, again using the TPro and CAB to provide feedback on the quality of posture and movement. This is a fairly typical example of advancing an exercise’s difficulty without adding external load.
- 1A: Overhead Squat
- 1B: Split-Hand, One-Foot Push Up
- 1C: Lateral Lunge with Knee Lift
- 1D: Single-Arm, Split-Stance Pulldown
- 1E: Prone Turn Under
- 1F: Split-Stance Pallof Press
- 1G: Lying Glute Bridge, Foot Up
- 1A: Gravity Cap Hurdle Walk
- 1B: Jonas Backswing Drill
- 1C: Follow Through
- 1A: Knee Band Crab Walks
- 1B: Crawling
- 1A: Goblet Squat
- 1B: Resistance Band Push Up
- 2A: Bulgarian Split Squat
- 2B: Cable 1-Arm Row
- 3A: 1-Leg Band Push Out
- 3B: Pallof Hold
Lateral Lunge with Knee Lift: This exercise is really quite challenging to perform with balance and control while avoiding the audio feedback that the CAB provides when the core isn’t working properly.
Single-Arm, Split-Stance Pulldown: Again, a variation on a simple exercise with the aim of introducing a balance and co-ordination challenge.
Return to Playing
Jonas’ transition back to golf wasn’t exactly smooth. Despite showing significant signs of improvements in his movement quality and overall back pain, he was still struggling with occasional flashes of pain into his left glute during play and when getting up and down from a low, seated position. His results and Strokes Gained statistics tell the story of on-course performance.
- Results: Four events, three missed cuts and a T48
- Strokes Gained Off The Tee: -1.441
- Strokes Gained Approach the Green: -0.464
Over the six-week Christmas break, it was decided that a complete rest from golf was a good idea. This would allow Jonas’ back more time to heal and also offered him the opportunity to receive some treatment and advice for the occasional flashes of pain that seemed to be hanging around. Dr. Craig Davies and the Swedish Spine Institute had very effective input into helping resolve the issue, which was eventually identified as a glute med/min tendonitis. Meanwhile, we continued to progress the difficulty of the training programs and added some more significant load.
We moved into more traditional strength movements and methods of loading. These were all done still using the GravityFit equipment to provide postural feedback.
- 1A: Fall to Wall – 2 Arms
- 1B: Single Arm Turn Under
- 1A: BB Front Squat
- 1B: DB Bent Over Row
- 2A: DB Step Up
- 2B: Torsonator Shoulder Press
- 3A: Suspended Leg Lift – Bent Knee
- 3B: Prone Hold 2 Limb Switch
Barbell Front Squat: This is a classic strength exercise that requires excellent squat mechanics and postural control to be performed safely.
Landmine Shoulder Press: Using a uni-lateral (one-sided) external loading technique requires more from the core and postural stabilizers. It was a big step forward when Jonas was able to comfortably perform these exercises.
With the New Year came a return to practice and first start in the Sony Open. All traces of pain by this time had been eliminated, and Jonas’ elusive long game seemed to be showing significant signs improvement through his first few events of the year.
- Strokes Gained Approach Green: -0.217 (his career average was -0.44)
- Strokes Gained Off the Tee: +0.242 (his career average was -0.24)
- Club Head Speed: Increased to 112.5 mph from (108.5 mph at first event of 2017 fall season)
Building to a Win
As we moved forward into the spring tournaments, I progressed Jonas on to much more traditional strength-and-conditioning training sessions while still using the GravityFit equipment to provide feedback on posture and technique. We also continued to retain the daily exercises that focus on postural control with spinal strength and stability.
- 1: Barbell Squat to Box
- 2: Dumbell Reverse Lunge
- 3: Barbell Hip Thrust
- 4A: Underhand Pull Up
- 4B: Plate-Weighted Push Up
- 4C: Dumbell High Row
- 1A: V Sit
- 1B: Split-Stance Pallof Press
- 1C: Back Hyperextensions – Arms Up
Plate-Weighted Push Up: We moved to standard variations of exercises like this and adding more external load with the aim of eliciting a strength and muscle growth response (as opposed to stability before).
Barbell Squat to Box: We used the box to avoid the lower-back strain that is most acute at the bottom of a squat. This is a natural progression toward full squats.
Jonas should be applauded for his tenacity, conviction, and work ethic during this tough time. He used a potentially career-threatening injury as an opportunity to improve his body to new levels. This all went a long way to helping Jonas collect his third PGA Tour win at the Zurich Classic of New Orleans with partner Cameron Smith. Cameron is also a client of mine, and he has been using GravityFit equipment and techniques for years to train his posture and movement patterns.
If you would like to access the training programs that helped Jonas on his journey, then check out the following products and services from Nick at Golf Fit Pro: