Is there an association between self-reported warm-up behaviour and golf related injury in female golfers?

Golfing injuries have been shown to occur frequently, and injury countermeasures have been suggested to help reduce injury risk. Performing an appropriate warm-up is thought to reduce injury risk, however there is a lack of evidence to support this notion. Therefore this study aimed to investigate the relationships between warm-up participation and injury in a cohort of female golfers. A total of 522 golfers participating in the Victorian Women's Pennant Competition completed the study. Over one-third (35.2%) of the golfers reported having sustained a golfing injury within the previous 12 months, with the lower back the most commonly injured region. Most golfers reported not warming-up prior to play or practice. Golfers who reported not warming-up on a regular basis were more likely to have reported a golfing injury in the previous 12 months than those reporting frequent warm-up participation (OR=45.2; 95% CI: 13.5, 151.7). Less skilled golfers were also less likely to report sustaining a golfing injury than more skilled golfers (OR=0.2; 95% CI: 0.1, 0.5). This study is one of the few to establish an association between warm-up participation and injury. Further prospective studies are warranted to determine whether warm-up reduces injury risk for golf participation.     

One-year follow-up study on golf injuries in Australian amateur golfers

BACKGROUND: Considering its popularity, little epidemiologic literature exists on golf injuries. HYPOTHESIS: The low back is the most common injury location for golf-related injury. Most golf injuries occur as a result of the golf swing, and occur mostly at impact. The variables age, handicap, practice habits, and warm-up habits are associated with injury. METHODS: A prospective survey over 1 year was used to study golf injuries among 588 golfers at 8 Australian golf clubs. Information collected included golfers' injuries sustained during the year, location of injury, onset, mechanism of injury, and whether injury occurred during the golf swing or at another time. Additional information was sought on the type of treatment received after injury. Logistic regression was used to examine the epidemiologic patterns of golf-related injury and any possible risk factors for the injury. RESULTS: The overall 1-year incidence rate of golf injury was 15.8 injuries per 100 golfers, which equates to a range of 0.36 to 0.60 injuries/1000 hours/person. Recurrent injuries were most common, while injuries were more likely to occur over time as opposed to an acute onset. The lower back was the most common injury site (18.3%), closely followed by the elbow/forearm (17.2%), foot/ankle (12.9%), and shoulder/upper arm (11.8%). A total of 46.2% of all injuries were reportedly sustained during the golf swing, and injury was most likely to occur at the point of ball impact (23.7%), followed by the follow-through (21.5%). Multivariate analysis revealed that the amount of game play (odds ratio [OR] = 3.73, 95% confidence interval [CI] 1.29-10.75) and the last time clubs were changed (OR = 0.32, 95% CI 0.12-0.86) were significantly associated with the risk of golf injury (P < .05). Other factors such as age, gender, handicap, practice habits, and warm-up habits were not significantly associated with golf injury. CONCLUSIONS: Nearly 16% of Australian amateur golfers may expect to sustain a golf-related injury per year. The injuries in golf are most likely sustained in the lower back region as a result of the golf swing. Based on statistical analysis, only game play and a changing of clubs seem to be significantly associated with risk of injury after adjusting for other risk factors (P < .05). Other factors such as age, gender, handicap, practice habits, and warm-up habits were not significant.     

Injuries and overuse syndromes in golf

BACKGROUND: Although golf is becoming more popular, there is a lack of reliable epidemiologic data on golf injuries and overuse syndromes, especially regarding their severity. OBJECTIVE: To perform an epidemiologic study of the variety of different musculoskeletal problems in professional and amateur golfers and to find associations of age, sex, physical stature (body mass index), warm-up routine, and playing level with the occurrence of reported injuries. STUDY DESIGN: Retrospective cohort study. METHODS: We analyzed the injury data from a total of 703 golfers who were randomly selected over two golfing seasons and interviewed with the use of a six-page questionnaire. RESULTS: Overall, 82.6% (N = 526) of reported injuries involved overuse and 17.4% (N = 111) were single trauma events. Professional golfers were injured more often, typically in the back, wrist, and shoulder. Amateurs reported many elbow, back, and shoulder injuries. Severity of reported injuries was minor in 51.5%, moderate in 26.8%, and major in 21.7% of cases. Carrying one's bag proved to be hazardous to the lower back, shoulder, and ankle. Warm-up routines were found to have a positive effect if they were at least 10 minutes long. CONCLUSIONS: Overall, golf may be considered a rather benign activity, if overuse can be avoided. If not, golf can result in serious, chronic musculoskeletal problems.     

