Roughly 24 million American golfers participated in the sport at least once in the last year. The game of golf places unique demands on the human body not seen in many other sports. Specifically, proper swing mechanics require adequate strength and range of motion throughout the hips and spine. This is often noted in the aging golfer who demonstrates shortened driving distance due in part to a reduced back swing caused by a loss of spinal and hip mobility. Low back pain is one of the most commonly sited musculoskeletal problems among golfers at all levels of play from professional down to amateur. Previous research has shown 1 in 2 professionals and 1 in 3 amateurs have experienced low back symptoms leading to lost practice or play. Contributing factors to the development low back pain include the asymmetrical demands and implied mechanical forces of the modern golf swing. Authors report increased separation of the trunk and pelvis at backswing, increased spinal side bending toward the back foot at ball strike, and increased spinal extension during follow through may contribute to increased forces across the spine and in turn low back pain. Golfers with adequate spinal mobility, strength, and swing technique can tolerate these mechanical forces but less fit golfers may be more prone to the development of low back pain.
A recent study highlights the main risk factors for the development of low back pain among golfers. Smith and colleagues in the journal of Sports Health analyzed the existing medical literature on the development of low back pain in golfers (2018). Authors included 19 studies of low to high methodological quality. The limited quality of the available evidence prevents us from making more confident conclusions on the data but authors did not report any relationships between swing mechanics and the development of future low back pain, but further high quality research trials are needed to further explore this relationship. Conversely, older golfers with higher body mass index scores were more likely to develop low back pain than younger golfer or their more fit peers. Additionally, individual studies have found core weakness and a loss of lead leg hip internal rotation flexibility to be predictive of future low back pain.