| Edward Staub, M.D. drstaub.com |
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GOLF INJURIES By Edward Staub, M.D. |
SHOULDER INJURIES IN GOLFERS
Shoulder injuries are very common in athletes who participate in overhead sports such as throwing,
tennis, and swimming. Golf is not really an overhead sport, but, nevertheless, there are
components of the golf swing that can injure the shoulder. Moreover, unlike athletes in most other
sports, golfers can play for years- literally until they go to golfer’s heaven. At around age 35,
degenerative changes develop in the shoulder and progress. The rotator cuff, an important muscle-
tendon complex that elevates the arm, can develop scarring, tendinitis, and small tears. Arthritis of
the shoulder joint can also occur. These problems are usually minor in people in their mid thirties,
but with each passing decade, degeneration can progress.
With repetitive swinging in golf, wear and tear and overuse of the rotator cuff occurs and without
adequate rest (try to get an avid golfer to rest), healing does not ensue. Studies have shown that
during the golf swing, there is relatively low use of the rotator cuff as other muscles such as the
pectorals and the latissimus dorsi muscles (see diagram below)are more dominant and important.
Yet, golfers with existing rotator cuff disease or shoulder arthritis will specifically aggravate these
problems, especially during the extremes of the backswing and the follow-through.
The golf swing can be broken down into three phases:
1. Takeaway and backswing: here the shoulder joint, ligaments,
and rotator cuff are stressed, especially at the top of the backswing.
2. Downswing and Acceleration: The lats are dominant during downswing and the pects
during acceleration. As the downswing gains speed, some of the rotator cuff muscles add force.
3. Follow Through: Again, stress is applied to the shoulder joint and surrounding ligaments.
Unlike other overhead sports, both shoulders can be affected during the swing, but frequently it is
the non-dominant lead shoulder that can be injured.
Older golfers commonly develop shoulder problems such as rotator cuff tendinitis , tears, and
arthritis. Younger golfers can also have these ailments, but also complain of shoulder looseness
and partial dislocations.
The treatment for a sore or inflamed shoulder is rest, anti-inflammatory drugs, and cortisone
injections. Most golfers don’t like to rest and I commonly hear excuses such as “ but, I have a big
match this weekend.”
If a few weeks of rest is not an option, then golfers should at least consider physical therapy to
strengthen and rehabilitate various muscles like the rotator cuff, the pects and the lats. Frequently
these muscles are weak and this hinders proper swinging mechanics. For example, pain during the
downswing may require strengthening the muscles that stabilize the shoulder blade.
Lessons may also benefit. Sean Garrity, my old friend and golf pro at the Smith-Richardson course
in Fairfield, CT., feels that duffers fail to rotate their torsos during the backswing and follow-through
– thus placing more stress on the shoulders. A golfer can feel this during a practice swing. Swinging
without rotating your body will make the shoulders feel tighter, whereas turning during the swing
loosens up the shoulders. Proper rotation of the torso will also utilize other muscle groups, thus
removing stress from the rotator cuff muscles.
Also, shortening up the backswing by 10-25% may help remove stress from the shoulder joint.
If these measures fail, surgery may sometimes be necessary. For rotator cuff problems and
arthritis, arthroscopic surgery to “clean out the shoulder” is fairly minor and the recovery can be
speedy. A golfer potentially could return to light golf activity within 3 to 4 weeks. Overall, long term
results are very satisfactory. If the problem is a sizable rotator cuff tear or shoulder instability, a
larger operation may be required, with a longer recuperation.
Golfers who have persistent and unrelenting shoulder problems should consult an orthopedist. The
phase of the swing causing the problem should be isolated and investigated: a treatment plan
specific to this problem can thus be initiated.
LATS
PECTS
| specific to any one patient's needs and, therefore, should not be construed as formal medical advice or treatment. Obviously, if you have a similar medical problem, you should consult a physician and not rely on these articles in lieu of treatment. If you reside in Dr. Staub's area, he will be delighted to accept you as a patient, but his ultimate opinion and recommendations will be based on his personal examination of you. |