When golf hurts: Musculoskeletal problems common to golfers

Golfers most frequently report injuries to the low back, nondominant shoulder, and elbow. Injury patterns differ between elite and recreational golfers; professional and elite golfers tend to experience golf injury related to overuse while amateur golfers may experience injury related to adverse swing technique and overuse. Therapeutic interventions should include assessment and treatment of deficiencies in the kinetic chain and professional instruction to modify swing technique. Changes in the swing may include instruction in a more efficient technique or shortening the swing to decrease biomechanical forces affecting the injured area.     

Magnetic resonance imaging findings of golf-related injuries

Injuries related to participation in golf are becoming more common given the increasing popularity of the sport itself. Golf is considered to be an activity associated with a moderate risk for sports injuries. Golf injuries are usually attributable to overuse or traumatic mechanisms and primarily occur at the elbow, wrist, shoulder, and lumbar spine. None of these injuries are unique to golf, but each of these injuries represent the most common injuries associated with golfing. This article reviews a wide range of injuries that are encountered in golfers and describes the magnetic resonance imaging findings of each of these injuries.     

Golf injuries: a review of the literature

Golf is one of a few activities that people of all ages and skill level can play. Injury as with all sports can occur. The low back is the most common injury sustained whilst playing golf, and the dynamic action of the golf swing is a major contributing factor to injury. The golf swing is a complex movement that utilises the whole body in a coordinated fashion and when repeated frequently can result in injury. Injury can be overuse or traumatic in nature. Overuse injuries predominate in the professional golfer, and amateur golfer injury tends to occur secondary to an incorrect golf swing. Upper limb injuries are also common due to their role in linking the fast moving golf club with the power-generating torso. Fortunately, injury from a club or ball strike is rare. More common are the overuse injuries associated with the back, neck and shoulder. Most golf injury data have been collected retrospectively and further epidemiological study of a prospective nature is required to determine injury incidence and factor relating to the onset of injury.     

Warm up practices of golfers: are they adequate?

BACKGROUND: Although it is widely recommended that golfers warm up before play or practice to enhance their physical performance and reduce their injury risk, it is not known to what extent they actually undertake such warm up procedures. OBJECTIVE: To collect information about the proportion of golfers who actively warm up and to determine the types of warm up behaviours. METHODS: This study was conducted over three weeks at three different golfing venues: a private golf course, a public golf course, and a golf driving range. Golfers' warm up behaviours, defined as any form of preparative exercise, were recorded by direct observation by two independent observers. RESULTS: The sample consisted of 1040 amateur golfers (852 men and 188 women) aged at least 18 years. Only 54.3% (95% confidence interval 49.8 to 58.8) performed some form of warm up activity. Air swings on the tee were the most commonly observed warm up activity, with 88.7% (95% confidence interval 85.9 to 91.5) of golfers who warmed up performing these. CONCLUSIONS: Only a small proportion of amateur golfers perform appropriate warm up exercises. To improve on this, golfers should be educated about the possible benefits of warming up and be shown how to perform an appropriate warm up routine.     

Professional Golfers and the Price They Pay

Professional golfers' injuries are usually related to their swings. A wide variety of acute and chronic injuries have been reported, including carpal fractures, ulnar and median nerve neuropathies, tendinitis, skin rashes, and eye injuries. There have been two deaths. In this study questionnaires were mailed to 500 professional golfers, and 226 were returned. During their careers 103 men and 87 women were injured, an average of two injuries per player. The left wrist, lower back, and left hand were most commonly injured. Repetitive practice swings caused the most injuries in both men and women.     

Preventing injuries to competitive and recreational adult golfers: What is the evidence?

