VOLUME 29 - 5 Golf to Save Your Back

Health Tips

Chiropractic Tips & Advice To Improve Your Golf Game & Save your Back

Many avid golfers contort their bodies into oddly twisted postures, generating a great deal of torque. Couple this motion with a bent-over stance, repeat 120 times over three or four hours, add the fatigue that comes with several miles of walking, and you've got a good workout-and a recipe for potential lower-back trouble.

As America's love affair with the game continues to grow, the American Chiropractic Association (ACA) has advice on how to take a proactive approach that will prepare your body for many years of pain-free play.

"Most golfers go until they get hurt, then look for help." "Back pain is a warning sign that there is an underlying problem responsible for a symptom that will likely get worse. Doctors of chiropractic look for the cause of the symptom and help reduce the likelihood of future injury."

If you take the chiropractic approach, you're in good company. Tiger Woods says that lifting weights and visiting his chiropractor regularly have made him a better golfer. Here are some simple measures to help you avoid back pain or injury and improve your game:

• Purchase equipment that fits. Don't try to adapt your swing to the wrong clubs: A six-footer playing with irons designed for someone five inches shorter is begging for back trouble.
• For the women in golf: If you have "inherited" your husband's or significant other's golf clubs, they might be difficult for you to use. Not only are the clubs often too long, but the shaft is often not flexible enough for a woman's grip. Women typically play better with clubs that are composed of lighter, more flexible material, such as graphite.
• For the men in golf: It is a good idea to spend some extra time performing quality stretches-before and after your game-to increase your trunk flexibility. While men are traditionally stronger than women, they usually aren't as flexible. Men need to improve their flexibility to maintain a more even and consistent swing plane and thus improve the likelihood of more consistent performance.
• For senior golfers: If you show some signs of arthritis in the hands, consider a larger, more specialized grip for added safety and performance.
• For all golfers: For some, scores may not be as important as enjoying the social benefits of the game. Having clubs that are comfortable will increase the chances of playing for a long time without significant physical limitations.
• Take lessons. Learning proper swing technique is critical. At the end of the swing, you want to be standing up straight; the back should not be twisted.
• Wear orthotics. These custom-made shoe inserts support the arch, absorb shock, and increase coordination. "Studies show custom-made, flexible orthotics can improve the entire body's balance, stability and coordination, which translates into a smoother swing and reduced fatigue," While the upper part of a shoe may score style points, what the foot rests on affects your game.
• Avoid metal spikes. They tear up greens and can increase stress on the back. Soft shoes or soft spikes allow for greater motion.
• Warm up before each round. "Stretching before and after 18 holes is the best way to reduce post-game stiffness and soreness," Take a brisk walk to get blood flowing to the muscles; then do a set of stretches. To set up a stretching and/or exercise routine, see a doctor of chiropractic or golf pro who can evaluate your areas of tension and flexibility.
• Pull, don't carry, your golf bag. Carrying a heavy bag for 18 holes can cause the spine to shrink, leading to disk problems and nerve irritation. If you prefer to ride in a cart, alternate riding and walking every other hole-bouncing around in a cart can also be hard on the spine.
• Keep your entire body involved. Every third hole, take a few practice swings with the opposite hand to keep your muscles balanced and even out stress on the back.
• Drink lots of water. Dehydration causes early fatigue, leading you to compensate by adjusting your swing, thus increasing the risk of injury. Don't smoke or drink alcoholic beverages while golfing, as both cause loss of fluid.
• Take the "drop." One bad swing-striking a root or a rock with your club-can damage a wrist. If unsure whether you can get a clean swing, take the drop.

Chiropractic Care Can Help Doctors of chiropractic are trained and licensed to treat the entire neuromusculoskeletal system. Some doctors of chiropractic have specialized training in sports medicine and can provide advice for golfers to help them decrease the stresses and strains placed on their bodies. Doctors of chiropractic can address other health concerns, such as shoulder, knee, arm and wrist pain that could affect your game. "If you golf consistently, you will no doubt feel the stress of the game, but by following a few simple prevention tips, it is possible to play without pain for a lifetime."

Research

Clinical Course and Prognostic Factors in Acute Low Back Pain: Patients Consulting Primary Care for the First Time

Study Design: Inception cohort study.

Objectives: To examine the clinical course of acute low back pain and to evaluate prognostic factors for nonrecovery.

Summary of Background Data: Few studies have explored clinical course and prognostic factors in patients who consult primary care for their first time because of an episode of low back pain of <3 weeks duration.

Methods: A total of 123 patients with acute low back pain <3 weeks consulting primary care for the first time were included, and 120 completed 3 months follow-up. Baseline assessments included sociodemographic characteristics, back pain history and current status, psychological questionnaires and clinical examination. Main outcome measures were pain intensity, disability by Roland Morris Disability Questionnaire, and recovery of disability. Potential prognostic factors for recovery or not were analyzed by multivariate logistic regression.

Results: At 4 weeks and 3 months 76% of the patients had recovered. Mean pain intensity and mean disability scores dropped 58% and 68%, respectively, of initial levels during the 3 months. The proportion with sickness absence was 8% at 4 weeks and 6% at 3 months. Several sociodemographic, clinical, and psychological factors were of prognostic value. Compared with their respective reference categories, age above 45 years (odds ratio 4.4, 95% confidence interval 1.4-14.0), smoking (3.0, 1.1-8.5), two or more neurological signs (4.6, 1.4-14.9), a score of >=90 on the psychosocial screening (3.1, 1.0-9.4), and high levels of distress (4.1, 1.3-12.8) were the best prognostic factors of nonrecovery at 3 months.

Conclusion: During a period of 3 months, 24% of the patients had not recovered. Psychological factors and neurological signs were strongly associated with nonrecovery at 3 months. In addition to the traditional examination of neurological symptoms and signs, psychological factors should be considered already at the initial visit of an episode of low back pain.

Grotle M, et al. Spine. April 15, 2005; Vol. 30, No. 8, pp. 976-982.

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The Rear End Collision

These are becoming more frequent now and you need to know what to do if you are hit from behind or slip into someonw else. Follow these simple rules if you are involved in a car accident and are not hospitalized:

• Stay calm and reduce movements of the spine
• Ice packs on the spine and neck for 5 minutes per hour will help for the first few days
• See your chiropractic physician right away - He is the only provider trained to evlauate spinal subluxations

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