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Golfing with Low Back Pain, Lumbar Stenosis and After Spine Surgery
by Patrick Arcement, PA-C
Golf is one of the most popular sports in the world and it’s a great form of exercise that can be enjoyed by men and women of all age groups. One of the unfortunate downsides to the sport is the strain it can put on your lower back. This article will focus on not only the prevention of a lower back injury from playing golf, but also how to enjoy the game if you are someone who has been diagnosed with lumbar spinal stenosis or has had spine surgery in the past.
As with any sports related injury, prevention is key. Here are some tips to preventing low back pain from golfing:
- Stretch before and after playing. Key areas to stretch prior to playing include the hamstrings, shoulders, torso, and hips. It’s better to warm up with short irons first, before taking larger swings with long irons and woods.
- A smooth, rhythmic swing produces less stress on the lumbar spine.
- Avoid carrying your golf bag if possible. If you must, it is better to have a bag with a built in stand and 2 straps, one for each shoulder. This prevents repetitive bending over to lift the heavy bag and carrying an uneven load on one shoulder.
Some patients suffer from a condition called lumbar spinal stenosis, where the canal that contains the nerves in the lower back is narrowing and can cause low back and sciatica pain. Here are some additional tips (in addition to the tips above) for this group of patients who want to continue to play golf:
- Swing 50-75 % of your normal force. This will prevent additional stress on your lumbar spine.
- Wear a low back brace while you play. The brace acts as a reminder to avoid maneuvers that can strain your lower back, while also providing support and preventing excess motion. Wearing a brace also increases warmth to the lower back, keeping the muscles and soft tissue loose.
- If ok with your doctor, take an anti-inflammatory medication (i.e. NSAID) 30 minutes before playing.
- Take a break from golf for a few weeks if low back and sciatica pain worsens.
For patients who have had lumbar spine surgery in the past, here are some general recommendations for returning to the golf course. It should be mentioned that every patient is different, and clearance from your spine surgeon should be granted prior to attempting any activity, especially golf.
For patients who undergo lumbar microdiscetomy:
- After 8 weeks post-op, the patient can begin gentle stretching of the low back and core strengthening exercises. Once these are mastered, the patient can transition to light swinging with short irons; eventually progressing to a full swing with long irons and woods as tolerated. Developing good stretching habits before and after golf is a must.
- No shots from the sand, rough, or uneven lies should be performed until at least 16 weeks post-op. During this time, patients should avoid riding in carts and not hit any balls off of the tee.
- After 16 weeks post-op, it is recommended to play no more than 9 holes at a time to start. Patients can gradually progress to a full 18 hole round of golf once tolerated.
- Any flare-up of pain should result in the patient holding all golf activity for at least 4 weeks, and starting from #1 with gentle range of motion stretches and core strengthening.
For patients who undergo lumbar spine fusion:
- Recommendations vary patient to patient and it is especially important to get clearance from your spine surgeon prior to starting golf after lumbar fusion surgery. Return to gentle swinging can vary anywhere from 6 to 18 months post-op.
- Once patients are told it is ok to begin playing golf again, they should adhere to the same return to play restrictions as stated above for microdiscectomy patients. Begin with gentle swinging of short irons and gradually progress to long irons and woods. Eventually working up to playing 9 holes at first and then 18 holes as tolerated.