SPORTS SPECIFIC REHABILITATION

14a+b: Forward lunge with trunk rotation to help generate power

made that does not control the center of gravity to finish on a firm lead-side will cause the golfer to lose balance. This utilises the brain stem and associated areas for visual input and balance pertur- bations. Therefore, all three motor control centres of the body are enhanced to pro- mote coordinated, sequenced movements as well as fostering a stable, core founda- tion and spine (14).

5) Power The ‘golf lunge’ (figure 13) is an indis- pensable power-developing exercise. With the tubing wrapped around the waist and anchored from a low position, the golfer must fire out of the side lunge position promoting hip and leg power. When power is generated through the pelvis, it starts with the trail side hip extensors and abductors firing first (21). Then, the lead side adductors fire to stabilise the lead leg as the body rotates around it (21). The ‘golf lunge’ forces the golfer to fire the glu- teus medius, gluteus minimus, tensor fas- cia latae, piriformis, gluteus maximus, semimembranosus and semitendinosus to generate power in a functional move- ment pattern while rotating around a balanced lead leg that is stabilised by the lead side adductor magnus, semimembra- nosus and vastus lateralis (21). This exer- cise also targets the abdominal muscles and requires the lumbar muscles to fire to hold the body upright. The golfer can then incorporate the torso rotary muscles nec- essary for a powerful move through impact. By rotating the upper body in the opposite direction (especially while hold- ing a medicine ball for resistance), strength and power are enhanced in the

18

15a+b: Diagonal chops to increase power in the upper body

abdominal obliques and other trunk rotary muscles.

Another good power generating exercise for the legs and trunk is the forward lunge with trunk rotation (figure 14). Resistive tubing is wrapped around the upper body and the golfer performs a forward lung to develop strength in the legs while twisting the upper torso against the resistance to increase rotary power.

COMPONENTS OF A GOLF FITNESS PROGRAMME

1) Flexibility 2) Motor control and movement patterns

3) Balance and stability 4) Strength 5) Power 6) Cardiovascular endurance

After the initial power is generated by the hips and legs, the energy is transferred to the upper body. The main power develop- ing muscles in the upper extremities are the trail side latissimus dorsi (used as an adductor during the forward swing) and the trail side pectoralis major (used as an adductor and internal rotator during the acceleration phase). Power can be increased in these muscle groups by per- forming diagonal chops (figure 15), diagonal lifts (figure 16) and medicine ball throws in functional golf patterns (figure 17).

Each golfer will progress through the above exercises at different rates. The most important thing to remember when a

golfer is performing these exercises is quality over quantity. They should only perform the number of repetitions they can do with proper form. As they continue to do them, their strength, balance and range of motion will improve. When they can perform 15 repetitions of an exercise with proper form, they are ready to start a progression of the same exercise or advance to the next component. For exam- ple, when a golfer can perform 15 quality repetitions with the ‘extension and flexion

quadrants’, they are ready to do the same exercise without holding on to the long pole/golf club, plus they are ready to progress to the functional strengthening exercise, ‘resisted swing’, now that they have good core stability and strength.

6) Cardiovascular endurance Contrary to popular belief, cardiovascular fitness is essential to playing golf at a high level. After repetitively swinging the club and walking up and down hills in the heat, the body will fatigue. This will neg- atively affect fine motor control, which will lead to less accuracy and consistency with golf shots. Also, fatigued muscles are more susceptible to injury and breakdown. This component of the golf programme can be implemented at any stage. Any form of cardiovascular endurance will ben- efit a golfer. If there are no contraindica- tions, making cardiovascular workouts functional to golf would include treadmill workouts, either walking of jogging, with different inclines and declines. Knowing that muscle endurance to the hip exten- sors and abductors is extremely impor- tant, side shuffling (figure 18) and retro walking on a treadmill can be beneficial. Also, using equipment such as the slide- board and fitter are functional cardiovas- cular exercises for golf.

CONCLUSION The golf swing is physically demanding on the human body and has contributed to various types of injuries, most notably to the low back. Studies have shown that 36% of all amateur golfers will sustain an injury to their low back (2). To prevent or successfully rehabilitate a golfer with a low back injury, the muscles and muscle groups which provide the strength and stability to this region must be function- ally enhanced (18). The therapeutic exer- cises designed in a low back rehabilitation programme must be golf-specific. This will retrain the muscles in how they will be

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