Golf and Chiropractic
Sooner or later, most men and women who are committed to playing better golf go through lesson after lesson and frequent changes of the latest equipment. Eventually, the realization settles in: Without golf-specific fitness and conditioning, the average golfer will find it difficult to improve, and quite simply, most golfers do not have adequate posture or flexibility to play well.
They will begin to recognize that their bodies have been the primary barrier to performance.
Chiropractic care and golf are a perfect fit. In short, if a golfer wants to improve, regular chiropractic care should be an essential component of his or her overall approach.
Golf and Chiropractic: A Natural Combination
With Spring/Summer finally here, less people will be entering your office with injured backs from spring cleaning, yard work and other winter activities. However, millions of Americans are dusting off their golf clubs and hitting the links, a location that is swarming with back pain and potential patients.
If you are suffering call Dr.Zeudiann Coleman at Z`Chiro MedSpa wellness office today. I am a Board certified Chiropractic Doctor that specialize in Extremity care, Recreational Sports care and General Body maintenance from everyday work and play stresses.
Call us at 678-754-6877 or visit our website www.zchiromedspa.com
Swing Myths that Promote Injury
I recently read an article that discussed many of the myths associated with modern golf instruction. One of the biggest myths involves the notion that club head speed at ball impact is dependent on maximum spinal rotation during the backswing. In this regard, the term "x-factor" has been coined to describe the difference (in degrees) between hip position and shoulder position at the top of the backswing. Many instructors advocate this theory and recommend that golfers keep their pelvis as stationary as possible while the spine is maximally rotated. These swing positions are popular because it is believed that maximal spinal rotation somehow engages the "big" muscles of the back, allowing for a sling-shot effect during the downswing, i.e., the modern golf theory of power generation. With respect to the "big muscle" theory, we are never told how maximal spinal rotation helps to engage spinal muscles or muscles such as the latissimus dorsi.
Nonetheless, it is difficult to understand why modern golf instruction would promote such concepts. Regarding spinal muscles, it is known that they provide only five percent of the torque generated during spinal rotation, the abdominal obliques doing nearly all the work. Like the spinal muscles, the latissimus dorsi have nothing to do with generating spinal rotation. Nor is maximal spinal rotation necessary for the latissimus dorsi to perform its normal function, i.e., adduction, medial rotation and extension of the humerus. The true source of power generation in the golf swing involves the creation of elastic energy, which is thought to be the power generator for most athletic maneuvers.
Briefly stated, elastic energy is created by imparting a short, quick stretch on the muscles involved in performing a particular movement. In the case of the golf swing, it is generally thought that the rotator cuff, latissimus dorsi and pectoralis major muscles are the "power muscles," as well as the muscles of the arm and forearm. To effectively pre-stretch these muscles, no spinal rotation is needed. The only purpose for pelvic and spinal rotation in the backswing is to achieve a body position that allows for effective club head delivery at ball impact. There are three main reasons to urge your patients to adopt a short backswing that reduces spinal rotation:
If you are suffering call Dr.Zeudiann Coleman at Z`Chiro MedSpa wellness office today. I am a Board certified Chiropractic Doctor that specialize in Extremity care, Recreational Sports care and General Body maintenance from everyday work and play stresses.
Call us at 678-754-6877 or visit our website www.zchiromedspa.com
Swing Myths that Promote Injury
I recently read an article that discussed many of the myths associated with modern golf instruction. One of the biggest myths involves the notion that club head speed at ball impact is dependent on maximum spinal rotation during the backswing. In this regard, the term "x-factor" has been coined to describe the difference (in degrees) between hip position and shoulder position at the top of the backswing. Many instructors advocate this theory and recommend that golfers keep their pelvis as stationary as possible while the spine is maximally rotated. These swing positions are popular because it is believed that maximal spinal rotation somehow engages the "big" muscles of the back, allowing for a sling-shot effect during the downswing, i.e., the modern golf theory of power generation. With respect to the "big muscle" theory, we are never told how maximal spinal rotation helps to engage spinal muscles or muscles such as the latissimus dorsi.
