The Golfer's Body #3 - Maintenance and Preventative Care
- Dr. Brian Abelson DC
- Apr 10, 2023
- 9 min read
Updated: Dec 5, 2023
In the second installment of "The Golfer's Body," we illustrated the connection between individual golf swing phase dysfunctions and their respective anatomical components, specifically muscles.
After presenting a detailed list of the involved anatomical structures for each phase, we then provided you with a targeted treatment plan to address these specific elements.
Article Index:
Introduction
Treatment
Exercise
Conclusion & References
Anatomy of a Full Swing
The following chart has been created to depict the comprehensive involvement of all anatomical structures in both the upper and lower extremities throughout each phase of a golf swing. As you scrutinize this chart, pay attention to the structures engaged and the activation frequency for a specific structure during a right-handed golfer's swing. Moreover, observe golf's asymmetrical character and the potential consequences of overusing a limited set of structures, which may lead to muscle imbalances and injury.(2,3,4,6,8,11,12)
This information provides a foundation for creating an evidence-based maintenance care program to enhance golf performance and reduce injuries.
Addressing Upper Body Restrictions
From the above diagram, we can see that in the upper extremity, the primary muscles involved in a full golf swing are:
Trapezius
Upper right (1-time activation)
Middle Trapezius Bilateral (2 times activation)
The trapezius muscle originates from the external occipital protuberance, nuchal ligament, and spinous processes of C7-T12 vertebrae, and inserts onto the lateral third of the clavicle, acromion, and spine of the scapula.
Pectoralis Major
Bilateral (2-times activation)
The pectoralis major originates from the clavicular head (anterior surface of the medial half of the clavicle) and the sternocostal head (anterior surface of the sternum, superior six costal cartilages, and the aponeurosis of the external oblique), and inserts onto the lateral lip of the bicipital groove of the humerus.
Subscapularis
Bilateral (2-times activation)
The subscapularis muscle originates from the medial two-thirds of the subscapular fossa on the anterior surface of the scapula and inserts onto the lesser tubercle of the humerus.
Serratus Anterior
Right side (3-times activation)
The serratus anterior originates from the external surfaces of the upper eight or nine ribs and inserts onto the anterior surface of the medial border of the scapula.
Infraspinatus
Left side (2-times activation)
The infraspinatus muscle originates from the infraspinous fossa of the scapula and inserts onto the middle facet of the greater tubercle of the humerus.
Rhomboid
Left side (1-time activation)
The rhomboid muscles, comprising rhomboid major and rhomboid minor, originate from the spinous processes of the C7-T5 vertebrae and insert onto the medial border of the scapula, from the level of the spine to the inferior angle.
Upper Body Treatment Protocol:
A common way to address these specific structures as a practitioner is to:
Start with your patient in a seated position first, focusing on the trapezius muscles (upper right and bilateral middle trapezius)
Then, address both the pectoralis major and subscapularis muscles in a supine position. (both bilateral)
Move to a left side-lying position for the serratus anterior. (right serratus anterior)
Finally, address the infraspinatus and rhomboid muscles in a prone position. (left side for both muscles) (9)
Please note: Conducting a thorough examination of these structures for the upper or lower body alone should require around 15 minutes. To comprehensively review the upper and lower body, expect to allocate roughly 30 minutes.
Addressing Lower Body Restrictions
From the above diagram, we can see that in the upper extremity, the primary muscles involved are:
Erector Spinae
Left Side (1-time activation)
The origin of the lumbar erector spinae muscles is the posterior iliac crest, sacrum, lumbar and lower thoracic spinous processes, and the insertion is the thoracic and cervical transverse processes and the occipital bone.
Gluteus Maximus
Bilateral (2-time activation)
The origin of the gluteus maximus muscle is the posterior ilium, sacrum, and coccyx, and the insertion is the iliotibial band of the fascia lata and the gluteal tuberosity of the femur.
Gluteus Medius
Right Side (3-times activation)
The origin of the gluteus medius muscle is the outer surface of the ilium, and the insertion is the lateral surface of the greater trochanter of the femur.
Abdominal Obliques
Bilateral (3-times activation, 2 right, 1 left)
The origin of the abdominal oblique muscles is the lower eight ribs and the iliac crest, and the insertion is the linea alba, pubic crest, and the anterior half of the iliac crest.
