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Physiotherapy


Golf Injuries

Introduction

Golf is a Gentle, Low-level and Innocuous sport. Comparing to other sport golf injuries is less and is mostly due to overuse, bad golfing techniques and poor posture.
Most common injury in golfer’s players is Back, Shoulder, Elbows, Hands and Wrists. The injuries occur due to hard impact and stress of the repetitive swinging motion on muscles and joints.
Good swing mechanics and Proper health

conditioning during the play avoid injury.

Common Golf Injuries

Back Injuries

    This occurs due to poor swinging mechanics and poor

physical fitness. Fatigue causes uncontrolled muscle balance leading to injuries.
    Muscle strains of back
    Herniated discs
    Back pain

Hand and Wrist Injuries

    These may be due to overuse and repetitive strain. Mostly left hand is injured due to poor wrist control during swing leading to excessive movement.
    Hamate bone fracture – It occurs due to direct blow from handle of the golf club during the shot.
    Chronic fractures may lead to Ulna neuropathy.
    Wrist tendinitis
    Trigger finger
    To prevent hamate bone fractures, the butt of the club is to be in appropriate size and length which extends beyond the palm of the leading hand.

Elbow Injuries

    Golfer’s elbow (Medial epicodylitis)
      - Tennis elbow is an inflammation, soreness, or pain on the outside of the upper arm near the elbow.
      - Golfer's elbow is an inflammation, soreness or pain on the inside of the upper arm near the elbow. Golfer’s elbow is actually more common among golfers.
      - In chronic cases, wrist extension and passive wrist flexion increase pain.
    Tennis elbow (Lateral epicondylitis)
    Elbow bursitis.
      - After recovery, Grip tension is to be reduced, Swing errors are to be avoided.

Shoulder Injuries

    It is less common and occurs due to overuse of the part.
    Shoulder Tendinitis, Bursitis, and Impingement syndrome.
    Rotator cuff injuries
    Frozen shoulder
    Shoulder instability

Knee pain - Golfer’s experience a variety of knee pain.

Plantar fasciitis- Pain in the bottom of the heel.

Muscle cramps

    Cramp is a sudden intense pain in the muscle which contracts involuntarily and forcibly which does not relax.

Stress fractures

    They are common in Hip, Knee, Ankle and Feet due to repetitive pressure, force and contraction of the muscles attached to them.

Tendinitis

    Inflammation of the tendon due to overuse syndrome, Forceful contraction of muscle fibers which cause injury.

Over training syndrome

    This occurs due to repeated training and overuse of the same muscles beyond their limit and capacity during competition/work-out lead to over training syndrome.

Sprains and Strains

    These are acute injuries causing Pain, Swelling, Bruising and Movement loss in the joint

Physical Therapy Treatment

Diet

    Proper nutrition should be taken. Improper diet prevents from early recovery. A balanced diet includes:
     - Carbohydrate intake which help in refueling muscles
     - Proteins to rebuild muscles
     - Drink plenty of water to keep hydrated.
     - Vitamins and Minerals

Wrist Exercises

    Clubs should be with large grips and flexible shafts. Heads should have large sweet spots to reduce vibration. This reduces wrist injuries.

Finger Exercises

Shoulder Exercises

    Back swings should be shortened. Rotator cuff and chest strengthening should be done.

Back Injuries

    Golf using larger shoulder turn and less hip turn is good technique and prevents back injuries and strain.
    The modern technique involves tightly coiled body which enables club-head acceleration.
    Strengthening Exercises, Endurance Exercises, and Core stretching helps in reducing injuries to back.
    Back pain injury players should follow classic swing technique – Rotate pelvis and shoulder together, Lift forward heel at the top of the back swing which helps in reducing torque on their spines.
    Straight body posture without hyperextension of the lumbar spine is to be maintained.

Prevention

Injury prevention methods are similar to all most all the sports but slight variations regarding protective equipments and conditioning exercises should be taken care of.

Warm-up Program

    It should consist of 5 min Cardio/Pulse raising exercises like Jogging, Cycling, and Skipping etc.
    Stretching exercises
    Jogging

    Benefits

     - Increasing temperature of muscles.
     - Increases blood circulation and oxygen to muscles.
     - Increase the speed of nerve impulses making the muscle action faster.
     - Increase the range of motions of the joints.
     - Improves the performance of the joint action.

Stretching Exercises

    All muscles and joints stretching to be done. This helps in preventing injuries.
    Good stretching program for upper and lower limb muscles is to be done.
    Stretches should be static without any bounce and held for at least 30 sec.

Cool-down Program

    It consists of gentle jogging followed by light stretching.

    Benefits

     - Gradually lower your heart rate
     - Restoration of blood and oxygen to muscles as they were before exercise program
     - Removes toxic and waste products
     - Reduces muscle soreness present after activity.

First Aid Kit

    Adhesive bandages, Adhesive tape, Ace bandages
    Ice packs
    Pain killers
    Sterile gauze pads,
    First aid cream/Disinfections cream/Analgesic cream
    Scissors
    Cloth swatches for making slings in case of emergency.

Sports Massage

    Regular sports massage help in flushing of toxic and waste products.
    Relaxes the muscle stress.
    Releases tight lumps and bumps in the muscles.
    Give more importance to Lower limbs.

Fitness maintenance

    General conditioning of health.
    Aerobic Exercises
    Muscle Strengthening Exercises.
    Stretching Exercises

Dress appropriately

    Proper Shoes - Good sneakers/Shoes with skid resistant soles.
    Proper socks
    Play with larger club grips which reduces wrist and hand injuries.
    Use soft and neutral grips.
    Large head irons, Graphite shafts and sweet spots lessen vibration.
    Correct club length is to be used i.e. club end should extend slightly beyond the leading hand palm.

• Minor injury should also be treated as early as possible as this may lead to severe injury in later stage.

• Good fitness training and trainer are also necessary. During practice also wear good and protective shoes.

• Use a sunscreen lotion in summer and moisturizer in winter season while playing to protect the skin.

Simple Exercises to strengthen Wrist muscles

    Squeezing a tennis ball – This is effective exercise to strengthen your forearm muscles.
    Wrist curls – Take a light-weight dumbbell and place your hands in front keeping palms side down. Move the dumbbell up and down with movement in the wrist. Stabilize the forearm to limit the motion.

Simple Exercises to strengthen Back muscles

    Rowing - Tie the ends of rubber tubing and place it around an object at shoulder height. Stand keeping the arms straight in front and grasp the tube and pull it towards the chest. Release slowly and repeat.

    Pull-Downs -  Tie the ends of rubber tubing and place it around an object at shoulder height. Kneel and hold the tubing over your head and pull it slowly towards your chest with lowering your arms bending your elbows. Then raise the tubing over your head.

Phases of Golf  Swing

    Back swing - Shoulder and Hip are to be rotated together
    Down swing
    Ball strike
    Follow-through - Spine is to be in vertical position which helps in avoiding hyperextension of spine.

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