As a certified Titleist Performance Institute (TPI) level 3 medical provider, I get the honor of treating a lot of golfers. As golfers will tell you, the game is like a heroin addiction…but it’s actually more expensive! A golfer will do just about whatever it takes to improve his/her game. From shoes to gloves to clubs to lessons to whatever, nothing is too much if it will shed a few strokes off each round. Whether the golfer is a 20 handicap or scratch or better golfer, improvements can always be made. As is the case with any sports activity, proper stability and mobility are important and for a precision game like golf, they’re vital.
One major movement fault that many people and golfers alike have is a lack of internal hip rotation. Proper hip mobility is not only vital for back health, but it is vital for proper swing mechanics. I’d say, in my experience, that about 80% of golfers suffer from this issue. It can be on the either side and depending which side it is on, the fault affects the backswing or the follow-through. Regardless of which one it is, it must be corrected to improve that score and lower the risk of musculoskeletal injuries…mostly, the force transmission into the low back. This is one of the major reasons why so many golfers get low back pain.
Early extension, as caused by a lack of internal rotation on the ‘back’ leg during the backswing, leads not only to a poor golf score but to an incorrect spine angle and subsequent back damage.
For an example, we’ll use the right leg as lacking internal rotation on a right handed golfer. When the right hip does not internally rotate properly, on the backswing, the golfer hits a point where the rotation ends and to make up for this lack of motion, the golfer comes out of the proper spine angle and compensates by going into early extension. Of course, with early extension, this can lead to ‘casting’ and other swing faults. The bottom line is that the issue with the hip causes a serious swing fault and it must be corrected or the golfer can never achieve a proper swing. I have to mention here that with the backswing, for visualization, the body is rotating around the right hip and by doing so, it effectively is internally rotating the right hip.
The great thing about this issue is that it can improved significantly with a combination of interventions. First and foremost, the hip joint function has to be restored (we’ll assume for this discussion that the patient does not have FAI or other significant hip joint pathology). The only way to do this is with manipulation. Joints have to be moved if they are fixated. No amount of soft tissue work will accomplish what manipulation can do. We have to yet again mention Arthrogenic Inhibition in this this discussion as we do with most other joint and muscle problems. If the joints are not working properly (damaged, fixated, hypermobile, etc…), then the surrounding tissue cannot function well either. It is imperative to restore normal movement to the hip joint itself.
Once this is done, soft tissue techniques, such as Active Release Techniques (ART), Graston, Dry Needling, and others, can be implemented to aid in restoring proper muscle function in the region. From this point, a few exercises are recommended to lock in the changes. Many times, this is all it takes. For those who are serious about long-term improvement in their game, it’s off to a TPI and/or FMS certified fitness instructor to lock in the changes and build strength for better body control and increased club head speed. This is all straight forward and easy provided the practitioner treating you is TPI certified. It’s that important! It’s about getting you feeling better and lowering your handicap and properly trained medical golf providers are best equipped to do so.
