Low Back Pain in Golf

Sports injuries causing lower back pain are one of the most common golf-related sports injuries. The incidence of golf-related lower back sports injury ranges from 15% to 34% in the amateur golfer and 22% to 24% in the professional. Collectively, the incidence of lower back pain in the male golfer is 25% to 36% and 22% to 27% in the female golfer. According to various studies Chiropractors are more often sought to manage the incidence of low back pain in golf.

Low Back Pain Sports Injury Golf

A study entitled Golf-related lower back injuries: an epidemiological survey by McHardy et al., 2006 described the play characteristics of golfers who had a sports injury and hence low back pain in the course of play or practice in the previous year (12 months). In addition, common sports injury mechanisms for the back sports injury were sought to determine if factors such as age, sex, and the amount of play or practice affected the back sports injury rate. Finally, the study aimed to report the use of Chiropractors and back sports injury management among the golfers surveyed.

How do Golfers get Low Back Pain?

The golf injury literature reports the lower back to be the most common sports injured part of the body. The data collected in the McHardy et al., 2006 support this view on low back pain and sports injury. The study found that the swing was reported to be the most common injury mechanism, accounting for nearly half of all lower back sports injuries in golf. The golf injury sports literature suggests that the golf swing is the most common cause of golf related sports injury. However, little direct evidence exists to describe the exact nature of the sports injury mechanism causing lower back pain in golfers. Burdorf et al conducted a 1-year prospective study on lower back pain in novice golfers and reported risk factors for low back sports injury in golfers.

Whats causes Low Back Pain & Sports Injuries in Golf?

The present study by McHardy et al., 2006 found that the lower back sports injuries sustained by the respondents were most commonly felt during the follow-through phase of the golf swing (impact to completion of swing). From these results it appears that the follow-through phase of the golf swing is an aggravating movement and potentially a predisposing factor for a low back sports injury. It has been postulated that the body position of the follow through and contraction’s displayed by the decelerating torso muscles are significant factors in the causation of lower back injury in golfers. This finding appears to be in agreement with Sugaya et al who examined lower back pain among 282 right-handed professional golfers and found a correlation between right side back pain and the follow-through phase of the golf swing. The literature suggests that 30% of all golf injuries occur in the follow-through and around 40% of low back injuries occur in the follow-through. This study found that 41.6% of lower back injuries occurred in the follow-through.

Are we predisposed to Low Back Pain as a Sports Injury in Golf?

McHardy et al found lower back sports injury associated with golf was twice as likely to occur over a period as opposed to a single episode. This figure is lower than that reported for amateurs and professionals by Gosheger et al, who reported 91% of lumbar spine sports injuries to be due to overuse, as opposed to traumatic singular events. The differences between the studies were that the results of the present study reported changes in amateurs and not professionals, whereas Gosheger et al examined both golfing groups. The difference in the response may be due to the difference in the player characteristics between the relative proportions of amateurs and professionals in the 2 studies. In addition, the McHardy et al found those golfers that sustained a lower back injury due to golf in the previous 12 months were 3 times more likely to have had a previous history of lower back sports injury. The study performed by Gosheger et al appeared to report sports injuries sustained throughout a career.

Does too much emphasis on Sports Specific training cause Sports Injuries in Golf?

When comparing the playing and practicing habits between those injured in the lower back and those uninjured, the only significant difference seen was that the golfer who performed less practice had less risk of injury than the golfer who performed more. It may be intuitive that more actual game play would increase the risk of injury through greater participation; a round of golf takes approximately 4 hours to complete with an average of 40 to 45 full shots. This figure compares with the golfer who performs full shot practice at the driving range. In the practice scenario, a bucket of 60 balls generally takes 60 to 70 minutes to hit. Thus, there is a significant increase in the intensity of play in the golfer who performs full shot practice compared with one who performs less full shot practice; this appears to be associated with an increased injury rate.

The type of golfer who sustained low back sports injuries was more likely to have had a previous history of lower back injury and it was chronic in nature. The lower back sports injury was most likely due to the golf swing and was very likely to have occurred in the follow-through phase. Most of the injured golfers received treatment of their injury from the chiropractor. The treating practitioner should be knowledgeable of the golf swing of this popular sport to educate the patient with a history of lower back sports injury on appropriate follow through positions that are thought to predispose injury, and thus, the chance of golf-related lower back sports injury can be reduced or eliminated.

