OVERUSE INJURIES OF THE UPPER EXTREMITY IN GOLF
Section snippets
FREQUENCY
The frequency of overuse golf injuries to the upper extremity has received little attention in the literature. In a study of professional golfers, the left wrist was injured most frequently followed by the left hand, left shoulder, and left elbow (Table 1).15 In the amateur golfer, the elbow was injured, most frequently followed by the hand and wrist and shoulder (Table 2).16
CAUSES
The most common causes of overuse syndromes are summarized in Table 3. In the professional golfer,15 the most common mechanism of injury was too much practice; in the amateur, the most common mechanism of injury was too much play or practice followed by poor swing mechanics (Table 3).16
HAND AND WRIST INJURIES
Tendinitis is the most common problem seen in the wrist and forearm of the golfer. It is due to the repetitive dorsiflexion and palmar flexion motions of the right wrist, the radial deviation–ulnar deviation motion of the left wrist, and extremes of pronation and supination. Ulnar deviation of the left wrist occurs only minimally just before impact, but it occurs at a faster speed while the wrist is under high degrees of stress. Tendinitis can involve the extensor carpi ulnaris, extensor carpi
ELBOW INJURIES
The golfer can suffer two common elbow injuries: medial and lateral epicondylitis. During the backswing, little physical stress is put on the elbows or forearms. A slower and smoother backswing, however, allowing the wrist to cock naturally, causes even less force on these muscles and tendons. At the transition to the downswing and impact, stress is reduced if motion is begun by the hips, with forward arm motion initiated by the shoulder, not the wrists. The common swing fault of “casting” the
SHOULDER INJURIES
Repetitive overuse of the shoulder in golf yields rotator cuff pathology. Disregarding pathology in the sternoclavicular, scapulothoracic, and acromioclavicular joints, which must be considered in the clinical setting, the overuse injury usually affects the rotator cuff tendons.2, 14 This overuse syndrome can range from tendinitis or subacromial bursitis to impingement syndrome and perhaps, eventually, to rotator cuff tears.
Initially, after the diagnosis of rotator cuff overuse, the patient is
PREVENTION OF GOLF INJURIES
The golfer should start with a professional to assure proper swing mechanics and the proper equipment to prevent injuries and to reduce abnormal stresses to various body parts. Preventing injury in any sport is difficult, and golf is an activity demanding a high degree of refined motor skills. Many frustrated golfers try to play when they are not in shape. The weekend and even the professional golfer must condition the body or assume the risk of injury.
Three types of exercises are required to
SUMMARY
Golfers are athletes, for golf is a sport. To play it well, one must have athletic ability, strength, agility, coordination, and endurance. The golf swing is physically demanding and has contributed to overuse injuries in the upper extremity. The wrist, elbow, and shoulder are the most frequently injured joints.
References (23)
- et al.
The shoulder
Injuries of the articular disc of the wrist
J Bone Joint Surg [Am]
(1960)- et al.
The Search for the Perfect Swing
(1968) - et al.
Tendinitis: Its Etiology and Treatment
(1984) - et al.
Sports stress syndromes of the hand and wrist
Am J Sports Med
(1978) The Biomechanics of Sports Techniques
(1973)- et al.
Rotator cuff function during a golf swing
Am J Sports Med
(1986) - et al.
30 exercises for better golf
(1986)
Chronic sprains of the carpometacarpal joints
J Bone Joint Surg Am
Cited by (0)
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Methodist Sports Medicine Center, Indianapolis, Indiana