Category Archives: health

Golfers take care of your back

I guess this is Healthy Golf Week on the blog. Today’s post concerns golf’s number one injury, the lower back.

The human body was not designed to accommodate the stresses golf places on the lumbar spine. Regardless of what anybody says, there is no stress-free golf swing.

What you can do is get fit for playing the game, and adopt practices that minimize the stress.

There is one book I have found that tells you everything you need to know on this subject.

It is titled, Golfers Take Care of Your Back, written by Susan M. Carpenter and Florence P. Kendall.

Florence Kendall comes to golf with heavy credentials. She is, coequally with her husband, Henry O. Kendall, the founder of physical therapy in this country.

Her book, Muscles: Testing and Function, is on the desk of every working physical therapist today.

When she speaks, listen.

You can find this book at I recommend you get a copy and follow its advice.

If you want to know more about golf and the back from a clinical perspective, I would refer you to this comprehensive but somewhat imposing metastudy.

One thing. On the golf forums I read, every now and then someone will say, my back really hurts whenever I play. Should I stop playing and see a doctor?

That’s not a dumb question. We are often reluctant to seek medical assistance because we are afraid of what we might find out, afraid of what the treatment might be, or afraid of how treatment might affect our life’s routine.

But if your back hurts after every time you play, or after every time at the range, Stop! Get it checked out. It might be something that eventually affects more than your golf game.

This part is important: if you have back pain and have lost control of your bowels and bladder, this is an emergency condition. See a doctor immediately!

Sun and Heat Safety on the Golf Course

Warm weather is upon us, we are golfing again, and getting out in the sun. Let me say in the strongest way, protect yourself.

You have heard why. Overexposure leads to skin cancers later in life.

I’m a redhead, very sun-sensitive. In my 20s, even then, I let my head be exposed and got some mild sunburns. Nothing that really gave me a problem, but after a few I started wearing a hat whenever the sun’s burning rays were out.

Too late.

In the past few years I have had three malignancies removed, one by a procedure called Mohs surgery. Look it up online. Not fun.

This is what I recommend, based on my experience with hiking in the Southwest. Cover up. Sunscreen might not be as effective as we would like it to be, and it has to be applied at the right time and replenished.

Wear a broad-brimmed hat. Wear something loose-fitting to cover your arms and legs. This also preserves moisture, and helps you stay cool.

Wear gloves on both hands around the green, and keep your hands out of the sun when you walk down the fairway. I keep one hand in my pocket and the other hand pulling the cart in the shade of my body.

Hydrate! Drink plenty of water before you get to the course. Then have a few ounces (frequent sipping doesn’t do the job) every few holes, and on every tee if it’s really hot.

Play early or late in the day to avoid the highest temperatures.

If you feel yourself getting overheated, take off your hat and shirt and get them soaking wet. Wearing wet clothes like this will keep your head (especially your head!) and chest cool, keeping your body temperature down.

Learn to recognize the symptoms of heat exhaustion and heat stroke.

Heat exhaustion:
Cool, moist skin with goose bumps when in the heat
Heavy sweating
Weak, rapid pulse
Low blood pressure upon standing
Muscle cramps

What to do:
Stop all activity and rest
Move to a cooler place
Drink cool water or sports drinks

Heat stroke (this is an emergency condition):
Altered mental state or behavior.
Sweating stops, skin is dry.
Nausea and vomiting.
Flushed skin.
Rapid breathing. Racing heart rate.

What to do:
Call 911
Get the person into shade or indoors.
Remove excess clothing.
Cool the person with whatever means available

Then there’s lightning, but that’s a different post.

Does Playing Golf Prolong Your Life?

A recent study published in the Scandinavian Journal of Medicine & Science in Sports concluded that playing golf regularly may increase your life expectancy by five years.

Actually, it’s not a recent article, it came out in 2008. But it caught someone’s attention recently.

Unfortunately, the full article is available only for a price, and you can buy access if you want to here.

