Where Your Swing Hurts
How to avoid 5 common golf injuries
Editor's note: A lot of golfers are playing hurt. Not broken-bones hurt, but with things like tendinitis, sore muscles and arthritis. These aren't flashy injuries, but they still can keep you off the course. We called in two experts—Dr. James Andrews, a leading orthopedic surgeon, and Hank Johnson, one of Golf Digest's 50 Best Teachers—to tell us where golfers are feeling the pain and how you can avoid it. —Peter Morrice
Dr. James Andrews: Jack Nicklaus had it right when he said, "Professional golfers condition to play golf; amateur golfers play golf to condition." That explains why 62 percent of amateurs will sustain a significant golf injury, typically because they're out of shape, have poor swing mechanics, or don't adequately warm up. For the pros, that number is even higher—85 percent—but their injuries tend to come from hitting 200, 300, 500 balls a day. Here we'll look at five injuries, and I'll tell you what happens in the swing to cause them.
Hank Johnson: I agree that most injuries to amateurs come from faulty technique, often because they overreach their capabilities. You have average players trying to copy tour players, and they get (a) frustrated and (b) hurt. After Dr. Andrews explains the injuries, I'll give you a setup or swing adjustment that takes some strain off that part of the body. These adjustments might move you away from the ideal biomechanics of the golf swing, but they'll help you do something even more important: Keep playing golf.
THE LEAD WRIST
WHAT HAPPENS: Hold your lead hand (left hand for righties) in front of you, thumb up, and make a fist. Notice there's a little cup or angle in the back of the wrist; this is the natural power position. Most amateurs don't have the strength to lead the club into impact with the back of the left wrist, as they've been told to, and that creates overload. Sometimes hitting the ground flattens the wrist angle, stressing the extensor tendons on the top of the wrist and causing tendinitis. —Andrews
HOW TO AVOID INJURY: If you grip the club with your left hand in a weak position, the thumb down the top of the handle (above, 1), you risk having a flat or even bowed left wrist at impact. Instead, rotate your left hand away from the target about 30 degrees from that weak position. This will put the thumb at about 1:30 on an imaginary clock face, more down the right side of the grip, and create the slight cup you want in the wrist (2). —Johnson
THE LEAD ELBOW
WHAT HAPPENS: The problem here is similar to that in the wrist: The extensor tendons on the outside of the elbow are overloaded by the jarring of impact and begin to tear away from the bone. It's called lateral epicondylitis, or tennis elbow. Golfer's elbow affects the inside of the trail arm and is caused by the repeated straining and rotation of that arm through impact, but it's less common. —Andrews
HOW TO AVOID INJURY: Many golfers confuse keeping the left arm straight with locking it (below, 1). Consider this: If you let your arm hang at your side, it's straight but relaxed. That's the straight you want. Think of the arm as staying "soft" from start to finish (2). The momentum of the downswing will pull your left arm straight without you thinking about it. —Johnson
THE LEAD SHOULDER
WHAT HAPPENS: There are several parts of the shoulder at risk, and the rotator cuff is the granddaddy of them all. But labral tears (torn cartilage) are becoming common and often can be traced to the backswing. When golfers keep the left arm tight to the chest as they swing back, they can tear the labrum that stabilizes the shoulder joint. This is called a posterior labral tear, and the golfer feels pain in the back of the shoulder. —Andrews
HOW TO AVOID INJURY: Players who don't turn well in the backswing tend to pin the left arm across the chest (above, 1). Turning the upper body can be physically challenging for some golfers; others find it just plain scary, because they feel as if they won't get back to hit the ball. A good swing thought is, Turn more, swing less (2). When your body stops turning back, your arms should stop swinging. Think of swinging your arms with your turn, not with the muscles in your shoulders. —Johnson
THE LEAD KNEE
WHAT HAPPENS: We're really picking on the lead side, and rightfully so—it takes a real beating when you shift forward to swing through. This results in the inner side of the left knee absorbing a tremendous amount of torque and compression. Many golfers square the left foot and lock the knee in an internally rotated position (right, 1), which leads to an increased shearing force on the knee joint. The typical injury is to the medial meniscus and can lead to degeneration of the articular cartilage and arthritis. —Andrews
HOW TO AVOID INJURY: For the left leg to function properly, the knee has to shift in front of the hip very early in the downswing. Excessive shifting of the hips toward the target prevents this. The line of the left thigh should be vertical or leaning away from the target on the downswing, not leaning toward the target. To promote more turning and less sliding of the hips, rotate your left foot 20 or 30 degrees toward the target at address (2). —Johnson
THE LOWER BACK
WHAT HAPPENS: A strained lower back is the most common golf injury, and the one most likely to shorten a career. The modern power swing is all about the rotation of the pelvis through the shot. The torque this creates between the pelvis and the lumbar spine pulls the ligaments, tendons and muscles in that area. Also, the shearing effect can wear away the discs between the vertebrae in the lumbar spine, leading to disc disease; that's the real career-ender. —Andrews
HOW TO AVOID INJURY: Teaching today says to create separation between the rotation of the pelvis and the rotation of the trunk, especially on the downswing, where more separation means more speed (below, 1). The problem is, many golfers can't do that without a lower-back injury. Instead, try to turn everything in unison; the hips and shoulders should rotate back together and through together (2). You might sacrifice some power, but you'll save your back and stay in the game. —Johnson
Dr. James Andrews is based at St. Vincent's Hospital in Birmingham, Ala., and the Andrews Institute in Gulf Breeze, Fla. He has treated Jack Nicklaus (knee), Tom Kite (shoulder), Greg Norman (wrist), Jerry Pate (shoulders) and Gary Woodland (shoulder).
Hank Johnson, a Golf Digest Teaching Professional, has studied biomechanics for 30 years and runs a golf school at Greystone Golf & Country Club in Birmingham.