Nonetheless, it is difficult to understand why modern golf instruction would promote such concepts. Regarding spinal muscles, it is known that they provide only five percent of the torque generated during spinal rotation, the abdominal obliques doing nearly all the work. Like the spinal muscles, the latissimus dorsi have nothing to do with generating spinal rotation. Nor is maximal spinal rotation necessary for the latissimus dorsi to perform its normal function, i.e., adduction, medial rotation and extension of the humerus. The true source of power generation in the golf swing involves the creation of elastic energy, which is thought to be the power generator for most athletic maneuvers.
Briefly stated, elastic energy is created by imparting a short, quick stretch on the muscles involved in performing a particular movement. In the case of the golf swing, it is generally thought that the rotator cuff, latissimus dorsi and pectoralis major muscles are the "power muscles," as well as the muscles of the arm and forearm. To effectively pre-stretch these muscles, no spinal rotation is needed. The only purpose for pelvic and spinal rotation in the backswing is to achieve a body position that allows for effective club head delivery at ball impact. There are three main reasons to urge your patients to adopt a short backswing that reduces spinal rotation:
- A short swing with less spinal rotation gives a golfer more control of the golf club and club head throughout the swing, which translates into better control of the golf ball.
- Research has demonstrated that short backswings achieved the same clubhead speed at ball impact as long backswings.
- A short backswing will help to minimize the torsional stress in the lumbar spine.
Chiropractic Intervention
There are several avenues of care that chiropractors can offer golfers, including spinal adjustments, preventive swing advice, rehabilitation exercises and anti-inflammatory nutrition. As most Doctors of Chiropractic(DCs) know, spinal adjustments are known to be effective in reducing pain and improving spinal mobility. While the adjustment provides these beneficial outcomes, it is important to realize that adjustments cannot prevent injury. For this reason, DCs need to urge their golfing patients to reduce spinal rotation during the swing to lessen the chance of torsional injury. Golfers should be urged to adopt the principle of rigid parallelization throughout the golf swing, which requires rigid abdominal control. As previously alluded to, an aggressive lumbar spine rehabilitation program should be instituted as both a therapeutic and preventive measure. The golf swing is inherently stressful and injurious to the lumbar spine. Thus, it is very important to make sure the lumbar spine's stabilization mechanism is well- trained. Treating golfers without taking this into consideration can lead to reinjury and dependence on passive care. Research has recently demonstrated that lumbar stabilization exercises can reduce pain and disability in patients with spinal instability caused by spondylolysis and spondylolisthesis. McGill has recently discussed the stabilizing exercises that impart the least amount of stress on the lumbar spine, which included the cat stretch, curl-ups, isometric horizontal side support, and the quadruped track of exercises. These exercises will also help golfers develop the rigid abdominal control needed to maintain pelvis and shoulder parallelization during the swing to reduce torsional strain.
Are you up to 'Par' on the Golfer Diet/ Supplements
Nutritional factors should also be considered when treating golfers. As mentioned earlier, golfers commonly self-medicate with aspirin and NSAIDs to help deal with inflammation and pain. These medications are known to cause gastrointestinal ulceration and reduce connective tissue healing. It would be wise for golfers to adopt a diet that is rich in dark green and other colorful vegetables, which are known to be sources of anti-inflammatory omega-3 fatty acids, bioflavonoids and other phyto-chemicals. Supplementation with omega-3 fatty acids, flavonoids, ginger, turmeric, Boswellia and bromelain can add additional anti-inflammatory support, while supplemental glucosamine and chondroitin sulfate are useful for enhancing the repair of connective tissues.
McCarroll JR, Mallon WJ. Epidemiology of golf injuries. In: Stover CN, et al. eds. Feeling up to Par: Medicine from Tee to Green. Philadelphia: FA Davis; 1994: p.9-13.
