Back disorders are the most common injury in golf, accounting for 55% of injuries among professional golfers and 35% among those who play the sport at an amateur level.
It's also recognised that modern professional golfers experience low back pain and degenerative disc disease at far younger ages than the general population.
To understand why this is occurring, Drs. Corey T. Walker, Juan S. Uribe and Randall W. Porter from Barrow Neurological Institute looked at how the golf swing has changed in recent decades and the clinical consequences of this.
According to the study published in the Journal of Neurosurgery: Spine, the modern golfer repeatedly experiences minor traumatic injuries to the spine, which over time can result in a pathogenic process termed 'repetitive traumatic discopathy' (RTD).
The forces necessary to generate swing speeds that allow golfers to hit the ball at their current distances are significant and place extraordinary loading and torsional stress vectors on the lumbar spine, the researchers explained. With the average golf player taking more than 300 swings per day, potentially over many years, the long-term effects are considerable.
These days, high-performance golfers -- particularly professional players -- tend to have a slow, deliberate backswing followed by an explosive, rotational downswing. By rotating their hips, shoulders and hands backwards, players generate wound up, spring-like potential energy which is then released in a concentric movement as the club comes back down. During this phase, the hips slide forward and both hips and shoulders twist toward the target to pull the club into the follow-through.
This swing style differs from that historically employed by golf greats such as Jack Nicklaus or Ben Hogan, for whom a much longer backswing was followed by a relaxed downswing and follow-through.
A 1997 study of Japanese professional golfers demonstrated on radiographic imaging an asymmetric degeneration of the lumbar spine compared to non-golfer controls.
Dr. Walker and colleagues also highlighted the increasing focus on developing the athlete's strength, particularly that of core stability areas. But while this has resulted in players achieving stronger swings, it may also place greater forces on their spines.
Modern-day golfers -- particularly elite players who follow intense strength-training regimens to let loose the enormous potential of tightly wound muscle fibres -- are repeatedly traumatising their lumbar spine, the researchers concluded.
They advised that patients with back pain may benefit from the involvement of "physical therapists and spine interventionalists with an advanced understanding of this special disease pathology" in receiving treatment and returning to play.