Golf-related low back pain: a review of causative factors and prevention strategies.

Golf is a popular sport with both perceived and real health benefits. However, certain injury risks are also prevalent, particularly to the lower back. Epidemiological studies have shown that lower back pain (LBP) from golf account for between 18% and 54% of all documented ailments, leading many researchers to regard the condition as the most common golf injury. The purpose of this review was to examine the scientific literature to ascertain the risk factors associated with the development of LBP from playing golf and suggest methods to modify or limit these factors. Results of the review indicate that the high frequency of LBP appears multi-factorial although the asymmetrical and forceful nature of the swing along with excessive play and practice, particularly amongst elite players, appear to be common factors. Other factors include swing flaws leading to excessive side-bend and over-rotation of the spine, abnormal muscle recruitment, poor trunk endurance, restricted lead hip internal rotation and the use of unnecessarily stressful club transportation methods. Methods to help control or eliminate excessive stress on the lower back would include reducing the amount spent playing or practicing, seeking professional assistance to assess and adjust swing mechanics, improve trunk and hip flexibility, increase the strength and endurance of the trunk musculature, consider different footwear options and avoid carrying the golf bag. Adopting some or all of these recommendations should allow players to continue to enjoy the sport of golf well into their senior years.