As the summer days are getting warmer, more people are out on the greens working on their golf game. It’s usually around this time of year my schedule gets booked up with golfers complaining of back pain. While I will be treating their back pain, if I want to keep the pain away and improve their golf game, then I will be looking at hip mobility. I haven’t treated a single golfer complaining of back pain where I didn’t find a lack of hip rotation is the primary driver (pun intended). About 80% of them have an inefficient internal rotation of their back leg as the most dysfunctional factor to their back pain. The other 20% are lacking internal rotation of their lead leg which affects their follow through.
“The knee bone is connected to your hip bone” childhood song helps explain why hip mobility can have such an impact on the back. The entire body is connected and when asking the body to perform a whole-body motion, when you have areas that don’t move as well, the range of motion is transferred either above or below that joint to complete the desired task. Below the hip joint is the knee which doesn’t rotate a lot and is more for straightening and bending. Above the hip joint is the lumbar spine which has a lot of rotation movement available. Excessive pressure is put on the discs and joints when combining all the motions of the golf swing coupled with insufficient hip rotation.
Excessive rotation paired with slight lumbar flexion going into the backswing and transferred through to back extension in the follow through puts significant 3D stress on the joints and discs of the lumbar spine. Add in the velocity of a golf swing, and it’s only a matter of time before pain will start radiating from the back. If you look at older footage of Tiger Woods, you will see a nice easy swing where the motion and force are beautifully transferred through his entire body. Now look at his swing leading up to his first of 3 back surgeries and you can see how his hips no longer move have the smooth rotation, and more motion is coming from his back. I would have been curious to examine this hip rotation before that first surgery to see if that was a culprit.
There are some exercises you can do to improve the strength and mobility of your hip rotation, like resisted motions with resistance bands, but if you are already experiencing back pain, it might be worth it to see a trained manual therapist to assess your body. Your low back will need to be treated because there is a reason why you are having pain in that area. Dysfunctions have been present in the lower backs of all the golfers I have treated in the past. If you want a lasting relief that keeps you off the physical therapy table and on the greens, then you need to get your hip mobility improved through soft tissue and joint mobilizations to restore efficient mobility.