Although injuries to golfers are not common, both survey studies and hospital emergency department records have provided objective evidence that golfers are sometimes at risk of injury. While many golf injury studies describe the associated mechanisms and types of injuries, less attention has been given to research relating to the various injury prevention measures for this sport. This paper provides a critical review of the range of countermeasures to prevent golf injuries and highlights areas to be considered for future research, development, and implementation. In particular, it focuses on the strength of the evidence for the effectiveness of these measures. This review concludes that there needs to be more formal evaluation of the suggested countermeasures to prevent golf injuries. Particular attention should be given to evaluations of the golf swing and its relationship to particular injuries such as low-back, wrist, and shoulder problems. These countermeasures and associated strategies are recommended to reduce the incidence of injury in this popular and accessible sport.     

Kinematic analysis of swing in pro and amateur golfers

As golf grows in popularity, golf related injuries have increased. The purpose of this study was to calculate and compare upper body kinematics of healthy male golfers from different skill levels. Kinematic data were obtained from 18 professional, 18 low handicap, 18 mid handicap and 18 high handicap golfers with an optoelectronic system at 240 frames per second. Ten displacement parameters were calculated at address, peak of back swing and ball contact. Angular velocity parameters and respective temporal data were calculated during the downswing phase. Most parameters were significantly different between the higher skilled golfers (professional, low handicap) and the least skilled golfers (high handicap). At the peak of the swing, professionals produced the largest magnitudes for left shoulder horizontal adduction (125 +/- 6 degrees ), right shoulder external rotation (66 +/- 11 degrees ), and trunk rotation (60 +/- 7 degrees ). During the downswing, the professionals produced the largest angular velocities for the club shaft (2413 +/- 442 degrees /s), right elbow extension (854 +/- 150 degrees /s), right wrist (1183 +/- 299 degrees /s) and left wrist (1085 +/- 338 degrees /s). The results of this study show that improper mechanics of golf swing existed in middle and high handicap groups. These improper mechanics may contribute to golf related injuries.     

Verletzungen und Überlastungsschäden beim Golf

In 2016 in Rio de Janeiro golf as a new discipline will be part of the Olympic games for the first time. High loads in training and competition can lead to injuries and overuse problems in leisure sport golfers and in high competitive golfers. Low back pain and neck pain occur in 20-30% of all golfers. Tendinopathies and ligament strains of the shoulder, elbow or wrist are very common in the upper extremity. Soft tissue injuries around the hip and overuse syndromes around the knee including meniscal tears and cartilage problems can stop the sporting activity. Golf can be recommended for patients with arthroplasty of the hip or knee joint. Strengthening exercises and proprioceptive training can reduce the risk of injury or overuse.     

Warm-up attitudes and behaviours of amateur golfers

Although it is widely recommended that golfers warm-up before play/practice to enhance their physical performance and to prevent injuries, few actually undertake this activity. The reasons why golfers do/do not warm-up are not known. The aim of this study was to determine the self-reported behaviours and attitudes of adult golfers towards warming-up. A survey of 1040 randomly selected golfers was conducted over a 3-week period in July 1999. Information about golf participation, usual warm-up habits and reasons for these warm-up behaviours was obtained by a verbally administered self-report survey. Over 70% of the surveyed golfers stated that they never or seldom warm-up, with only 3.8% reporting warming-up on every occasion. The most common reasons why golfers warmed-up included to play better (74.5%), to prevent injury (27.0%), and because everyone else does (13.2%). Common reasons for not warming-up were the perception that they don't need to (38.7%), don't have enough time (36.4%) and can't be bothered (33.7%). These findings suggest that in order to increase the proportion of golfers who warm-up, education programs focussing on the benefits of warming-up, including injury prevention, need to be developed and implemented. Different strategies may need to be adopted to accommodate golfers' differing attitudes and baseline behaviours.     