The North Wales Spine Clinic
Effective Golf is Safe Golf

If you live in Conwy, Gwynedd or Anglesey and would like a thorough examination to find out if you are predisposed to the sports injury low back pain in golf or if you have low back pain then contact our professionals at The North Wales Spine Clinic for help.


1. McHardy A, Pollard H, Luo K. Golf injuries: a review of the literature. Sports Med 2006;36:171- 87.
2. McHardy A, Pollard H. Lower back pain in golfers: a review. J Chiropr Med 2005;4:135- 43.
3. Gosheger G, Liem D, Ludwig K, Greshake O, Winkelmann W. Injuries and overuse syndromes in golf. Am J Sports Med 2003;31:438- 43.
4. McCarroll JR, Gioe TJ. Professional golfers and the price they pay. Phys Sportsmed 1982;10:64- 70.
5. McCarroll JR, Retting AC, Shelbourne KD. Injuries in the amateur golfer. Phys Sportsmed 1990;18:122-6
6. Batt ME. A survey of golf injuries in amateur golfers. Br J Sports Med 1992;26:63-5.
7. Theriault G, Lacoste E, Gaboury M, Ouellet S, Leblanc C. Golf injury characteristics: a survey of 528 golfers. Med Sci Sports Exerc 1996;28:S65.
8. Dillman DA. Mail and telephone surveys: the total design method. New York7 John Wiley & Sons; 1978.
9. Salant P, Dillman DA. How to conduct your own survey. New York7 John Wiley & Sons, Inc.; 1994.
10. Burdorf A, Van Der Steenhoven GA, Tromp-Klaren EG. A one-year prospective study on back pain among novice golfers. Am J Sports Med 1996;24:659- 64.
11. Stover CN, Wiren G, Topaz SR. The modern golf swing and stress syndromes. Phys Sportsmed 1976;4:42 -7.
12. Lieber RL, Friden J. Mechanisms of muscle injury after eccentric contraction. J Sci Med Sport 1999;2:253- 65.
13. LaStayo PC, Woolf JM, Lewek MD, Snyder-Mackler L, Reich T, Lindstedt SL. Eccentric muscle contractions: their contribution to injury, prevention, rehabilitation, and sport. J Orthop Sports Phys Ther 2003;33:557- 71.
14. Sugaya H, Tschiya A, Moriya H, Margan DA, Banks SA. Low-back injury in elite and professional golfers: an epidemiologic and radiographic study. In: Farrally MR, Cochran AJ, editors. Science and golf III: proceedings of the World Scientific Congress of Golf. Champaign, IL7 Human Kinetics; 1999. p. 83- 91.
15. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 2nd ed. New Jersey, NJ7 Prentice Hall Health; 2000. p. 286.
16. Harris LE, Weinberger M, Tierney WM. Assessing inner-city patients’ hospital experiences. A controlled trial of telephone interviews versus mailed surveys. Med Care 1997;35:70-6.
17. Stang A, Jockel KH. Studies with low response proportions may be less biased than studies with high response proportions. Am J Epidemiol 2004;159:204- 10.
18. Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol 1997;50:1129- 36.
19. Jepson C, Asch DA, Hershey JC, Ubel PA. In a mailed physician survey, questionnaire length had a threshold effect on response rate. J Clin Epidemiol 2005;58:103-5.
20. Nicholas J, Reidy M, Oleske D. An epidemiologic study of injury in golfers. J Sport Rehabil 1998;7:112-21.
21. Massett HA, Greenup M, Ryan CE, Staples DA, Green NS, Maibach EW. Public perceptions about prematurity: a national survey. Am J Prev Med 2003;24:120-7.
22. Formoso G, Moja L, Nonino F, Dri P, Addis A, Martini N, et al. Clinical evidence: a useful tool for promoting evidence-based practice? BMC Health Serv Res 2003;3:24.
23. Greenwald R. Brief assessment of children’s post-traumatic symptoms: development and preliminary validation of parent and child scales. Res Soc Work Pract 1999;9:61 – 75.
24. Salim Silva M, Smith WT, Bammer G. Telephone reminders are a cost effective way to improve responses in postal health surveys. J Epidemiol Community Health 2002;56:115-8.
25. Australian Bureau of Statistics. Participation in sport and physical activity. Doc No. 4177.0. Belconnen7 ACT: Australian Bureau of Statistics; 1999-2000.
26. Barribeau P, Butler B, Corney J, et al. Overview: survey research. Boulder7 Colorado State University; 1993-2007 [monograph on the Internet, cited 2006 Jan 6]. Available from: http://writing.colostate.edu/guides/research/survey/.