From TPI (Titleist Performance Institute):
“Lower back pain is by far the most common ailment suffered by golfers of all ages. Based on data collected at TPI from over 31,000 golfers, 28.1% of all players deal with lower back pain after every round.”
Types of Back Injuries
There are a variety of back injuries ranging from damage to the nerves, herniated discs, degeneration of vertebrae, stenosis, arthritis, bulging discs, sprained ligaments and or muscles, inflammation…and the list goes on. Severe injuries may need surgery or other medical intervention whereas others like disc degeneration and arthritis often result in chronic pain that is managed under the care of a medical professional. Less severe (but sometimes equally as painful) injuries like muscular and ligament inflammation or strains and sprains can come and go with activity or flare up under certain conditions.
It’s important to know the source of a back injury – don’t ignore pain! Having an understanding of where your pain originates allows it to be managed correctly. Arthritic, nerve and disc injuries should be managed under the care of a medical professional who gives you guidance and restrictions (if needed) so your injury is not further exacerbated.
Causes of Lower Back Pain – General
In the absence of one of the previously mentioned severe forms of injury, the pain you may experience in the lower back is often “referred” pain. Remember, in the body everything is connected. If you imagine the human body is like a chain; each link is connected and impacted by the others. If one part of the chain is deficient, the others parts of the chain experience more stress. and do more work than when all links in the chain are doing their job. Referred pain is the result of reduced flexibility, mobility or strength or an imbalance in another part of the body that manifests.
Limitations in one part of the body lead to compensations in other parts of the body..often the lower back. The most common limitations related to back pain are weakness in one set of muscles combined with tightness in the opposing set of muscles. This combination of weakness/tightness can lead to recurrent injury and severe pain that can feel unbearable – even when the injury does not need a surgical intervention. And while this type of pain may come and go without the need for intervention, it can result in scar tissue and adhesions which can further limit your mobility and often lead to chronic pain (now your back pain doesn’t seem to ever really go away).
The best plan is to understand the origin of your pain and have a plan for either eliminating it permanently or managing it using the guidelines of a medical professional.
Causes of Lower Back Pain In Golfers
Muscular Imbalances– Tightness on one side of the body combined with weakness on the opposite side. Lower Cross Syndrome (LCS) is a medical term used to describe an extremely common source of back pain in the L4-L5 area. LCS is the result of tightness on one side of the body (hip flexors and thoracolumbar extensors) combined with weakness on the opposite side (deep abdominal muscles and glutes).
Posture Deficiencies – Poor posture in daily life often translates into poor golf posture. Often the result of weakness in the glutes, core, neck and upper back.
The most common postural deficiencies are the “C” or “S” pattern in the spine. Both of these posture can result in rotational movement in the lumbar spine instead of the hips and thoracic (mid) spine which is where it is supposed to occur (too much movement at the wrong link in the chain because of a restriction in another). Rotation of the lower back causes pain because the lumbar spine is not designed to rotate, only to flex and extend.
Poor Motor Patterns– There is an ideal order for muscles to fire to move body parts but alternate patterns can also develop as protective mechanism or a limitation in mobility. When a new pattern occurs, the lumbar spine moves differently (less than ideal) because different muscles are firing or they are firing out of order.
Poor Swing Mechanics– The three previously described causes of back pain often result in compensations during the swing. Physical training, and treatment that allows for the management and healing of injury can restore proper motor patterns and allow you to implement proper swing mechanics that keep you free from golf related back pain.
Managing Back Pain
Muscular injuries such as strains, pulls or chronic soreness should focus on controlling inflammation and allowing time for healing. Once healing takes place, you can work to restore proper function. If you have disc or nerve issues, I encourage you to seek the help of a medical professional. Typical treatments include some combination of:
Manual Therapy – Chiropractic, physical therapy and massage to reduce recovery time and stimulate the healing of muscle and ligament strains and sprains.
Cold Therapy – Apply ice to reduce inflammation and potentially relieve muscle spasms.
Heat Therapy – Apply heat to increase blood flow and temporarily reduce stiffness, pain and spasms.
Acupuncture – A professional treats various points using the insertion of thin needles.
Rest & Recovery – Often, muscle strains just need a few days of rest. Be aware, unless it is excruciating to move, you should not remain 100% bedridden. Light activity (e.g. walking) while avoiding shoveling, lifting or anything else strenuous will facilitate the body’s healing mechanisms.
Medications- Anti-inflammatory and muscle relaxant medication should be regarded as a last resort. While these medications can be helpful in reducing inflammation and muscles spasms (and therefore pain), they do not fix the damaged tissue that resulted from the injury.
Exercises For Preventing Back Pain
If you are someone that deals with chronic or golf specific back pain it’s likely there is an explanation for why this problem re-occurs. You have likely developed a habitual way of moving joints, ligaments and muscles in a different manner than they were designed for, and this has lead to a chronic issue. This is called an altered movement pattern.
