Blog 2: Everything Golf ⛳
Part 2: The Big Three: Lower Back, Hip & Elbow Injuries in Golfers
Welcome back to Everything Golf! In Part 1 Dr. Keirstyn established why golf is far more physically demanding than it looks and mapped out the injury landscape. Now we go deep on the three injuries I see most in golfers — what's actually happening, why it develops, and the warning signs that mean it needs proper attention.
The Big Three:
1. Lower Back Pain: Golf's Most Common Injury
Up to 35% of amateur golfers experience low back pain connected to their game. It's the injury I see most, and it's almost never a mystery once you understand the swing mechanics behind it.
Why it happens:
Thoracic restriction forces lumbar compensation: when the mid-back can't rotate properly in the backswing, the lumbar spine picks up the slack. The lumbar spine is built for stability and load-bearing, not rotation. Ask it to rotate repeatedly under load and it will eventually protest.
Early extension through impact: a common swing fault where the hips thrust toward the ball at impact rather than rotating. This creates significant shear force through the lower lumbar segments.
Reverse spine angle: leaning toward the target in the backswing instead of coiling away from it. This places the lumbar spine in a compromised position at the top of the swing with significant compressive load to follow.
Weak glutes and core: when the posterior chain isn't supporting the lumbar spine through the swing, the disc and facet joints absorb forces they weren't designed to handle alone.
Warning signs: pain that builds through a round, stiffness the morning after playing, pain that radiates into the glute or down the leg, or a swing that feels restricted on one side.
2. Hip & Glute Issues: The Overlooked Driver
The hips are the engine of the golf swing. They generate the rotational force that transfers through the core to the club. When they're restricted, weak, or painful, everything above and below them compensates — and that's when injuries start.
What I see most:
Hip impingement (FAI):
Particularly in the lead hip, which has to internally rotate aggressively through impact. Restricted internal rotation leads to compensatory lumbar movement and anterior hip pinching. Common in golfers with naturally less hip mobility or degenerative changes.
Gluteal Tendinopathy:
The glute medius and minimus tendons attach to the outside of the hip and are under significant demand during weight transfer in the swing. Tendinopathy develops when load exceeds tissue capacity — particularly in golfers who walk courses and carry bags on top of playing volume.
Hip Flexor Tightness and Strain:
Golfers who sit for long periods and then play golf are asking tight hip flexors to perform in a range they're not prepared for. This alters pelvic position throughout the swing and feeds directly into lower back loading.
Warning signs: lateral hip pain worse with walking or stairs, deep groin pinching at the end of hip rotation, glute soreness that doesn't resolve between rounds, or a feeling of the trail hip 'getting stuck' in the backswing.
3. Golfer's Elbow: More Than Just a Name:
Medial epicondylitis, also known as golfer's elbow, is inflammation and degeneration at the common flexor tendon origin on the inside of the elbow. Despite the name, it's common in anyone whose forearms are loaded repeatedly, and golfers create a very specific mechanism for it.
Why it develops in golfers:
Impact forces through the trail arm: at ball contact, significant force travels up through the grip and into the forearm flexors, particularly with thin turf, divots, or off-centre contact
Grip tension: excessive grip pressure activates the forearm flexors continuously throughout the swing, increasing cumulative loading on the medial epicondyle
Swing path issues: an over-the-top swing path or casting motion increases the rotational stress through the trail elbow at impact
Volume without preparation: ramping up practice balls or rounds without building forearm and wrist tissue capacity first
Warning signs: pain on the inside of the elbow with gripping or wrist flexion, tenderness directly over the medial epicondyle, pain that worsens through a round, or morning stiffness in the forearm.
The Common Thread
Looking at all three of these injuries, the pattern is consistent: mobility restrictions elsewhere force compensation at a vulnerable structure, volume accumulates, and the tissue eventually fails. None of this happens overnight. And none of it is inevitable with the right approach.
Up Next — Building Your Optimized Golf Body:
Now that you know what breaks down and why, Part 3 of Everything Golf is all about what to do about it — the off-course strength, mobility, and preparation work that protects your swing and keeps you playing. See you there.
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Recognise any of these? Lower back stiffness after a round, hip tightness that's affecting your rotation, elbow pain that flares with every swing — these are all treatable and preventable. Book an assessment with Dr. Keirstyn today and let's sort it out.
📍 Endurance Therapeutics | Oakville, Ontario
📞 905-288-7161