Occupational injuries and stressors among Canadian air medical health care professionals in rotor-wing programs

INTRODUCTION: Air medical health care providers work in a unique environment that may affect occupational injury rates and patterns. Despite this knowledge, little high-quality evidence exists regarding occupational injuries specifically incurred by air medical health care professionals. We sought to characterize the epidemiology of occupational injuries experienced by Canadian rotor-wing health care providers. METHODS: A survey was sent to the 4 rotor-wing programs in Canada. All crewmembers participating directly in patient care were asked to complete the survey detailing any acute occupational injuries sustained within the previous year. A series of both open- and closed-ended questions was used to collect participant demographics and information regarding any injuries sustained. RESULTS: One hundred and six (40.6%) participants completed the survey. Three hundred and thirty acute injuries were reported. Hand lacerations and leg contusions were most prevalent (31 and 24 individuals incurred these injuries, respectively). Acute back injuries were also prevalent with 25 (23.6%) participants reporting at least one back injury. Overall, an injury rate of 3.2 injuries per person per year was reported. Lifting was cited as a common factor in injury (30 cases). Most injuries required little treatment, with only 17 needing physician intervention, and only 6 required more than 1 week off work. CONCLUSION: Injuries among Canadian air medical crews are common, but fortunately, the majority are minor. Specific injury prevention strategies may focus on stretcher design, cabin ergonomics, and extremity protective equipment.     

Lower back and elbow injuries in golf

Golf injuries to the lower back and elbow are common problems in both the professional and amateur player, and any information regarding the successful treatment of these injuries has important implications for the medical practitioner. This paper presents the successful management and outcome of two case studies associated with low back pain and lateral epicondylitis in golf. Exercise therapy and conditioning has been shown to be an effective treatment modality for these two types of injury. In particular, a dynamic exercise programme which incorporates golf functional rehabilitation, is a modern and accepted method by both the patient and the clinician. Effective programmes need to be golf-specific to maintain the interest of the participant and yet at the same time they need to be able to accommodate other factors such as age, gender and the level of the golfer. Furthermore, it is critical that the clinical practitioner has a fundamental knowledge of normal swing mechanics and a working knowledge of the musculoskeletal requirements needed to swing a golf club. In the case of the lower back injury, evaluation was based on detailed computer tomography and centred on the conditioning of the transversus abdominis muscle. Although this muscle is not considered to be paraspinal, it has particularly important implications in the maintenance of spinal stability so that other more specific golf functioning exercises and rehabilitation can be performed. For the case study of lateral epicondylitis detailed evaluation and consideration of neuropathy was an important factor in the diagnostic process. In part, it was necessary to deviate from conventional treatment to produce an effective outcome. A comprehensive resistance-strength-training programme and golf functional 'hitting' programme was used to treat the problem. The conformity by the patient to complete the exercise regimen has been an issue of concern for clinicians managing and treating golf-related problems. Many golfers are 'fanatical' and unless they can see that by continuing the programme their injury will be overcome, it is difficult trying to restrict their time on the golf course. The two case studies described in this article highlight how an extensive and dynamic golf functional programme could be used as an effective method for managing and preventing golf injuries.     

Professional Basketball Injuries

In a ten-year study of 70 professional basketball players, 47 sustained 265 injuries that most frequently occurred during early-season games. Centers, who had the highest injury rate, most frequently injured their backs; guards most frequently injured elbows and knees; and forwards most often injured fingers and knees. Strains and sprains were the most common problems. Most injuries resulted from trauma rather than from training or conditioning errors.     

Abdominal muscle activation of elite male golfers with chronic low back pain

PURPOSE: The purpose of this study was twofold: 1) to determine whether elite male golfers with chronic low back pain (CLBP) exhibit different abdominal muscle activity patterns during the golf swing than asymptomatic control (AC) golfers and 2) to determine whether elite male golfers with CLBP experience greater fatigue in the abdominal muscles than AC golfers after a typical practice session. METHODS: Surface EMG data were collected bilaterally from the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles. Muscle activity during the golf swing was measured using the root mean square (RMS) of the EMG signal in various phases of the golf swing. Fatigue was assessed using the median frequency (MF) and RMS of the EMG signal during a 10-s submaximal isometric contraction. Low back pain was quantified with the McGill Pain Questionnaire before and after the practice session. RESULTS: No differences in the RMS of abdominal muscle activity were noted during the golf swing between AC and CLBP subjects. However, EO (lead) onset times were significantly delayed with respect to the start of the backswing in CLBP subjects. Low back pain in CLBP golfers increased significantly after the practice session. Abdominal muscle fatigue, as measured with MF or RMS, was not evident after the practice session for either AC or CLBP subjects. CONCLUSION: Abdominal muscle activity and muscle fatigue characteristics were quite similar between AC and CLBP subjects after repetitive golf swings. Despite this, it was clear that repetitive golf swings were aggravating some part of the musculoskeletal system in CLBP subjects, which resulted in increased pain in the low back area.     

