Golfers With Low-back Pain May Be Helped By University Of Pittsburgh Research

The findings are being shown today with a poster presentation at theannual meeting of the American Orthopaedic Society for Sports Medicine,July 14-17, at the Keystone Resort in Keystone, Colo.

"More than 30 percent of golfers have experienced issuesrelated to low-back pain or injury that have affected their ability tocontinue enjoying the game of golf," said principal investigatorYung-Shen Tsai, Ph.D., P.T., of the University of PittsburghNeuromuscular Research Laboratory (NMRL), where the study wasconducted.

"The results of this study are being used, for example, todevelop injury prevention programs that will be offered at the new UPMC(University of Pittsburgh Medical Center) Golf Fitness Laboratory atPinehurst Resort (Pinehurst, N.C.), which will open to the publicofficially on July 18," said Scott Lephart, Ph.D., director of the NMRLand the UPMC Golf Fitness Lab. For more information, go to http://golffitnesslab.upmc.com.

"Modified swing patterns and general exercises have beensuggested for golfers with back problems. However, it is difficult todesign an appropriate back-specific swing or exercise program forlow-back injury prevention and rehabilitation without knowing thedifferences in the kinematics and spinal loads of the golf swing andthe physical characteristics of golfers with low-back pain," Dr. Tsaiexplained.

So, Dr. Tsai's team set out to examine the kinematics of thetrunk and spinal loads in golfers with and without low-back pain (LBP)and their trunk and hip physical characteristics. Sixteen male golferswith a history of LBP were matched by age and handicap to 16 malegolfers with no history of LBP. All study participants underwent abiomechanical swing analysis and physical characteristics assessment.The researchers used a 3D motion analysis system and two force platesto assess kinematics and spinal loads of the trunk. They used abottom-up inverse dynamics procedure to calculate spinal loads of thelower back. In addition, they measured trunk and hip strength andflexibility, back proprioception and postural stability.

"We found deficits in physical characteristics in the golferswith a history of LBP compared to the non-LBP group," reported Dr.Tsai. "These differences may hinder dissipation of the tremendousspinal forces and movements generated by the golf swing over time andlimit trunk rotation during the backswing. These conditions may lead tolower back muscle strain, ligament sprain or disc degeneration.

"Although differences found in this study cannot be determinedas causes or results of low-back injuries in golfers, clinicians may beable to use our data to design appropriate back-specific exerciseprograms for golfers to prevent or rehabilitate low-back injury," saidDr. Tsai.

Specifically, the LBP golfers in Dr. Tsai's study demonstratedless trunk and hip strength and less hamstring and right torso rotationflexibility. The LBP group also demonstrated back proprioceptiondeficits significantly in trunk flexion. No significant differenceswere found for postural stability. The LBP group showed less maximumangular displacement between shoulders and hips during the backswing.No significant differences were found in other trunk kinematics andspinal loads during the golf swing.

This study is part of theNeuromuscular Research Laboratory's ongoing Golf Injury PreventionProject. The NMRL, housed in the UPMC Center for Sports Medicine,contains state-of-the-art neuromuscular and biomechanical assessmenttools with which researchers use the latest sports medicine andathletic conditioning techniques to concentrate on two main goals: toprevent and manage injury while enhancing athletic performance.Laboratory faculty includes those from the sports medicine andnutrition department at the university's School of Health andRehabilitation Sciences and the orthopaedic surgery department at theuniversity's School of Medicine. In addition to golf-related research,the NMRL also has ongoing studies of sports performance, injuryprevention, treatment and rehabilitation involving cycling, the femaleanterior cruciate ligament, and the shoulder and lower extremities. Formore information, go to www.pitt.edu/~neurolab/.

Other investigators for this study were: Timothy Sell, Ph.D.,P.T.; James Smoliga, D.V.M; Joseph Myers, Ph.D., A.T.C.; Jean McCrory,Ph.D.; Richard Erhard, D.C., P.T.; and Scott Lephart, Ph.D., A.T.C.