Flexibility is the Key
Relationship Between Flexibility and Club Head Speed
Spinal/Pelvic Rotational Flexibility
Club Head Speed
Average Amateur 160 degrees 90 mph Average Professional Golfer 180 degrees 115 mph Top 1/2% of Professionals 200 degrees 125 mph Tiger Woods 215 degrees ("Golf" Magazine) 135 mpg ("Golf" magazine)
Shoulder Flexibility vs. Club Head Speed vs Driving Distance (right-handed golfer)
Swing Arc
Club Head Speed
Yards of Carry
Left Arm to 9 O'clock Position 85 mph 200 yards Left Arm to 10 O'clock Position 110 mph 225 yards Left Arm to 11 O'clock Position 115 mph 240 yards Left Arm to 12 O'clock Position 125 mph270 yards
The Problem
The average golfer tends to take up golf at an age when he or she is no longer participating in energetic, competitive and physically demanding sports. Unfortunately, this decreased involvement in competitive play contributes to an overall decrease in flexibility – especially of the spine, shoulders, hips and pelvis (key components of a good golf swing).Common everyday activities like working on computers or commuting long distances tend to contribute even more to this lack of flexibility. This is important to note because flexibility is the key to improving your game and reducing your pain.
Flexibility plays a greater role in golf than just an improved long game – it also decreases the likelihood of experiencing injury while practicing or playing. In fact, the root cause of golf injuries is a lack of golf-specific flexibility. This flexibility comes in two different varieties – joint mobility and muscle pliability.
The golf swing depends on nearly every joint between the tips of the toes and the ends of the fingers. All these joints taken together create an unbroken chain. Any limitation in motion of any of these joints will shift the work burden to other “healthier” joints causing unnecessary strain and contributing to increased muscular fatigue (Does your swing improve or degrade as you near the 18th hole?).
This can cause serious repetitive motion injury to both the dysfunctional joints and the over-burdened (but otherwise healthy) joints, as well.
The Solution
This joint chain is worthless without muscles to both support and move the bones of the skeleton. Golf involves many of these muscles and places significant strain on several. In fact, fourteen (14) of these muscles have been shown to be of great importance to a proper golf swing. All of these muscles working in concert transform a chain of bones and joints into one giant spring. The purpose of the spring is to “coil” to store up potential energy. That energy is converted into action (kinetic energy) when the spring tension is released and the club is allowed to swing around the body at high speed.
Therefore, any effort to treat golf-related injury or improve the golf swing requires a combined approach that addresses both the joint mechanics AND muscle flexibility. Joint mechanics are best addressed with corrective chiropractic adjustments to the affected joints. Active Release muscle therapy is effective at restoring flexibility to tight damaged muscles.
Golfer’s / Tennis Elbow
Golfer’s elbow and tennis elbow are similar conditions that fall under the category of Cumulative Trauma Disorders. Both conditions usually involve pain and tenderness around the elbow that tends to be increased with movement and decreased with immobilization.Although the pain associated with these conditions stems from inflammation, the source of the inflammation must be addressed in order to achieve complete recovery and long-lasting benefit. The most common culprit is chronic muscular contraction, which can be brought on by overuse or as a result of a joint dysfunction. This constant “tugging” on the tendons can reduce the already poor circulation to the tendons. The tendons then become inflamed (tendonitis) and, eventually, scar tissue will form further reducing the flexibility and strength of the soft tissues.Common sense would tell you that treatment directed at the tendons and aimed at reducing the inflammation will only produce mediocre results for a short period of time. Also, given the mechanism listed above, doesn’t it also make sense that strength training would only serve to increase the strain on the tendons and further inflame the tissue?
Treatment for Golfer’s / Tennis Elbow
The only effective way to recover from a problem related to tendonitis is to address the source of the strain. Chiropractic adjustments are used to correct any mechanical problems that may by associated with the joints of the elbow, wrist or shoulder. Reduction of the chronic muscle tightness and spasm is achieved using a muscle therapy technique known as Active Release, a treatment method that often provides immediate and dramatic results. It is a patented, state-of-the-art soft tissue (muscles, ligaments, fascia and nerves) treatment system that was designed specifically to deal with cumulative trauma disorders like golfer’s and tennis elbow.The Active Release doctor uses his hands to evaluate the injured tissue. Then, precisely applied tension is combined with specific patient movements. Treatment is an interactive process involving both doctor and patient and every Active Release session is actually a unique combination of examination and treatment. Patients often notice improvement in their levels of pain, flexibility and strength within seconds following the treatment.