The study’s abstract is here, but you have to have some experience reading abstracts to make sense of it.

You can find a discussion of the article here, and that should be all you really need to read.

The study did mention the full effect of prolonging life occurs in low handicap golfers, which should give all of us a new incentive to get better.

So you see, all long I have been adding add years to your life and you never knew it.

You’re welcome! Now start practicing!

Golf and Skin Cancer

The word is out. Skin cancer is bad for you, and too much sunshine causes it. (Did anyone really not know this?)

Read this article about it, now appearing Golf Digest. Really! Read it!

I’m a redhead, and I keep covered up from head to toe on the course. I wear a hat with a 5″ brim, a sun-protective jacket (both pictured below) from Solumbra, long pants, and gloves on both hands most of the time.

The photo below was taken at the Thunderbird Golf Course at Mt. Carmel Junction in southern Utah in 2011, on the way back from having hiked across the Grand Canyon from the North Rim to Phantom Ranch and back out to the South Rim.

The glove I wear aren’t golf gloves, they are running gloves I get at a sporting goods store. Off the tee and off the fairway, I do not wear them. While walking from tee to fairway, one hand is in my pocket and the other hand pulls the cart behind me so it is in the shade of my body.

Once I have hit into the the green, both gloves go on. All short shots and all putting is done with them on.

I ain’t kidding, folks, and the article ain’t kidding, either. Stay covered up. I have spent a lot of time in the Southwest. You know what the Navajo wear outside? Enough to cover their arms and legs and face.

If you wear light, loose-fitting clothing made of cotton that covers your arms and legs, you will actually stay cooler in hot weather, so don’t let the heat prevent you from keeping out of the sun.

Sunscreen? O.K., but you have to remember to apply it every few hours, and apply it correctly. I don’t recommend relying on it.

Stay covered is the best option.

The Latest on Your Back and Golf

Last week a new paper was published describing the effects of the modern golf swing on the lumbar spine. The effects are not good.

The article states that professional golfers generate “about 7500 N compressive on the spine during the downswing.” One N (newton) is the amount of force needed to move one kilogram at an acceleration of one meter per second per second.

No one’s back is designed to stand up to 7500 of those.

Then the article takes on the X-factor, without mentioning Jim McLean. But I will. The greater the angle between the hip line and the shoulder line at the end of the backswing, the more power can be generated on the downswing.

However, this position sets up the golfer to deliver a huge load of lateral bending and torsional axial moments (twisting of the spine) right before impact.

More distance = more back damage. Thanks, Jim.

Exercising the core muscles, and muscles in the back that support the spine, which golfers are told to do, do not help matters. Stronger muscles create stronger swings, which place more force on the spine, not less.

If you read the article, which you should absolutely do, there are some technical terms in it. This little glossary should help with a few of them.

acromion – a bony process (portrusion) on the shoulder blade that hooks over the front to make a joint with the collar bone.

facet joint – joints that allow vertebrae to slide over each other when the back goes through various movements.

spinal erector muscles – a set of long muscles that surround the spine and govern certain movements of the back. When these muscles are engaged they exert longitudinal compression on the spine which raises intradiscal pressure.

disc annulus – the outer portion of the pulpy mass between the bony vertebral bodies.

So. What does this mean for you?

First of all, study Justin Thomas’s swing carefully. Then do not do what he does. He is a case study of the scary swing identified in this article.

Second, remember that the pros need all the distance they can get to be competitive. You don’t if you play from the appropriate tees.

Again, though the X-factor that Jim McLean identified might well be true in terms of hitting the ball farther, it is murder on a golfer’s back. Don’t go there. Don’t force your backswing. Get your distance from hitting the ball on the center of the clubface.

Fourth, do the things I mentioned in this post about building a back-friendly golf swing.

A Flexible Body for Golfers

A few years ago I wrote a post showing five exercises designed to strengthen the core in order to play better and prevent injury.

