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Injuries caused by golf

The UK is famous for its superb golf courses, and the golf industry is worth around £2 billion every year. Although the number of people playing golf has declined slightly over recent years, it is still a very popular sport - especially with those aged over 55.

Golf may not be thought a particularly dangerous sport but between 15% and 20% of golfers report an injury each year. Most injuries arise due to wear and tear and these are referred to as over-use injuries. The repeated sudden and powerful motion of hitting the ball with a golf club can take its toll on the body. But some injuries can instead arise from direct trauma.

Those who play golf as a recreation are also more likely to sustain an injury than professional golfers. And the likelihood of getting injured increases with age. The prevalence of all over-use injuries increases with age as the joints and soft tissues lose their ability to withstand strain. Injuries sustained previously can also be aggravated by playing golf.

Below are the most common golfing injuries with some advice on how to prevent and treat them.

Lower back injuries

The lower back is the area of the body most commonly injured when playing golf. This is because the golf swing involves a repetitive twisting of the spine. Any of the structures in this region can be affected, including the discs and facet joints. Soft tissues such as the muscles and ligaments can also be damaged and cause pain. The most common injury in older golfers is to the discs. These are fibrous structures found between the vertebrae (small bones in the spine). They can herniate, which means that there is a protrusion of gel material from inside the disc. The common name for this is a ‘slipped disc’. It causes pain in the lower back, which possibly radiates into the pelvis and legs, especially when bending forwards.

If you have a lower back injury, you may be prescribed painkillers. Your doctor may also want to check that there is no nerve damage. It is advisable to remain as active as possible, so long as the symptoms are not aggravated and only on the advice of your doctor. Some golfers find that a back brace improves their posture and helps with pain.

You can do a lot to prevent lower back golfing injuries. If an incorrect posture is adopted, the chances of an injury increase. A golf professional can identify issues with your swing and give you appropriate advice. The most common fault is termed a ‘reverse angle swing fault’, which causes the spine to deviate from the vertical. Certain exercises, known as core strength and stability exercises, can also be very effective in preventing injury.

Golfer’s elbow

If you grip your golf clubs forcefully (sometimes called a 'wristy' technique) you may develop golfer's elbow. This is caused by inflammation of the tendons of the forearm. The damage originates at the insertion point on the inner side of the upper arm bone. You will typically experience pain in the inner elbow when your hand is moved forward and back at the wrist. It may also be painful to touch. You can treat golfer’s elbow yourself with rest, ice and anti-inflammatory medication. However, in longstanding injuries, there can be a degeneration of the extensor tendons and medication can cause more damage and should be avoided. In these cases, a TENS machine may be useful for pain relief. You can strengthen the tendons following injury using a resistance band strengthening programme prescribed by a physiotherapist. Some may find that an elbow compression strap works well because it prevents the wrist extensor muscles from contracting fully. Therefore, the strain on the tendons at the elbow is reduced and the pain is improved.

You can help prevent golfer’s elbow by avoiding gripping the club too hard. You should also stretch the muscles by doing a ‘limp wrist’ action followed by a 'policeman halting traffic' type stretch.

Plantar fasciitis in the sole of the foot. The plantar fascia is a fibrous sheath under the sole of the foot. It can become inflamed where it attaches to the heel bone and this is called plantar fasciitis. The symptoms are heel pain on the underside of the heel and the sole of the foot. The pain is most severe first thing in the morning.

It is caused by walking long distances around the golf course in shoes that do not have support for the sole of the foot. The result is an excessive pronation (which is an uncontrolled lowering of the arch) and pain. You can prevent the injury by wearing supportive shoes and using orthotic insoles to support the arch on the inner side of the foot if necessary.

You can treat plantar fasciitis with ice packs on the heel and sole as well as anti-inflammatory medication. A heel support may also take some strain off the area. Stretching exercises have proved successful in many cases, and a plantar fasciitis night splint will apply the stretch overnight.

Knee injuries

Golf puts considerable strain on the knees. There is a lot of walking involved and the knee joints have to bear weight whilst they are rotated during a golf swing. Previous knee injuries can be aggravated and so the meniscus (cartilage) or cruciate ligaments can be involved. When you have pain in the knee joint it can result in quadriceps (thigh) muscle weakness, which, in turn, can lead to further knee joint instability and pain.

If you have knee pain, it is best to take a break from golf for a while and apply ice packs. When you return to the golf course, you may find that a knee brace supports the joint and relieves knee pain.

To prevent knee pain, you could try specific exercises recommended by a physiotherapist to strengthen the quadriceps and hamstring muscles.