Where do golf driver swings go wrong? Factors influencing driver swing consistency

One of the challenging skills in golfing is the driver swing. There have been a large number of studies characterizing golf swings, yielding insightful instructions on how to swing well. As a result, achieving a sub‐18 handicap is no longer the top problem for golfers. Instead, players are now most troubled by a lack of consistency during swing execution. The goal of this study was to determine how to consistently execute good golf swings. Using 3D motion capture and full‐body biomechanical modeling, 22 experienced golfers were analysed. For characterizing both successful and failed swings, 19 selected parameters (13 angles, 4 time parameters, and 2 distances) were used. The results showed that 14 parameters are highly sensitive and/or prone to motor control variations. These parameters sensitized five distinct areas of swing to variation: (a) ball positioning, (b) transverse club angle, (c) transition, (d) wrist control, and (e) posture migration between takeaway and impact. Suggestions were provided for how to address these five distinct problem areas. We hope our findings on how to achieve consistency in golf swings will benefit all levels of golf pedagogy and help maintain/develop interests to involve more golf/physical activity for a healthy lifestyle.     

A survey of golf injuries in amateur golfers.

A survey of 461 amateur golfers was undertaken to assess golf injuries. There were 193 respondents of whom 57% reported injuries. Wrist, back, muscle, elbow and knee problems were the most likely ailments to compromise a player's game. Overuse and poor technique were the main aetiological factors. Attention to those factors in addition to maintenance of physique would reduce the incidence of these problems.     

Swing kinematics for male and female pro golfers

The purpose of the study was to compare golf swing kinematics between female and male professional golfers, with particular focus on areas where different risks of injury exist and variables that may be related to driving distance. Twenty-five LPGA golfers and twenty-five PGA golfers were tested. Customized computer software was developed to analyze kinematic data obtained with an optoelectronic system at 240 Hz. At the peak of back swing, significant differences were found in trunk forward tilt (LPGA: 25 +/- 4 degrees and PGA: 31 +/- 4 degrees ), and in pelvis orientation (LPGA: 49 +/- 8 degrees and PGA: 42 +/- 7 degrees ). Significantly different pelvis rotation at the ball impact was found (LPGA: - 52 +/- 11 degrees and PGA: - 42 +/- 12 degrees ). The LPGA group produced significantly less angular velocities of the club shaft (2049 +/- 512 degrees /s), the left wrist (816 +/- 186 degrees /s), the right wrist (864 +/- 198 degrees /s) and the elbow extension (705 +/- 109 degrees /s) than the PGA group. The results of this study show there are differences in the swing mechanics for men and women at the professional level. Major differences were found at the wrist and elbow, where different incidences of injury were previously reported.     

The epidemiology of knee injuries in Iranian male professional soccer players

Detailed injury epidemiology is an invaluable tool for minimising risk associated with sporting injuries. The aim of this study was to investigate epidemiology of knee injuries in Iranian male professional soccer players. In total, 390 soccer players of 16 clubs were studied during one season. A total of 43 injured soccer players were interviewed and 16 team physicians were consulted. All information was collected through standard questionnaires. Furthermore, medical personal prospectively reported time-loss injuries sustained by players over one season and the knee injuries were evaluated. The results showed that in total, from 390 players, 43 of them suffered knee injuries (14.9 per 100 players). The anterior cruciate ligament was the most commonly injured ligament of the knee, in which 12.5% were accompanied by injuries to the medial meniscus and medial collateral ligament. There was a significant difference in incidence of injury between the preferred (62.9%) and non-preferred leg (37.1%). Most injuries were characteristically severe (82.3%). Most injuries occurred in away games (52.94%), mostly in the second half and most commonly in the final 15 min (35.3%). The incidence of non-contact injuries (66.12%) was significantly higher than contact injuries (33.87%). It can be concluded that the incidence of knee injury was high (0.12 injuries per team per match). Injury tends to be more common in match play and mostly at the end of season. Midfielders suffered more knee injuries. Most injuries occurred in the losing teams.