Core Strength Exercises
- transverse abdominis activation
- side plank
- hip rotations
Lower Body Flexibility
- single leg to chest
- pretzel stretch
- hamstring stretches (standing & lying hamstring/downward dog)
- piriformis stretch
T- Spine Flexibility & Mobility
- Twist stretch
- Reachbacks – Quadruped with ER
- A-frame stretch
- Helicopters, Standing Reachback & Windmills
Glute Activation Exercises
- hip lift
- figure 4 hip lift
MYTH: IF YOU EXERCISE, IT DOESN’T MATTER WHAT YOU EAT.
FACT: IF YOU EXERCISE, IT MATTERS EVEN MORE WHAT YOU EAT.
If you don’t have the nutrients in your body, you will not recover properly from a good workout. It’s like flicking a lighter without any butane. If there’s no material for the exercise to spark there will be no flame – and you may creating a nutrient deficient.
MYTH: AEROBICS IS BETTER THAN WEIGHT TRAINING FOR LOSING WEIGHT.
FACT: TO REALLY TRANSFORM YOUR BODY, YOU MUST WEIGHT TRAIN.
If you’re doing nothing, any extra activity is good for you. But if you really want to burn fat and change the shape of your body, you need to ramp up your metabolism by building more muscle. Even though aerobics does help burn fat, it does not change how small your waist looks or how slim your arms look the way weight training does.
MYTH : THE LONGER YOU EXERCISE, THE BETTER.
FACT: TOO MUCH EXERCISE PREVENTS RESULTS.
The purpose of exercise is to stimulate muscle and burn fat. To do this, workout sessions should be brief, intense and highly effective. This can be accomplished in less than 4 hours per week. Anything more can drain you – mentally and physically – and take you further away from your goals.
MYTH: MUSCLES GROW WHILE YOU’RE WORKING OUT
FACT: MUSCLES GROW WHILE YOU’RE RESTING AND RECUPERATING.
During a good workout, slight muscle damage occurs. This micro-trauma triggers the body to re-build the tissue – if you give it time and proper nutrients to recovery.
MYTH: IF WOMEN LIFT WEIGHTS, THEY GET “BULKY”
FACT: RESISTANCE TRAINING HELPS WOMEN BECOME LEAN AND TONED.
Fat takes up 5 times more space than muscle. If you replace the fat on your hips or thighs with muscle, you get smaller hips or thighs.
MYTH: WEIGHT TRAINING IS ONLY FOR YOUNG PEOPLE.
FACT: PEOPLE OF ALL AGES SHOULD BE WEIGHT TRAINING.
Loss of muscles mass begins at age 25! This is the age most people see their body fat levels go up. Without weight training, we lose strength and become fragile and more prone to injury as we age.
LIFT WEIGHTS TO LOSE WEIGHT!
Banana and Blueberry smoothie summer breakfast with vanilla sticks.
I often have clients tell me how I’d be so proud of them because they whipped up a delicious smoothie for breakfast. When I ask what they put in their smoothie, I hear things like – “bananas, strawberries, yogurt, orange juice and milk.”
Here’s the problem with most peoples smoothies…
The ingredients. Yes, the ingredients I mentioned -the ones almost everyone uses to make a “healthy” smoothie…are all “healthy”… but a common oversight people have is that combinations like this leads to a meal or snack that is very high in sugar.
Smoothies made with lots of fruit and combined with juice and or sweetened yogurt often contain little to no protein or fat (ratio-wise) and will cause a spike in your blood sugar and a release of the insulin hormone which will then result in unwanted fat storage, energy crashes and perpetuates sugar cravings. You see, fruits are great and high in antioxidants and vitamins, but they are also sweet (especially fruit juice!) and rich in fructose (fruit sugar), so having too much fruit and combining it with sweetened yogurt or juice can cause blood sugar issues and insulin sensitivity just the way a bagel or donut might!
You might be surprised to know that one of the most common ingredients in smoothies that spikes overall sugar content is yogurt?! I’ll explain more by pasting an email conversation I had with a client (see below).
What do you think of this for my breakfast shake?
- small apple
- small banana or half a large (frozen)
- 1 container of Activia vanilla yogurt (the small one)
- 1/2 teas cinnamon
- Almond milk and ice to a good consistency.
If using 3/4 cup almond milk, check out the break downs of each listed:
The one on the right is using Activia (4 oz.), the one on the left is replacing Activia(4 oz.) with protein powder. Why do this? As you will learn going forward, creating balance within meals is a key to having balanced blood sugar, reduced fat storage, satiation and more even energy levels. It is also important for active people to get enough protein. The one on the right is really high (ratio-wise) in carbs and especially sugar. Replacing the Activia reduces sugar by almost half, reduces overall carbs and increases protein. Try it and see how it tastes.