Sciatica Related to Nerve Irritation at the Spine
Irritation of the nerve as it exits the spine is often the result of mechanical dysfunction of the joints of the spine. Occasionally, the nerves exiting the spine can become “pinched”. Although the traditional idea of an impinged nerve is one that is sandwiched between two bones, we now know that nerves can become irritated at the spine in a number of different ways. Nerves can be pressed upon by bulging discs, encroached on by bony overgrowth or “stuck” to surrounding soft tissues (muscles, ligaments, fascia).
Treatment of Sciatica Related to Joint Dysfunction or Bone Malposition
Sciatica related to joint dysfunction or bone malposition is best corrected using chiropractic adjustments. By using carefully directed and controlled pressure to restore joints to a normal position and motion, the pressure placed on the nerve is quickly and painlessly reduced. This often results in immediate (sometimes dramatic) pain relief.Sciatica related to disc injury often requires additional treatment methods. The McKenzie protocol and Cox Flexion/Traction are both techniques available in our office. The aim of the McKenzie protocol is to reduce nerve impingement by “reshaping” the spinal disc with sustained pressure over successive treatments. Cox Flexion/Traction uses a specialized chiropractic table that bends and elongates the spine to reduce pressure within the disc. Both techniques are capable of providing both immediate pain relief and rehabilitation to prevent future recurrences.
Treatment of Sciatica Caused by Bulging Discs
Non-Surgical Spinal Disc Decompression provides relief to sciatica sufferers by gently reducing the pressure within spinal discs. The most effective treatment available to reverse sciatica caused by a disc bulge or herniated disc is Non-Surgical Spinal Disc Decompression. The bones of the spine are slowly and gently separated. As the vertebrae are separated, pressure within the disc (intradiscal pressure) is reduced to the point where a vacuum is formed. This vacuum “sucks” the gelatinous center of the disc back into the disc thereby reducing the Disc Bulge. This takes pressure off the spinal nerves and drastically reduces pain. This action also allows much-needed oxygen and nutrients to flow into the injured discs to aid in the healing process.
Sciatica Related to Entrapment at the Piriformis Muscle
The sciatic nerve passes directly under or through the piriformis muscle (in most people). When healthy, the nerve should slide easily within its sheath and never “stick” to the muscle directly. This is important as the nerve stretches like a rubber band with certain movements of the spine and legs.Traumatic injuries or repetitive motions can cause inflammation to reside near the piriformis muscle. This inflammatory process can lead to the formation of scar tissue “adhesions” that can force the piriformis muscle and nerve to become “stuck” to one another. The first symptom is usually stiffness in the low back, hips or legs. If allowed to progress, stiffness can degrade to typical “sciatica” symptoms: sharp pain, numbness, tingling and weakness in the buttocks or back of the legs.
Treatment of Sciatica Related to Entrapment at the Piriformis Muscle
The goal of treatment is to loosen the adhesion between the muscle and nerve and allow the piriformis muscle to regain its complete length and strength. Elongation of the piriformis muscle and separation of the adhesion between the nerve and muscle is best accomplished with the Active Release Technique, but the source of the initial problem must also be addressed. This is usually accomplished by applying specific pressure with a thumb or finger at the piriformis muscle while moving the hip or leg through a full and complete range of motion. Using this technique, the adhered tissue is held stationary while the nerve is pulled away and separated from the adhesion. This often creates an immediate reduction in nerve tension and, therefore, immediate (sometimes dramatic) symptom relief. The piriformis muscle can become chronically tight due to an uncorrected sacroiliac joint problem, hip joint dysfunction or anterior pelvic misalignment (pubic symphysis). Common causes include running and cycling sports, prolonged sitting, auto accident with a foot on the brake at the time of the accident or pregnancy/childbirth.Chiropractic adjustments commonly correct these dysfunctions allowing the supporting musculature to return to a healthy, balanced state. The primary goal of chiropractic is to locate and correct the cause of your problem. Treatment of the muscle alone will likely provide only temporary benefit as the dysfunctional joint will merely cause the muscles to become unbalanced again over time. Likewise, ignoring the muscles and only treating the joints will often produce mediocre results as the muscles pull the joints back into dysfunction. A combined approach of corrective chiropractic adjustments and restorative Active Release muscle work is often the most effective approach.