Flexibility is a big part of an efficient and healthy golf swing, too. Here are five exercises that will keep you limber for golf.

1. Lateral bend — Stand with your feet apart. Bend to the side as shown, supporting yourself with a hand on the leg. Reach over your head with the other arm to complete the stretch.

lateral bend stretch

2. Supine trunk rotation — Lie down on your back and bring your knees up, feet flat on the ground. Rotate your knees to one side, keeping your shoulders in contact with the ground. This the preferred way to rotate the trunk. Rotating the trunk while standing adds compression force to the torque. When you lie down, there is no compression, only torque.

A different way to do this stretch is to start lying on your side with your knees bent, untwisted, with your arms straight in front of you on the ground. Slowly move your top arm away from your other arm toward the floor on the other side as you rotate your trunk, to arrive in the position shown.

supine trunk rotation

3. Rotator cuff — (1) Bring one arm across your body at shoulder level. Use the other forearm to press inward and complete the stretch. (2) Stand in a doorway with both hands on the doorway as shown. Lean forward for the stretch.

rotator cuff stretch 1

rotator cuff stretch 2

4. Hamstring stretch — Sit on the floor with one leg straight out in front of you. If you can’t tuck your other leg as shown, that’s all right. Lean forward (not down) to complete the stretch.

hamstring stretch

5. Neck stretch — Rotate the head to the left and hold for a few seconds. Do the same to the right side.

neck stretch

You can do all these stretches daily in less than five minutes.

Spine Health at the Range

I was browsing through my hard drive a few days ago when I found an article about spine loads during a golf swing. Since I have a delicate lower back, I thought I would read this article again to see if had missed anything when I read it the first time some years ago. Indeed, I had.

While loads on the lumbar (lower) spine are considerable during the swing, especially in the late downswing, they are not damaging. The caveat is that the discs between the vertebra are viscoelastic and time-rate dependent.

This means they deform when stressed (viscoelastic) and need time to get back to their original shape (time rate dependent). The article noted that “accumulated stress due to repeated swings may lead to disc degeneration, and even submaximal exertions may lead to structural deformation of the lumbar spine.”

What they’re telling us not to do is hit one ball after the other like there’s a race going on. Maybe your back doesn’t feel sore after you do that, but you are putting undue stress on it in any event and not letting it recover. It you do hit balls rapid fire and you do feel your back getting a little sore, that’s a big warning sign.

All of us should hit balls slowly. Rest between each shot. Take some time to review in your mind why the ball you just hit did what it did, and what you want to do with your next swing. Or take a few easy partial swings to rehearse a move you’re working on. Then hit another ball.

At the range, when it is possible to take a swing every fifteen seconds, instead of every five minutes, like out on the course, slow down. It can only help to keep your lower back healthy while playing a sport that challenges it.

A Back-Friendlier Golf Swing

I’m not going to beat around the bush. The human body, especially the lower spine, was not designed to withstand the stresses the golf swing places on it. As a recreational golfer, there is no sense in letting your pastime harm your health.

Stress on the back in golf is caused by leaning forward, twisting, and bending to the side. There is also compression, which is the weight of your upper body bearing down vertically on your spine.

You can’t eliminate these stresses, but, except for compression, you can minimize them. Here are a few ways to do that.

NOTE: If you have low back pain right now when you play, something is wrong. Please see a doctor to find out what that is. Continuing to play golf could be making a problem worse.

1. Slow down your swing, including the part where you swing through the ball. All the forces being applied to your back multiply when you swing through the ball, and they the faster you swing, the more force they load onto your lower back.

2. Stand a little closer to the ball. Not a lot, just a few inches. This will put you in a more upright posture and reduce the unsupported mechanical stress that leaning forward places on your lower back. The lie angles of your irons might need to be adjusted, depending on how much closer you set up.

3. Turn your right foot out. To get more hip turn, turn your right foot out 10 degrees or so. Not too much, because you will create problems for yourself on the throughswing. But do not leave that foot square, like Ben Hogan wanted you too.

