SPORTS SPECIFIC REHABILITATION

4a,b+c: Accelerated swing to promote proper hip rotation and weight shift during forward swing 5a,b+c: Shoulder accelerated swing to promote movement sequence

enough to form an engram on the cerebral cortex making the movement automatic, requiring no conscious thought (14,15). Therefore, the resistive tubing is used to “pull” the golfer into correct or efficient movement patterns to help retrain the brain and body on how it “feels” to per- form a proper movement pattern.

Motor control exercises include: ■ Assisted backswing (figure 3) to pro- mote loading on the trail leg during the backswing

■ Accelerated swing (figure 4) to pro- mote proper hip rotation and weight shifting onto the lead leg during the forward swing

■ Shoulder accelerated swing (figure 5) to promote the correct sequence of movement (hip rotation followed by shoulder rotation) with a proper weight shift to the lead side

3) Balance and stability Balance is one aspect of a golf programme that is

often overlooked but vital to the consis- tency of the swing. It is the missing link that keeps all of the swing mechanics together. Players on the PGA Tour work very hard on balance. This is one reason for their consistent ball striking.

Static stability starts with core strength and trunk stabilisation, taking posture into account (16). Challenging the bal- ance system of the body, through static or postural stability, will help reconnect the neurological communication between the nervous system and the muscles. Once static stability is enhanced, dynamic sta- bility can be addressed. Dynamic stability is the ability to maintain necessary work- ing relationships of muscles and joints, proper spinal alignments and appropriate rotational axes throughout all phases of the swing (16). It is not how hard one can hit the ball; it is how efficient they can hit the ball. Dynamic stability is the foun- dation of biomechanical efficiency. To enhance balance functional to golf, we

have golfers move through the different phases of the golf swing while decreas- ing their base of support. This can be accomplished using balance discs, a foam roller, a swiss ball or resis- tive tubing. See figures 6-8.

5c: Shoulder accelerated swing 6a, b and c: Different phases in golf swing with decreased support base using balance disks 7a, b and c: Different phases in golf swing with decreased support base using foam roller 16

4) Strength To successfully rehabilitate a golfer with low back pain, or to simply prevent injuries to this region, the muscles which provide stability must be functionally enhanced. These muscles are the pubo- coccygeus (pelvic floor), transverse abdominus, multifidus and abdominal obliques (17). As these core, foundational muscles are more developed, the other abdominal and trunk muscles will be allowed to function more effectively and efficiently. This is achieved with function- al low back and hip stabilisation exercises (figure 9, the extension quadrant and fig- ure 10, the flexion quadrant) utilising resistive tubing attached to a belt around the hips. The extension quadrant isolates the pelvic floor muscles, multifidus and abdominal obliques while strengthening the hip external rotators (psoas major, obturator externus and internus, gluteus medius, gemellus inferior and superior, piriformis, sartorius) of the planted leg. The flexion quadrant isolates the pelvic floor muscles, transverse abdominus and abdominal obliques while strengthening the hip internal rotators (adductor longus and brevis, tensor fascia latae, gluteus minimus and medius, semimembranosus, semitendinosus) of the planted leg. Both of these exercises use a concentric muscle contraction pulling against the resistive tubing, an isometric muscle contraction holding against the resistive tubing and

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