Golfers’ Low Back Pain – The Core Issue

Biomechanics-the study of motion in living organisms-is the topic of this lesson. Biomechanics is a very broad field. Thousands of people are researching how the human body moves, and why it moves the way it does. At Body Balance for Performance we have taken on this study relative to the motions of the golf swing. Let’s take a look at the biomechanics of the lower back, pelvis, and hips. To do this we need to apply here what we learned earlier about low back anatomy.

The vertebrae of the lumbar spine are uniquely shaped and oriented. These vertebrae are stout compared to the cervical and thoracic vertebrae. This stoutness is consistent with the large forces they must withstand. The facet joints are vertically oriented in this part of the spine. To understand this orientation, position your hands with the palms facing one another, the fingers pointing upward, and your thumbs slightly closer together than the little fingers. In thinking about this orientation, you might envision that the facet joints would allow forward, backward, and side bending but also that they might inhibit rotation. That is exactly the case. The biomechanical studies of motion in the lumbar spine indicate that there is only about one to two degrees of rotation between any two lumbar vertebrae, but that side bending is three to four degrees. Flexion and extension are the most extensive motions in the lumbar spine. This is not coincidence. The facet joint anatomy causes these motion limitations. From this data that supports these statements we can conclude that there is little rotation in the lumbar spine in any activity, including the golf swing. So where does the necessary rotation happen…in the hips and thoracic spine…we will take that up later.

Looking at the pelvis, we see three major joints. There are two sacroiliac (SI) joints and a pubic symphysis. The SI joints are in the buttocks. If you put your fingers on your belt line in your lower back about 4 inches apart and then slide the down to the upper buttocks you will feel two bumps (one on each side). These are the approximate location of the SI joints. There is great controversy in the medical community about the biomechanics of these joints. One school of thought that claims that these joints do not move because of their shape, the orientation of the joint surfaces, and the ligament structure. Another school of thought points out that there is about 3 to 4 degrees of forward and backward rotation in these joints. The SI joints are oriented similarly to the lumbar facet joints. The upper half of the joint surface is similar in structure to any synovial joint, such as the knee or shoulder joints. This structure is consistent with movement. The lower half of the joint is similar in structure to the sutures of the skull and are consistent with no movement. Which camp is correct? This clinician has witnessed motion in these joints. This does not make the motion camp correct; it is just what I have observed.

pelvic-bones

Based on these observations, I believe there is a limited amount of motion in the SI joints. If you once again hold your hands like we did for the lumbar spine demonstration, you will be able to simulate the motion of the SI joint and the pelvis. If you rock your hands toward the little fingers and then back to the thumbs you generally have the motion of the SI joints and the pelvis. If the little finger represents the front of the body, then movement toward that side of the hand would be called anterior torsion or rotation, and the opposite motion would be called posterior torsion or rotation. In golf these motions are important because if one side of the pelvis is positioned in forward torsion and the other is not, we see significant muscle imbalances that prevent correct movement in the swing. We also see this positional problem at the root of a large percentage of the back pain felt by golfers. In this position the hip flexors and low back muscles are shortened, the hip extensors and abdominals are lengthened and weakened. We can even see inhibition of the glutes…and this is a recipe for disaster. When this happens, it’s not a matter of “If you will have back pain.” it’s “When.”

hip-rotators-anterior

There are some who also believe that this pelvic imbalance is responsible for improper loading on the lumbar discs and the hip joints, and this may be at the root of much of the herniations, degeneration, and arthritis seen in these areas.

Golfer, this is important to you. If you have an imbalance in the pelvis, you will develop degenerative conditions, and you will see motions like reverse spine angles, lateral sways, straightening of the backswing side knee, loss of spine angle, and most disastrous, recurrent lower back pain episodes. Our experience has told us that if we resolve these imbalances, most back pain can be resolved or prevented. Finally, improving pelvic balance will improve the efficiency of your golf motion.

The anatomy of the lumbar spine and pelvis helps us understand how the region should move, and gives us a road map to restore normal motion; that is, normal biomechanics of the area. Once we have an assessment of the biomechanical situation in the region, we can design and implement an exercise or training program to restore normal biomechanics and therefore normal motion. This is how we eliminate lower back and mechanical pelvic pain and improve the results of the golf swing. Biomechanics are a key, maybe the key, to understanding and fixing the lower back and pelvis.

Please email me at [email protected] if you have any questions.

Here’s to your healthy back and good golf.

Dave

 

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