4. Take a narrower stance. This frees up the hips to turn more, reducing the amount you twist your spine. This point also helps minimize lateral bending, since your right side is now closer to the ball.

5.Play the ball in the center of your stance when it is on the ground. If the ball is too far forward, you will need to put more lateral bend in your back to go get it.

6. Take a shorter backswing. Use the backswing you would use for an 80-yard pitch. This will prevent you from twisting your spine too much, too. Jim McLean wants you to have a big X-factor so you can hit the ball a long way. Your back does not like a big X-factor.

7. Let the left heel float. If it comes off the ground, fine. If it stays there, fine. Just don’t glue it to the ground. Let it do what it wants to do.

8. Let the right leg straighten on the backswing. I know, everybody these days wants you keep the angle in it you had at address. Allowing the right leg to straightening lets you turn your right hip back more, reducing your X-factor. This will not hurt your ball-striking once you get used to it.

9. Keep your weight balanced through impact. Let your weight go left after you have hit the ball, but not before. Putting the weight left early creates excess lateral bending, because while the lower body is going left , the upper body has to stay back where it was until you have hit the ball. There will always be some lateral bending at impact. Just don’t overdo it.

10. Swing the club with your hands, both hands equally. Swing like you one have one clump of hands on the club, not two separate ones. This not only a better way to swing, for technical reasons, but it will prevent you from trying to hit with your right hand, which can induce lateral bending.

11. Finish upright. Your torso should be straight up and down at the finish, not learning toward the right. A line running down the front of your torso and left leg should be straight — no bending your torso backward, or bowing your left leg.

This comprehensive but somewhat technical article from the medical literature explains in detail the relation between golf and low back pain. It would serve you well to read it. (Accessed July 4, 2016.)

[August 2019. In the comment section, I refer to Natalie Gulbis, whose back-unfriendly swing led to back surgery. As of this date, she has had four back surgeries.]

Sitting Is the New Smoking

This post has nothing to do with golf. Let’s call it a Public Service Message from TRG.

I am tangentially connected with the health industry. What I heard last week makes perfect sense and I want to pass it on to you.

Sitting is the new smoking.

A raft of modern health problems have their origin in sitting too much. Sitting at the computer, in front of the tube, anything that lures you into sitting for hours a day.

The solution in one word. Move.

Get up and move. Get up often and move. Be active. Move. Throughout the day, every day.


Thank you. Now back to golf.

A Solid Core for Golfers

Golf is not a walk in the park, though it looks like one. The golf swing is an athletic movement, which requires physical strength to perform correctly, and to avoid injury.

The physical foundation of the swing is your core, or the trunk and the lower back. Do these exercises three times a week to develop it. No equipment is required.

Exercises 1-3 strengthen your abdomen. Exercises 4-5 strengthen your back. You must do both groups to be balanced.

1. Abdominal crunch – Lie down on your back, both knees bent. Elevate your upper back so your shoulder blades are off the ground. Hold for five seconds and lower your shoulders to the ground. Start with three times and work up to ten.


2. Plank – Get into a push-up position, with your body supported by your toes, and your forearms instead of your hands. Make sure your body line is straight. Hold for 30 seconds and work up to two minutes.


3. Side plank – Lie on your side. Raise your body off the ground and support it on your forearm and underside foot. Make sure your body line is straight. Hold for ten seconds. Do five times on each side. At first, you may wish only to raise your upper body off the ground.


4. Butt squeeze – Lie down on your back, legs straight out. Clench your buttocks and hold for ten seconds. Try not to squeeze your thighs, too. Do five times.

5. Prone pointer – Get down on all fours. Raise your right leg and stick it straight out behind you. Raise your left arm and stick it straight out in front of you. Hold for ten seconds. Lower and switch to left leg, right arm. Do five times on each side, work up to twenty.


See this post for flexibility exercises.