Transcription:
FORE! Getting Your Back into the Swing Again

Amanda Wilde (Host): Recovering from back pain means you can regain your golf game. So today we're talking about getting your back into the swing again with physical therapist Alyssa Cleary and Kyle Pearce from the Orthopedic Associates of Central Maryland Division.

Hello, I'm Amanda Wilde, and I've Got a Bone to Fix With You. Alyssa and Kyle good to have you here. Welcome.

Kyle Pearce, DPT (Guest 1): Thanks for having us.

Alyssa Cleary, DPT, CMTPT (Guest 2): Good to be here.

Host: So Alyssa, starting with you, how is returning to golf after back pain different from returning to other physical activities? What is the focus when we're specifically thinking about golf?

Guest 2: So when we're thinking about golf, we're thinking about multiple different body parts that can influence a player's swing. So we are using our arms, our back, certainly our hips. We're getting a lot of rotation going on. So because we have so many components going on with the swing of golf, we want to look at all these different parts.

Host: Not to mention the bending over and getting your

Guest 2: And the lifting.

Host: And the doing the walking. Yeah, the sand trap. We won't go there yet though. Kyle, what are the range of activities you're working with mostly in your practice when it comes to golf and back injuries?

Guest 1: So here in our Westminster office, we have often seen people trying to return to golf after multiple different injuries. Kind of like, the varied age groups that we see. We've had people coming in with spinal fusion who would like to return to golf, and some younger individuals may have injured a disc in their back and would love to return to golf as really a side hobby, not so much their retirement plan.

But we really like to get people with the strength needed to hit the ball as far as they want, that's probably their goal. But we want to focus on a healthy spine, being able to rotate safely and being able to stabilize and not undergo further injury.

Host: So Kyle, can you talk a little about what the comeback to the golf green looks like when healing from an injury? For example, at what point is it okay to pick up your clubs again and go out there?

Guest 1: So slow progressions. Definitely depend on severity of injury, but a lot of times I will get people on a schedule of just trying to swing a golf club slowly again, that actually helps with technique. And being able to do a smooth golf swing slowly helps you to focus in on skill. But the first step might be going to the putting green and working on a couple of putts where it's a much lower intensity form of a full swing. And then the next step would be going to the driving range, hitting a few balls. Not a whole bucket, but just testing it out, seeing your tolerance, and then maybe, doing a full bucket of balls as you build up to it. And then finally getting back towards actually playing the front nine maybe.

Host: So Alyssa, this sounds like a process and an individualized program for each patient depending on their injury and their own goals. Is that right?

Guest 2: Certainly. We want to look at pain, if it is more swing related or if it's more about carrying your clubs or is it at the tail end of your swing versus at the beginning of your swing. So certainly there are a lot of components that we like to look at and we want to tailor those activities and exercises and treatment plans to the specific injuries that you're feeling.

Host: Now I've heard that low back pain is the number one injury sustained by golfers, but we're not necessarily talking about back injuries that came from golfing. However, Alyssa, when you're starting back up with golf, how do you protect yourself so you don't aggravate an old injury or incur a new injury?

Guest 2: So what we want to start off with is even some core related exercises and then progressing to some spinal stabilizing exercises and core exercises too. Having them be more dual tasked where we're using our arms or using our legs to do different things while still engaging that core to provide some of that stability. Then we want to certainly work towards then adding more torque or more force onto those components as we break that up a little bit more.

Guest 1: I'd love to build on that a little bit and say, a quote from one of my favorite professors in school. I'll explain a little bit after I say it, but they said, "proximal stability helps with distal mobility" and in golf, that's a perfect lineup where we have to have a stable spine, a stable core in order to move our arms efficiently.

And without that strength centrally, then we're not going to be able to have that mobility of our legs and arms to have that full rotation.

Host: So Kyle, how do you protect yourself from injury while golfing?

Guest 1: So when you're on the course, there's definitely some things to think about as you transition your heavy golf bag from your car onto your cart. Having good healthy lifting principles, making sure you're lifting with your legs, not your back. That's the age old saying, and really we do mean it where you are putting force through your legs by bending your knees, stabilizing, thinking about belly button drawn in towards your spine as you lift that heavy bag. That's one of the heavier activities, but even bending down to pick up your golf ball. If we can create better strength in your legs and it's a little bit less of a torque, bending and rotating to pick up that ball, then you're going to have less risk of hurting that back while you're on the course.

Host: Alyssa, what about pre-course? Is there stretching involved or things you can do to sort of do what we've been talking about, really achieve some extra stability out on the course.

Guest 2: Certainly. So we want to make sure mobility is one of the biggest keys, before you do start playing golf. So you want to make sure that your hips are warmed up, that your hamstrings are feeling nice and stretched, even some of those hips rotators are nice and warm because we do get a lot of hip rotation.

Certainly we want to be able to warm up and stretch out the back. So making sure that we go into a little bit of flexion, or a little bit of light twisting to stretch out beforehand, to prime the muscles. If you're doing a full 18 hole, it's going to take a lot of strength and if those muscles are really tight, sometimes they'll continue to tighten up. So we want to make sure everything is nice and loose, or at least nice and warmed up in order to start engaging all those right muscles that we want to engage.

Host: And Kyle, how would you rate the success you've had with the techniques that you have taught people to get back on the golf course and get back into the swing after a back injury?

Guest 1: I would say at our division, Orthopedic Associates, our central Maryland division here, we've had great success. You know, I've worked in a few of our offices. Over in our Westminster office, our new office, we have had great success with helping people get back out on the course.

Sometimes people have to manage expectations if they've had something severe happen to them or require a significant surgery, but that doesn't mean you can't get out there and enjoy the outdoors and being on the course. And, definitely participating with friends and having that social aspect of the recovery as well. But we get most people back out doing the level of activity they want to, and sometimes their swing is even better than it was before.

Host: Oh wow. So I'm hearing that preventing back pain is kind of about being aware and modifying behavior. So after an injury with the right physical therapy plan, you can get back to golfing. Is there anything, Alyssa or Kyle, that you would like to add about getting back to golf after a back injury?

Guest 2: I would say just make sure that you take your time. Back injuries sometimes are quick to fix and sometimes, again, dependent on what you've had, sometimes they can take a long time. So we certainly want to progress you appropriately to get you back to the most optimal you can be. And again, like Kyle mentioned, it might be starting off really slow.

It might be just be putting, or it might just be taking some light swings, going to a driving range and maybe going through a half a swing or three quarters of a swing. And that might be where we're at for a period of time until we can get you back to being at a full 18 holes using your driver and all that good stuff.

Host: It's going to be different for everybody. So I think what I'm hearing is patience is important both in physical therapy and in the game of golf itself. The first question many patients ask about golf is, when can I get back on the course? So thank you both for answering that today.

Guest 1: Absolutely. It was fun being with you here today.

Host: That was physical therapists Alyssa Cleary and Kyle Pearce, both from the Orthopedic Associates of Central Maryland Division, Westminster location. Find out more online at mdboneddocs.com with eight physical therapy locations for your convenience.

Subscribe to this podcast for more insight into the physical therapy side of That's all for today. I'm Amanda Wilde, and That Was a Bone That's Fixed.