Semimembranosus
Bilateral (2-times activation)
The origin of the semimembranosus muscle is the ischial tuberosity of the pelvis, and the insertion is the posterior surface of the medial condyle of the tibia.
Adductor Magnus
Left Side (2-times activation)
The origin of the adductor magnus muscle is the inferior ramus of the pubis and the ischial tuberosity, and the insertion is the medial lip of the linea aspera and the adductor tubercle of the femur.
Vastus Lateralis
Bilateral (5 times activation, 4 left, 1 right)
The origin of the vastus lateralis muscle is the greater trochanter, intertrochanteric line, and the linea aspera of the femur, and the insertion is the patella and the tibial tuberosity via the patellar ligament.
Lower Body Treatment Protocol:
A common way to address these specific structures as a practitioner is to:
Start with your patient in a prone position to address the left erector spinae. A good point to start after addressing the infraspinatus and rhomboid muscles in a prone position of the upper extremity.
Move to a left side-lying position for the gluteus maximus, medius, and abdominal obliques.
Finally, address the infraspinatus and rhomboid muscles in a prone position. (left side for both muscles).
Move to a supine position for the semimembranosus and adductor magnus muscles.
Finish with the Vastus Lateralis, either from a prone position or seated, depending on the ability of the patient. (9)
Note: Attending to a golfer's body can be likened to fine-tuning a musical instrument. This analogy becomes especially evident when working with PGA golfers. After receiving treatment, we encourage players to head straight to the course to hit multiple buckets of balls, thereby integrating the recent bodily adjustments. As they adapt to these changes, one can quickly observe notable improvements in the golfer's physique and performance.
Joint Restrictions
Joint functionality is essential for optimal golf performance and injury prevention. Ensuring a wide range of movements requires preserving excellent joint integrity. Without addressing joint restrictions, it is not possible to achieve the best possible outcomes.
No joint operates in isolation. For instance, shoulder stability is often influenced by the joints of the cervical and thoracic spine, as well as by the hips and lower extremity joints. Injuries in one joint frequently cause compensations in both adjacent and distant joints.
The following videos demonstrate how we would either adjust or mobilize joints throughout the body. What procedures we would recommend should be based on patient preference and the practitioner's scope of practice.
Mobilizing the Hip Joint - Motion Specific Release:
Increasing Hip Mobility - Mobilizing the Hip Joint - Hip joint restrictions become increasingly prevalent with age. It is crucial to recognize that hip mobility is integral to your body's kinetic chain. As no joint functions in isolation, limited hip mobility impacts your hip, back, knees, ankles, and feet. (9)
Effective Shoulder Joint Mobilization
Welcome to part one of Effective Shoulder Joint Mobilization using Motion Specific Release (MSR) techniques. In this video, Dr. Abelson (the developer of MSR) demonstrates highly effective procedures for mobilizing the shoulder joint using the MSR technique. (9)
Exercise
The exercises we suggest differ considerably based on each patient's unique requirements. Generally, we initiate with flexibility and mobility exercises. Subsequently, we advance to strength training, gradually escalating the demands placed on the body. Ultimately, we recommend a set of functional exercises that necessitate greater balance and engagement of the nervous system. These exercises are vital for fostering performance enhancements and injury prevention.
It is important to note that treatment or exercise alone will often not achieve the desired results in improving golf performance or preventing injuries. That being said, the combination of both treatment and exercise can achieve some remarkable results in a relatively short period of time.
Below are some examples of exercises that we could possibly prescribe to our patients:
Five Great Daily Shoulder Mobilization Exercises
It is crucial to approach these exercises carefully, ensuring you do not push through the pain and allowing sufficient time for your body to adapt and increase mobility.
Twisting Forward Lunge
The Twisting Forward Lunge with a Medicine Ball is a dynamic exercise designed to enhance your golf game by targeting key muscle groups and incorporating essential biomechanical principles. By engaging your glutes, hamstrings, and hip flexors, this movement promotes strength and stability and supports the anatomical requirements for a powerful and efficient golf swing. Adding a medicine ball or weights to the mix will significantly increase the challenge, allowing you to develop greater control and core strength.
