Golf injuries have received little attention in the literature. Low back injuries in golf are both common and disabling but the specific mechanisms responsible for these injuries are unclear (1-3). It has been suggested that the mechanics of the golf swing may predispose to spinal injury when subjects have restricted movement in an adjacent part of the kinetic chain. Hip rotation deficits have been postulated as one possible risk factor and cause of low back pain in golfers. The aims of this study were to systematically review the evidence that investigated either the incidence of or correlation between, hip rotation deficit and low back pain (LBP) in golfers and to highlight any mechanisms of such. Studies were identified through a search on Medline, Cinahl, Embase, Web of Knowledge and Sport Discus data bases from the earliest date to December 2007. The key search terms were golf; injury; low back pain and hip rotation. No language restrictions were imposed. The preliminary evidence suggests that hip rotational deficits have been found to be significantly correlated with low back pain in both the sporting and non-sporting golfing population, although the studies are few in number (4-8). No studies have been carried out on amateur golfers, where alternative symptom mechanisms may exist to those of professionals. Future studies are necessary to investigate whether there is a relationship between hip rotation range and back pain in amateur golfers.

10

HIP ROTATION DEFICITS AND LOW BACK PAIN IN GOLF: A REVIEW OF THE LITERATURE

EOGHAN MURRAY, BSC (HONS) MSC MSCP SRP

over recent years because it is an activity which allows a variety of individuals to play simultaneously regardless of skill, gender or age (9). Golf ranks as the third highest participation sport amongst Australian adults (10) and England boasts the highest number of golf courses in Europe (2). Golf presents many potential cardiovascular health benefits, though conversely can also pose an injury risk (11).

G

Golf injuries have received limited attention in the literature, however three epidemiological studies (1-3) have shown the most commonly injured area to be the lower back (1, 3). Injury is common among both amateur and professional golfers. Low back injuries account for 23.7-34.5% of all injuries in one study (3) with another study suggesting a prevalence of 55% (12). Lower back injury has been shown to result in longer absences from golf than any other area (2), being responsible for missed play up to 55% of the time (12). Yet despite its prevalence there is little research concerning why this is the case (13).

Golf injury is both common and disabling, but the specific mechanisms responsible for these injuries still remain unclear (14). It is postulated that the mechanism of injury in professionals and amateurs is different. The most common mechanism in professional golfers is overuse (3), which is deemed to be compounded in amateurs by poor technique (1). Amateur golfers who exhibit such poor swing mechanics have been shown to develop a greater torque in the lumbar

olf has increased in popularity and participation raised considerably

spine that may result in overstrain to the spinal region (15). Studies have demonstrated contrasting findings with regard to determining golf injury risk (1, 2). One retrospective study with 1444 respondents found a slightly higher rate of injury among the lower handicap golfers (1). Another study found no difference in injury rate with handicap (2), though this study did have a smaller cohort, with only 703 golfers interviewed.

There is little published research

into why low back injury/pain is so prevalent in golf (13), and the specific mechanisms responsible for these injuries are not well understood. This review will attempt to correlate any associated hip range of movement deficits and compensated or supramaximal range in adjacent regions with a history of low back pain in amateur golfers.

GOLF SWING MECHANICS AND LOW BACK PAIN It has been suggested that the mechanics of the golf swing may predispose to back injury when subjects have limitation of movement in an adjacent part of the kinetic chain. In the golf swing, the lead leg (the left leg of a right handed golfer) provides a fulcrum around which the pelvis rotates. This acts as a pivot point about which rotation of the lumbar spine and pelvis can occur (3, 16). The hips are of great importance in the initiation of the swing providing power to drive the ball (17). The modern swing dictates greater shoulder turn relative to the hips which results in a greater potential

sportEX medicine 2008;37(Jul):10-14