Why Golf Gives You Lower Back Pain

The short answer

Lower back pain after golf usually starts in the hips, not in the back itself. Your hips are built to rotate a long way and your lumbar spine is built to rotate very little, so when the hips stop turning properly the lower back ends up absorbing a twist it was never designed to take.

What a golf swing actually asks of you

A full swing is a fast rotation under load, repeated. On the backswing the trunk turns away from the target while the hips resist. On the downswing the hips fire first and the trunk follows. That separation between hips and shoulders is where power comes from, and it is also where the problem starts when one part stops moving.

Most golfers who come to the clinic in Almancil with lower back pain do not have a back injury. They have a hip that will not rotate, or a mid back that has gone stiff from sitting, and the lumbar spine is making up the difference every time they swing.

The three places it usually comes from

• Hip flexors and hip rotators. Hours in a car or at a desk shorten the front of the hip. A tight hip cannot complete its rotation, so the pelvis and lower back take over. This is the single most common finding in golfers I treat.
• The thoracic spine. The mid back is meant to do most of the rotating. When it stiffens, usually from posture rather than injury, the lumbar spine rotates instead.
• Gluteus medius and the deep hip muscles. These stabilise the pelvis through the swing. When they are not doing their job you get a lower back that works as a stabiliser instead of the hip.

Why rest and stretching often do not hold

Rest settles the irritation. It does not change the restriction that caused it, so the pain comes back a round or two after you start playing again. Stretching the lower back feels good for an hour and treats the area that is complaining rather than the area that is causing it.

If you have been stretching your back for months and it keeps returning, that is useful information. It means the source is somewhere else.

What treatment looks like

The first session is mostly assessment. I want to see how far each hip rotates, how the thoracic spine moves, whether one side turns noticeably better than the other, and what happens to your lower back when it does not. Golfers are often surprised by how asymmetric they are.

Treatment is then aimed at the restriction, not the symptom. That usually means Active Release Technique on the hip rotators and hip flexors, trigger point work through the glutes and quadratus lumborum, and soft tissue work to free the thoracic spine. ART is a technique I am certified in for the full body, spine and both limbs, and it is particularly good at this kind of problem because it treats the tissue while you move it.

Most golfers notice a change in rotation inside the first session. Lasting change in pain usually takes a few sessions, because the tissue has been adapting for a long time.

What you can do between sessions

Warm up by rotating rather than by hitting balls harder. Five minutes of hip rotations, thoracic rotations and a few easy half swings does more than ten minutes on the range. After a round, get the hips moving again rather than sitting straight down for lunch.

If your pain travels down a leg, or you have numbness, weakness or any change in bladder or bowel control, that is a different problem. See a doctor before booking a massage.

Booking

I treat golfers at the clinic in Almancil and travel to villas and hotels in Vale do Lobo, Quinta do Lago and Vilamoura. Clinic sessions are €37 for 30 minutes, €52 for 45 and €60 for an hour. Mobile sessions are €140 per hour. Message me on WhatsApp on 925 382 490 and tell me which hip you think is the stiff one.