This is a guest post from Mitch Gill. Mitch is an athletic trainer and strength coach based in Georgia, USA. He also owner and operator of Gill Training Systems. GTS was created out of a desire of mine to educate the general public on how to become a better version of themselves through health and fitness, with a philosophy of moving well, before adding strength and volume at it’s core. He can be reached at his website Gilltrainingsystems.com or through Twitter, Instagram or Facebook
Me and Mitch have had some great conversations over twitter and I totally love his approach to and passion for fitness, strength training and athletic performance. So without further ado, over to Mitch.
Low back pain is a common occurrence in golfers both recreationally and professionally. In a study done by the TPI, it was found that 28.1% of 31,000 golfers surveyed deal with low back pain after every round of golf. It has also been reported that 23% of golfers who play professionally deal with back pain. Back pain is most often an accumulation of stress over 100’s of swings. In a round of golf a good golfer may take 60 to 70 max effort swings and that does not include the practice swings before approaching the ball or the time spent on the practice range before their round. This low back pain can be caused by a mobility restriction elsewhere, such as the thoracic spine or the “mid-back”, causing compensation in the lumbar spine.
The joint-by-joint approach, an idea by Grey Cook, can be used to better explain how this occurs. Cook describes the body as a stack of joints, with each one having a specific function and each prone to certain dysfunctions.
As you can see, as we move up the chain, the need for mobility or stability alternates. The ankle, for example, has a tendency towards becoming stiff and most people will benefit from mobilising this joint. As we move up the chain to the knee we see a greater need for stability.
What does this mean for injury prevention?
When an area, in this instance the thoracic spine, is dysfunctional or tight another area must adjust or compensate. The inverse is true when an area in need of stability becomes unstable, the joint above or below will compensate and create stiffness to achieve stability. In the case of a tight t-spine, greater motion must occur at the lumbar spine to achieve the task at hand. This increases the propensity for issues to occur as the lumbar spine is meant to be a stable segment; you are asking muscles and other soft tissue to do things they are not equipped to do, and in doing so putting them vulnerable position. When you add high speed and force through the area, it is a ticking injury time bomb
Our daily lifestyle can wreck our t-spine mobility due to poor sitting mechanics of the 9-to-5 job. The body will get good at what it’s repeatedly asked to do in order to be as efficient as possible, and as such with all that time sitting flexed over our desk, we lose the ability to extend at the t-spine.
As rotation at the t-spine is also of a form of extension, and what golfers refer to as shoulder turn is really t-spine rotation we can pretty quickly see how a lack of mobility in the t-spine can limit a golfers back swing.
“Our training/warm-ups should counteract our time in these poor posture and prepare us for our activities”
Before we begin with exercise interventions however, it is pertinent to establish a baseline for thoracic mobility and find out our limitations and asymmetries. A quick self-evaluation tool is the seated t-spine rotation test:
You will need 3 golf clubs or wooden dowels and a chair to complete the test.
- Place 2 of the clubs down on the ground in an X or perpendicular fashion.
- Sit in chair so that you create 45 degree angles between two ends of the golf club.
- Place club in the front rack position with arms in a “W” position.
- Rotate the thorax as far as possible to both the right and the left.
- The goal is to achieve 45 degrees of rotation.
- The hips should remain stable on the chair. A ball or foam roller may also be placed between the knees to help you maintain a solid base.
It is important to not only consider your total mobility but also look for any asymmetries left to right. Golf is a unilateral sport, unless you are the unicorn golfer who is ambidextrous, and can often lend itself to some asymmetries. Finding limitations and asymmetries can help lead your plan of attack.
Now you have found that you have the thoracic mobility of a 90 year old…what now?
The first point of emphasis in thoracic mobility work should be extension. A tight flexed thoracic spine can make it difficult to achieve any rotation. Increasing extension will help make your rotation drills more effective later on.
Below is a quick 4 exercise mobility session to include into your warm-up before working out or hitting the course:
- Foam Rolling
- Done with arms crossed to clear scapula to gain access to the paraspinal muscles
- Slowly work your way up the spine finding “hot spots”
- When finding a hot spot, roll back and forth or just press into the area until sensitivity has decreased.
- Foam Roller Extension
- Easy transition from the foam rolling of muscles
- Can also be done with the mobility peanut or two lacrosse balls taped together.
- Use implement as a fulcrum
- Try to stop at each segment
- With a stable “lower half”, “upper half” will extend or “rotate” about the implement.
- Try 8 to 10 mobilisations per segment.
- T-Spine Rotation with Reach
- Sidelying position with top hip flexed to 90 degrees
- Use a foam roller to support knee if need be.
- Put pad under head to support head and neck.
- Start with hands parallel to ground
- Begin rotating thorax, keeping top knee on ground or foam roll
- As arms become perpendicular to the ground begin reaching with top arm, attempting to reach the ground.
- Hold for a couple breathes and repeat
- 5-10 reps on each side
- Quadped T-spine Rotation
- Quadped position or on all fours with knees under hips and hands under shoulder
- Place hand behind head on one side
- Attempt to rotate as far as possible without losing contact of ground with knees
- Also try with hand behind back placing shoulder in internal rotation
- 10-12 reps of each position on each side
Incidentally if you are a lower back pain sufferer, I’ll be running a week long series of posts on lower back pain that will touch on many of the same concepts of spinal positioning and segmental mobility v’s stability on my Instagram page next week so follow us here if you’re not already, and to turn on notifications to make sure you see the posts.