Golf back and hip pain

What it is

A golf swing generates enormous rotational speed and asks for large ranges of hip and thoracic rotation in a fraction of a second. The lumbar spine is built for stability rather than rotation and has only a small amount available.

When the hips and the thoracic spine are stiff - which they are in almost everyone who sits for a living - the required rotation still has to happen. It comes from the lumbar spine, at speed, under load, hundreds of times a round. That is the mechanism behind most golf back pain.

What it feels like

• Low back pain that builds through a round and is worse the next day
• Pain on the lead side, at the top of the buttock or in the groin
• Stiffness and reduced turn compared with how it used to feel
• Worse on the range hitting many balls in succession
• Sometimes lead-side hip pain rather than back pain, which is the same problem further down

What causes it

Most people have more than one of these at once, and they feed each other. Read the list looking for the two or three that sound like your week rather than for the one true answer — the ones that describe you are the ones worth acting on.

Restricted hip internal rotation

The lead hip must internally rotate substantially through the downswing. When it will not, the pelvis cannot clear and the lumbar spine rotates instead - at speed, which is exactly what it cannot do safely.

A stiff thoracic spine

Most of the backswing turn should come from the thoracic spine. A locked mid-back means the lumbar spine and the hips have to supply it, and it also limits how far back the club can go without compensating.

Lumbar spine supplying rotation it does not have

The lumbar spine has around thirteen degrees of rotation across all five levels. Asking it to supply a large share of a swing hundreds of times is a load it will eventually object to.

Sitting for a living and playing at the weekend

Five days of stiffening, then four hours of the most rotationally demanding common sport. The mismatch between preparation and demand is the underlying story.

Weak trunk and hip muscles

The rotational forces have to be controlled by something. Weak obliques, glutes and deep trunk muscles mean the passive structures absorb what the muscles should.

No warm-up

Golf is very commonly played with no preparation at all - the first swing of the day is often a full-effort one at the first tee, on cold, stiff tissue.

High volume on the range

Hundreds of swings in succession with no variation is a far higher tissue load than a round, and it is where a lot of golf injuries actually happen.

Swing technique

A reverse-C finish, excessive side-bend and a large X-factor stretch all increase lumbar loading. Technique change is a legitimate part of the treatment for a recurring problem.

Carrying the bag

Carrying a heavy bag on one shoulder for four hours adds an asymmetric load to a back that is already being asked to do a great deal.

Age and existing degenerative change

Rotation available in the spine and hips falls with age while the swing demands stay the same, which is why this often appears in people who have played comfortably for decades.

Who tends to get it

• Golfers with desk jobs, which is a large proportion of golfers
• Anyone with restricted hip internal rotation or a stiff thoracic spine
• High-volume range practisers
• Players who never warm up
• Older golfers, whose available rotation has fallen while the swing has not changed

What makes it worse, and what settles it

The qFIT routine for this

Ready-made routineRotation Sports (Golf, Racquet & Throwing)

qFIT already has this one built. It runs massage first, then stretching, then strength — the order that works on a body that is already sore — and every activity in it carries the reason it is there.

The button below opens your Checklist with this routine already selected, so instead of your whole list you land on just its Categories, Targets and Exercises, each with its checkbox, ready to tick as you work through them.

Have more than one problem? Tick yours under My Problems on My Profile and your Checklist's Routine list gains Recommended for my problems — every routine for the problems you picked, merged into one. Your picks stay private; that filter is the only thing they feed.

Get it checked if…

Back pain with leg symptoms, or pain that worsens through a round and does not settle overnight, needs review

And whatever the body part: chest pain or unusual breathlessness on exertion; a fever alongside the pain; unexplained weight loss; pain that is constant and unrelated to how you move; new numbness, weakness or loss of bladder or bowel control; or one calf that is swollen, warm and painful. Any of those, stop and get assessed.

How it usually goes

Hip and thoracic rotation improve over six to twelve weeks and the effect on both comfort and clubhead speed is usually noticeable - this is one of the rare cases where the rehabilitation also improves performance. Long-standing back pain in a golfer often needs the swing looked at as well as the body, and a coach and a physiotherapist working on the same problem is far more effective than either alone. Leg pain, numbness or weakness alongside the back pain is a different problem and needs assessment.

Prevalence basis: Golf medicine surveys

Others the same routine covers

These share the Rotation Sports (Golf, Racquet & Throwing) routine, so the work is the same. If one of them also sounds like you, that is a reason to expect more from it, not less.

This is general information, not a diagnosis, and it cannot examine you. If it matches you, use it to ask better questions of a clinician rather than to replace one.