Today, Saturday, August 24, 2019

Golfers are at Greatest Risk for Knee Injury

Golf is often viewed by the uninitiated as a rather sedate sport where participants hit a few balls between drives around on a golf cart.  The reality is that the sport is very demanding on a golfer’s joints and musculoskeletal system. The forces involved are so great that they may wreak havoc on a golfer’s body. Particularly noteworthy is the fact that golfers are at greatest risk for knee injury. Inattention to this may not only result in physical disability but will delay recovery from an existing injury or surgery.

Analysis of a Golf Swing

The force that the golf swing exerts on the knees is more powerful than the force exerted on the knees of a jogger.  The golf swing actually exerts a force on the knees that is 4.5 times the golfer’s body weight. This happens very quickly, since it only takes approximately .23 seconds for a professional golfer to complete the downward swing.  The upward swing portion takes .82 seconds to complete.  The downward swing is therefore about three and one half times faster and produces the highest percentage of injuries in amateur and pro golfers alike.  Studies show that it would actually be less stressful to jog the eighteen holes of golf than to play them.

Contrary to appearances, golf requires that a participant develop strength, flexibility, endurance, coordination and agility.  The chronic repetition that is required of the sport is what will lead to injury if the golfer subjects an ill-prepared body to the punishing forces of the golf swing.

Here are some more facts:

·         A major swing flaw known as “coming over the top” will cause the ball to slice.  It is a result of coming down too steeply or verticallly upon the ball.  Large divots are typically produced.  This type of swing will increase the force being delivered to the hands and will negate the shock absorbing qualities that a high tech golf club may typically have.

·         Greater club head speed may be created by using light high tech graphite and titanium golf shafts.  This may benefit golfers who want to reduce the stress placed on the upper body, but the speed of the swing will still contribute to lower extremity stress.

Biomechanics of the Golf Swing
The motion involved with hitting a golf ball was once described by kinesiologists (scientists who study body motion) as a “reverse underarm pattern”.  This is a variation in the typical underarm pattern seen in sports such as softball (pitching) or bowling. This belief developed because the left arm was previously considered to be the dominant (in right handed golfers) influence in developing club head speed.  Studies now show that both arms are instrumental in developing it.  The goal is to create a stable center hub around which the coordinated arm movement swings.  Balance, coordination, stability and strength all play important parts in delivering a smooth and powerful swing.  If any of these are off, the swing will be less effective in driving the ball and the golfer will be more prone to knee injury.

Traditional Methods Used to Protect the Golfer

A properly fitting pair of golf shoes, with wide track rubber soles and spikes to prevent slippage will be helpful to the golfer in maintaining balance. Today there are even spike-free varieties that can offer traction without tearing up the golf green. Padding in the shoe will increase comfort, but it will not mitigate the force that is being delivered to the knee by the downward swing, despite manufacturer’s claims.

High tech golf clubs which are made to increase the speed of the swing and absorb shock also do not substantially decrease the force of the downward swing on the knees.

The Best Protection against Golfer Knee Injury
The best protection against golfer knee injury is to adhere to a sensible fitness program.  This includes:

·         Healthful eating to maintain an ideal body weight and optimize blood circulation to all extremities.

·         Proper stretching before golfing and all other exercise routines to warm up muscles and prevent stiffness and sprains.

·         A regular exercise program that includes aerobics and strength training will help prevent injury by promoting the flexibility, balance and endurance that a fast and forceful golf swing requires.

Best Practices when Recovering from a Golfer Knee Injury
There is one important, and often overlooked, piece of advice that a golfer recovering from a knee injury must do; refrain from golfing until fully recovered. The force on the knee will continue to reinjure the knee and prevent its recovery otherwise.

The good news is that there are a number of other exercises that can help build up leg strength.  One of the most surprising of the recommended exercises is biking. This activity creates the lowest pressure on the knee; only 1.3 times the body weight on the knee (recall that the golf swing places 4.5 times the body’s weight in pressure on the knee).

Swimming is another low impact exercise that will allow patients with knee injuries to recover without further damaging the knee.

For comparison, here are the forces that other leg exercises exert on the knee:

·         Leg lunges – force of 2.5 times the body weight

·         Kneeling – force of 1.5 times the body weight

·         Rowing machines have one of the lowest forces

·         Jogging – force of 4.3 times the body weight

·         Tennis serve – force of 3.8 times the body weight

·         Forehand stroke in tennis – force of 3.6 times the body weight

·         Golfing – force of 4.5 times the body weight on the forward knee of the swing and 3.2 on the other knee

Varying your exercise routine by mixing up the types of stress placed on the knee will strengthen your legs and help to prevent injury.  Doctors recognize that even patients who have had knee implants do not need to give up golfing if they adhere to this exercise plan.  The goal is to reduce the overall forces on the knee in order to increase the life of the prosthesis and prevent damage to it.  This can be accomplished by increasing muscle strength and, ultimately, reducing the golfer’s risk for knee injury.




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