Significant disc damage can lead to a Disc Bulge, become a tear called a Disc Herniation or the inner gelatinous material of the disc can leak out in the case of a Ruptured Disc. The “jelly center” of the disc can also dry out over time which is referred to as Degenerative Disc Disease. All forms of disc injury can eventually impinge on the nerves exiting the spine (“Pinched Nerve”) which can create numbness, tingling, burning or sharp pain down the arms or legs. Sharp pain originating from the back and “shooting” down the legs is often referred to as Sciatica.
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is the most commonly referenced Repetitive Motion Injury – a category of conditions that represent the fastest growing segment of injuries in American society today. Many factors have been blamed on this recent epidemic including increased computer usage, poor ergonomics, and improper medical treatment that is focused on symptom masking and not on prevention or correction. The term “carpal tunnel” refers to a tunnel formed by bones of the wrist through which nerves and tendons pass as they travel from the forearm to the hand. Although irritation of the nerves at the carpal tunnel is a common cause of this condition, there are usually other factors. “Trapped” nerves at the spine (usually the neck), pectoralis minor muscle of the chest, rotator cuff muscles of the shoulder and forearm muscles are commonly involved with this condition. Repetitive “rubbing” of sensitive soft-tissues or chronic muscle tightness will initiate an injury cascade that will eventually lead to significant dysfunction and pain. Both of these situations deprive the soft-tissues of much needed oxygen due to a decrease in full muscle contraction and complete relaxation. This reduces the “pumping” action that normally occurs within healthy muscle tissue. A decrease in tissue oxygenation triggers fibroblastic activity – the primary mechanism involved in the formation of scar tissue. As the scar tissue builds, the tendons passing through the carpal tunnel thicken. This thickening decreases the amount of space available in the tunnel for the nerves. Eventually, the competition for space within the tunnel will lead to a compression of the nerves triggering the typical carpal tunnel symptoms. In other words, carpal tunnel syndrome can develop over months or years before the first symptom is ever experienced!
Treatment for Repetitive Motion Injuries / Cumulative Trauma Disorders
A combined approach of corrective chiropractic adjustments and restorative Active Release Technique muscle work is often the most effective approach.Scar tissue adhesions located within and between soft-tissues are best removed using a muscle therapy called Active Release, a treatment method that often provides immediate and dramatic results. It is a patented, state-of-the-art soft tissue (muscles, ligaments, fascia and nerves) treatment system that was designed specifically to deal with repetitive motion injuries.The Active Release doctor uses his hands to evaluate the injured tissue. Then, precisely applied tension is combined with specific patient movements. Treatment is an interactive process involving both doctor and patient and every Active Release session is actually a unique combination of examination and treatment. Patients often notice improvement in their levels of pain, flexibility and strength within seconds following the treatment.As with any chiropractic procedure, addressing the source of the problem is a must. A chronic joint dysfunction of the neck, shoulder, elbow or wrist can force the muscles of the forearm to become “overworked”. This constant abuse can initiate the inflammatory cascade mentioned above that can eventually end with carpal tunnel syndrome. Chiropractic adjustments commonly correct these dysfunctions allowing the supporting musculature to return to a healthy, balanced state. Treatment of the muscle alone will likely provide only temporary benefit as the dysfunctional joint will merely cause the muscles to become unbalanced again over time. Likewise, ignoring the muscles and only treating the joints will often produce mediocre results as the muscles pull the joints back into dysfunction.
Is Surgery Effective at Treating Carpal Tunnel Syndrome?
Surgical procedures have been developed over the years to “release” the pressure on the nerves at the carpal tunnel by permanently severing the ligament that holds the tunnel together. Unfortunately, these procedures are rarely successful over the long term and almost never address the cause of the nerve irritation. Common sense would tell us that it is unlikely that the carpal tunnel would simply “shrink” without warning. Therefore, increasing the size of the tunnel will only provide temporary benefit especially if the tendons within the tunnel continue to thicken. Also, post-surgical scar tissue can also interfere with proper wrist and nerve function contributing to more pressure on the nerve. 