Improve Your Balance - Advanced Exercise
Balance exercises can be of great benefit to people of any age. Balance exercises improve your ability to control and stabilize your body's position. Balance exercises greatly reduce injury risk, rehabilitate current injuries, or increase your sports performance.
Conclusion
By employing the appropriate strategy, most golfers can substantially improve their game while avoiding injuries that might otherwise shorten their golfing careers. Contrary to common perception, golf is not a low-impact sport, so it is essential to take proper measures to minimize injury risks while simultaneously enhancing performance.
In essence, the same restrictions that cause injuries also hinder golf performance. Thus, every golfer seeking to elevate their performance and prevent injuries should include a competent musculoskeletal (MSK) practitioner in their professional team. Through the application of conservative therapy and exercise, you can boost your performance and sidestep injuries that could keep you away from the course.
DR. BRIAN ABELSON DC. - The Author
Dr. Abelson's approach in musculoskeletal health care reflects a deep commitment to evidence-based practices and continuous learning. In his work at Kinetic Health in Calgary, Alberta, he focuses on integrating the latest research with a compassionate understanding of each patient's unique needs. As the developer of the Motion Specific Release (MSR) Treatment Systems, he views his role as both a practitioner and an educator, dedicated to sharing knowledge and techniques that can benefit the wider healthcare community. His ongoing efforts in teaching and practice aim to contribute positively to the field of musculoskeletal health, with a constant emphasis on patient-centered care and the collective advancement of treatment methods.
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References
McHardy, A., & Pollard, H. (2005). Muscle activity during the golf swing. British Journal of Sports Medicine, 39(11), 799-804.
Barclay, J.K., & McIlroy, W.E. (1990). Effect of skill level on muscle activity in neck and forearm muscles during the golf swing. In A. Cochran (Ed.), Science and golf: Proceedings of the World Scientific Congress of Golf (pp. 49-53). London: E & FN Spon.
Bradley, J.P., & Tibone, J.E. (1991). Electromyographic analysis of muscle action about the shoulder. Clinical Sports Medicine, 10, 789-805.
Cole, M.H., & Grimshaw, P.N. (2008). Electromyography of the trunk and abdominal muscles in golfers with and without low back pain. Journal of Science and Medicine in Sport, 11(2), 174-181.
Hosea, T.M., Gatt, C.J., Galli, N.A., et al. (1990). Biomechanical analysis of the golfer's back. In A. Cochran (Ed.), Science and golf: Proceedings of the World Scientific Congress of Golf (pp. 43-48). London: E & FN Spon.
Jobe, F.W., Moynes, D.R., & Antonelli, D.J. (1986). Rotator cuff function during a golf swing. The American Journal of Sports Medicine, 14, 388-92.
Marta, S., Silva, L., Castro, M.A., Pezarat-Correia, P., & Cabri, J. (2012). Electromyography variables during the golf swing: a literature review. Journal of Electromyography and Kinesiology, 22(6), 803-13. doi: 10.1016/j.jelekin.2012.04.002.
Watkins, R.G., Uppal, G.S., Perry, J., et al. (1996). Dynamic electromyographic analysis of trunk musculature in professional golfers. The American Journal of Sports Medicine, 24, 535-8.
Abelson, B., Abelson, K., & Mylonas, E. (2018, February). A Practitioner's Guide to Motion Specific Release, Functional, Successful, Easy to Implement Techniques for Musculoskeletal Injuries (1st edition). Rowan Tree Books.
Glazebrook, M.A., Curwin, S., Islam, M.N., & Kozey, J. (1994). An electromyographic analysis of the role of dorsiflexors on the ground reaction force during the golf swing. Journal of Sports Medicine and Physical Fitness, 34(4), 304-310.
Watkins, R.G., Uppal, G.S., Perry, J., Pink, M., & Dinsay, J.M. (1996). Dynamic electromyographic analysis of trunk musculature in professional golfers. The American Journal of Sports Medicine, 24(4), 535-538. doi:10.1177/036354659602400420
Pink, M., Jobe, F.W., & Perry, J. (1990). Electromyographic analysis of the shoulder during the golf swing. The American Journal of Sports Medicine, 18(2), 137-140. doi:10.1177/036354659001800206
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