If you’re a smoothie lover and making them regularly, you don’t have to give them up or choke down disgusting tasting “chopped up salad” that tastes “like it was scraped off the top of a pond” lol. Just be sure to take a look at the overall sugar content in your smoothie…start minimizing sugary ingredients and balancing with protein powder and healthy fats.
In fact, start to minimize sugar in general. If you’re eating too much fruit, find yourself snacking on treats everyday or snooping around the kitchen after 10pm looking for a sweet fix, that’s a sign that your blood sugar is imbalanced and it is probably sabotaging your progress.
Interested in more information about balanced nutrition? Email me to receive the FREE 10 Day Fitness Reset program that sparked the conversation above!
Clean Eating Sweet Potato Cakes
– 1 pound peeled and cubed sweet potatoes
– 2 tablespoons healthy oil (I used coconut but you can also use olive or even organic butter)
– 1/4 teaspoon salt
– 2 eggs (1 egg if using whole wheat pastry flour)
– 1 cup coconut flour (or 3/4 cups whole wheat pastry flour) + more for kneading
– oil for cooking
– salt and pepper to taste.
– Put your potatoes in a large pot of water and boil until soft.
– Drain the water and mash in the oil and salt.
– When the mashed potatoes are still warm (NOT hot!), quickly stir in the eggs.
– Add the flour and stir until you have dough.
– Turn the dough out onto a work surface, and gently knead by hand, adding flour as you go. Remember, this is very soft dough. You want to add enough flour to keep it from sticking to everything, but not so much that flour is all you taste when you eat them.
– Press or roll the dough out to 1/4 inch thickness.
– Using a small glass or round cookie cutter, cut out circles and place in a skillet with warmed oil.
– Cook on low to medium heat until brown on both sides. They will burn quickly if the heat is too high. Take your time.
– Serve with maple syrup or savory toppings such as salt or raw cheese. [Credit: The GraciousPantry.com]
Tuscan Kale Spaghetti Squash Lasagna Bake
– 2 x 3-4 pound spaghetti squash
– 1-2 tablespoons sunflower oil, divided
– 1/4 cup minced shallot
– 4 teaspoons minced garlic
– 2 x 15oz cans cannellini beans, drained + rinsed
– 1 cup sliced sun-dried tomatoes, not oil-packed
– 10 cups ribboned Tuscan/dino/lacinato kale, stems removed ~2 med. bunches
– 1 1/2 tablespoons fresh oregano,
– 1 large egg
– 15oz full-fat ricotta cheese
– 1 cup grated parmesan cheese
– sea salt + pepper
– 3 slices gluten-free bread, I used Udi’s
– 1/4 cup grated parmesan cheese
– 1 1/2 teaspoons freshly chopped oregano
– Preheat your oven to 400° F.
– Slice spaghetti squash lengthwise and scrape out seeds. Drizzle with oil, a sprinkle of salt + pepper and then rub in. Line 1-2 baking sheets with parchment paper and place squash cut side down. Bake for about 35-40 minutes until just tender enough that you can scrape the squash into strands. You don’t want it fully cooked since it will be baked again.
– While cooking, place bread in a blender or food processor and grind into breadcrumbs. Toast on a pan in the oven [top rack is fine] for about 6-8 minutes. Remove and let cool fully, then toss with oregano and parmesan.
– Flip the cooked squash halves over and let cool for 15 minutes [longer is fine].
– While cooling, heat a large sauté pan over medium-low heat. Add 2 teaspoons of oil. Once hot, add the shallot and let cook for 3-4 minutes, stirring frequently. Add garlic with 1 teaspoon of oil and stir frequently for about 2-3 minutes, until lightly browned. Preheat oven to 350° F.
– Raise the pan heat to medium. Add white beans and a hefty sprinkle of salt + pepper. Cook for 4-5 minutes, stirring occasionally. Stir in sun-dried tomatoes and let cook for about 2 minutes. Stir in kale and oregano. Let cook for 1-2 minutes until just starting to wilt. Remove mixture from the heat.
– Scrape about 90% of the spaghetti squash into a large mixing bowl, leaving some attached to each shell. Empty the kale mixture over the squash and combine. Add salt and pepper until seasoned to your liking.
– Whisk the egg in a small mixing bowl. Mix in the ricotta, parmesan, a pinch of salt, and about 1/4 teaspoon black pepper until. Empty over the squash mixture and toss with your hands to evenly distribute. Scoop 1/4 of the mixture into each squash shell. Do not pack in. Bake for 25 minutes, until the top layer is a lightly crisped and brown.
– Sprinkle with toasted breadcrumb mixture and bake for another 5-8 minutes. Remove and let cool slightly, then serve.