KEYSTONE, Colo., July 14 -- Golfers with low-back pain may be helped by a University of Pittsburgh research study, the findings of which may assist clinicians in designing appropriate back-specific exercise programs for golfers to prevent or rehabilitate low-back injury.
The findings are being shown today with a poster presentation at the annual meeting of the American Orthopaedic Society for Sports Medicine, July 14-17, at the Keystone Resort in Keystone, Colo.
"More than 30 percent of golfers have experienced issues related to low-back pain or injury that have affected their ability to continue enjoying the game of golf," said principal investigator Yung-Shen Tsai, Ph.D., P.T., of the University of Pittsburgh Neuromuscular Research Laboratory (NMRL), where the study was conducted.
"The results of this study are being used, for example, to develop injury prevention programs that will be offered at the new UPMC (University of Pittsburgh Medical Center) Golf Fitness Laboratory at Pinehurst Resort (Pinehurst, N.C.), which will open to the public officially on July 18," said Scott Lephart, Ph.D., director of the NMRL and the UPMC Golf Fitness Lab. For more information, go to http://golffitnesslab.upmc.com.
"Modified swing patterns and general exercises have been suggested for golfers with back problems. However, it is difficult to design an appropriate back-specific swing or exercise program for low-back injury prevention and rehabilitation without knowing the differences in the kinematics and spinal loads of the golf swing and the physical characteristics of golfers with low-back pain," Dr. Tsai explained.
So, Dr. Tsai's team set out to examine the kinematics of the trunk and spinal loads in golfers with and without low-back pain (LBP) and their trunk and hip physical characteristics. Sixteen male golfers with a history of LBP were matched by age and handicap to 16 male golfers with no history of LBP. All study participants underwent a biomechanical swing analysis and physical characteristics assessment. The researchers used a 3D motion analysis system and two force plates to assess kinematics and spinal loads of the trunk. They used a bottom-up inverse dynamics procedure to calculate spinal loads of the lower back. In addition, they measured trunk and hip strength and flexibility, back proprioception and postural stability.
"We found deficits in physical characteristics in the golfers with a history of LBP compared to the non-LBP group," reported Dr. Tsai. "These differences may hinder dissipation of the tremendous spinal forces and movements generated by the golf swing over time and limit trunk rotation during the backswing. These conditions may lead to lower back muscle strain, ligament sprain or disc degeneration.
"Although differences found in this study cannot be determined as causes or results of low-back injuries in golfers, clinicians may be able to use our data to design appropriate back-specific exercise programs for golfers to prevent or rehabilitate low-back injury," said Dr. Tsai.
Specifically, the LBP golfers in Dr. Tsai's study demonstrated less trunk and hip strength and less hamstring and right torso rotation flexibility. The LBP group also demonstrated back proprioception deficits significantly in trunk flexion. No significant differences were found for postural stability. The LBP group showed less maximum angular displacement between shoulders and hips during the backswing. No significant differences were found in other trunk kinematics and spinal loads during the golf swing.
This study is part of the Neuromuscular Research Laboratory's ongoing Golf Injury Prevention Project. The NMRL, housed in the UPMC Center for Sports Medicine, contains state-of-the-art neuromuscular and biomechanical assessment tools with which researchers use the latest sports medicine and athletic conditioning techniques to concentrate on two main goals: to prevent and manage injury while enhancing athletic performance. Laboratory faculty includes those from the sports medicine and nutrition department at the university's School of Health and Rehabilitation Sciences and the orthopaedic surgery department at the university's School of Medicine. In addition to golf-related research, the NMRL also has ongoing studies of sports performance, injury prevention, treatment and rehabilitation involving cycling, the female anterior cruciate ligament, and the shoulder and lower extremities. For more information, go to www.pitt.edu/~neurolab/.
Other investigators for this study were: Timothy Sell, Ph.D., P.T.; James Smoliga, D.V.M; Joseph Myers, Ph.D., A.T.C.; Jean McCrory, Ph.D.; Richard Erhard, D.C., P.T.; and Scott Lephart, Ph.D., A.T.C.
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