by Sarah Voelkel Feierstein PT, DPT, OCS, CMPT

Spinal Manipulative Therapy (SMT) is known to help decrease pain and improve spinal mobility. The authors of this article, Effect of Spinal Manipulative Therapy with Stretching Alone on Full-Swing Performance of Golf Players, propose that this treatment also coincides with maintenance and improvement of joint function, muscle balance and speed of neuromuscular reflexes, thus optimizing an athlete’s performance in their sport.
A golfer’s swing is a complex full-body motion which requires spinal mobility and limb flexibility. The shoulders are required to rotate up to 90 degrees and the hips by 45 degrees. This rotation places higher compressive loads in the low back (8x body weight) than rowing (7x) or running (3x). Because of this increased force on the spine, muscle strains are a common injury amongst golfers.
The researchers in this article evaluated the effect of SMT on the performance of golf players with a handicap between 0-15 during their full swing using a driver club.

Men between the ages of 18 and 55 with a handicap from 0 to 15 and who practiced golf at least once a week for four hours were recruited from two golf clubs in Brazil. They were randomly selected to be in one of two groups: Group I was a stretch-only program and Group II was a stretch and SMT program.
The stretches performed by both groups included those for the forearm flexors, deltoids, brachioradialii, biceps, forearm extensors, levator scapulae, gastrocnemii, solei, quadriceps, hamstrings, and gluteal muscles which were performed bilaterally for 20 seconds. Each golfer was also evaluated for joint dysfunction in the cervical, thoracic, and lumbar spine. SMT was performed on the dysfunctional segments in participants in Group II only.
Prior to each treatment, the participants performed three full-swing shots and the average distance of the shots was recorded. Participants then participated in the intervention (stretching or stretching + SMT) and performed three more full-swing shots on the driving range. This process was repeated once weekly, for a total of four weeks.

Group II showed a gradual improvement in the pre to post intervention shot distances across the four days, as seen in Figure 1 below. The fourth and final day showed a statistically significant change between pre and post intervention. When looking at Group I’s pre to post intervention distances, the results were inconsistent, as seen in Figure 3 below. There was a statistically significant decrease in average pre to post shot distance on day two.

Figures 2 and 4 below compare the shot averages between the first and last days of the experiments in Groups II and I, respectively. There were improvements in both groups, but neither was of statistical significance.

This study has a small sample size (43 men) and is not representative of all golfers, including the estimated 80 million female golfers worldwide, according to the National Golf Foundation.

The authors concluded that stretching and SMT seemed to be associated with an improvement in golfer’s swing performance. Therefore, spinal manipulative therapy could be a treatment option for patients who enjoy golfing.
Clinical Significance
Our clinicians have extensive training in manual therapy and efficiently evaluate and assess our patients to ensure they are appropriate candidates for safe manipulation techniques. Assessment of spinal mobility in the cervical, thoracic and lumbar spine, extremity joint mobility, soft tissue flexibility and strength are considered and evaluated as all are important for a successful golf swing. Come see us for an initial evaluation and treatment session to get ready for your upcoming golf season!

Costa, S., Chibana, Y., Giavarotti, L., Compagnoni, D., Shiono, A., Satie, J.: Bracher, E (2009). Effect of spinal manipulative therapy with stretching compared with stretching alone on full-swing performance of golf players: a randomized pilot trial. Journal of Chiropractic Medicine 8: 165-170.