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Swing Without Fear Of Back PainThis month our Health & Wellness column focuses on back pain among golfers, its causes and the precautions golfers should take to avoid back ache, suggested by a specialist doctor of the BNH Spine Centre, BNH Hospital. The first 2 RBSC members who call the BNH Hospital at 02-686- 2700 ext. 3395 referring to this article will be eligible for a Complimentary 'Low Back Pain Screening Programme'.

Back pain is a recurrent problem among golf players. The majority of players suffer from regular back aches which develop while playing. Most often these aches develop if players do not exercise regularly or condition their bodies according to the needs of the game before playing. Back aches and pains can also occur if the game is played for too long or if a player makes a particular golf swing. Research has found that golfers experience aches when the club hits the ball and during the follow-through of the swing. The tilting of the player's body to one side during this swing action also contributes to back ache.

The problem of back pain is a perennial one and it can happen to people of any age though the middle aged and the older groups are more prone to these kinds of pains. The back pain also brings with it various kinds of problems and hence it is necessary that golfers be aware of the various kinds of causes of back pains and also solutions and treatments for alleviating the pain. The back pain can actually have you bed ridden for days if it is not treated on time and thus it is best to avoid the problems of back pain through various kinds of remedial solutions. The problems of backache can further be classified into pain in the lower back, middle back and the upper back. It is usually the pain in the lower back which affects most people and the reason is that the lower back receives maximum pressure and strain owing to its critical location and thus is more prone to injuries.

RBSC member and former golf captain Khun Vudhi Lenbury is one among many golfers who suffer from backache. Asked about this, he said: "I have been suffering from back pain over many years now. It has been on and off. Sometimes it is so excruciating that I cannot even move. X-ray tests showed that there's nothing wrong with my backbone. The problem was with my back muscles. That's why I have made it a must to wear a lumbar corset whenever I play golf."

To find out more about backache and the precautionary measures that golfers should take to avoid or reduce pain, ELITE accompanied Khun Vudhi to meet Dr. Arthit Hongvanit, Orthopaedist, at the BNH Spine Centre, BNH Hospital.

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How common is back pain among golfers and what are its causes?

The most common problem among weekend/holiday golfers is pain in the back associated with muscle pull or strain. Professional golfers usually don't have the problem since they work- out regularly and keep their bodies always fit.

Back pain can be caused predominantly due to four factors - age (senior golfers may have natural degeneration of the spine due to ageing), incorrect swing, bad condition of muscles and lifestyle habits - obesity, alcoholism and smoking.

Can mismatched golf clubs lead to backache?

In my opinion, using golf clubs that are not suited for your height/weight may lead to backache. But it is a minor factor. The four factors (already mentioned) can cause more serious injuries. Thanks to modern technology, drivers and woods of optimum weight and length and with wider sweet spot available in the market that can reduce injury to the back. Similarly, cavity back irons can lessen the transmission of vibration from the clubhead to your wrists, elbows and back thereby reducing the chances of an injury.

What can cause a slipped disk?

A slipped disk (also called a herniated disk) happens when a disk between the bones of the spine bulges and presses on nerves. This is often caused by twisting while lifting. In golf, making a full swing in a wrong way, can cause a disk to slip. People who twist the spine while making a full swing without using their hips exert pressure equivalent to 8-10 times of their normal body weight on their lower back which can cause muscular sprain or spasm. In the worst case, it may cause the disk to break and press against the nerve leading to severe pain. If the nerve gets ruptured severely, the pain can transmit down to the bottom and legs. Most commonly, a slipped disk can happen between lumbar vertebrae 4 and 5, followed by lumbar vertebrae 5 and sacrum 1.

What lifestyle habits increase the risk of getting back pain?

What precautions should golfers take to avoid back pain?

Recreational golfers should exercise regularly, even when they don't play golf, to increasethe flexibility of their muscles. Golfers shouldarrive at least 30-40 min. before their teetime and do warm up and stretches. If theyjust arrive in time and tee off straightaway,it means that they are playing with coldmuscles and thus face a high risk of injury.If they don't have much time, they can justdo warm up exercises such as fast-walking for 15 minutes and work up a bit of a sweat. Other things to consider include controlling body weight, quitting smoking and reducing alcohol. The more overweight you are, the more pressure you are putting on the spine and disks. Obesity causes the spine to bend more than normal which is called Hyperlordotic position. The back muscles of an obese golfer work much harder to keep the spine in normal position and maintain balance while he/she swings and eventually undergo wear and tear. Smoking and alcohol decrease the flow of blood to the disks causing their premature degeneration.

Does playing for too long a time, say, two rounds of golf on a single day, cause pain in the lower back?

Yes. It is possible in respect of weekend golfers depending on the condition of their muscles. If your back muscles are in bad shape, you will face a high risk of an injury. When you are playing the game for long, your body will normally tell you if there's anything wrong. Listen to it. You can continue playing as long as there are no indications of pain.

Can a lumbar corset offer a solution to back pain?

It is okay to use a lumbar corset since it will reduce the pressure exerted on the back muscles. But it cannot prevent back pain or offer a permanent solution to the problem.

When back pain occurs during a round of golf, what should the golfer do first?

I don't recommend the use of painkilling tablets, sprays or creams to continue the game since medication may alleviate the pain but the condition of the injured muscle remains the same. If the muscle is injured, you just need to rest. The best position for relief when your back hurts is to lie on your back on the floor with pillows under your knees, with your hips and knees bent and your feet on a chair or just with your hips and knees bent. This takes the pressure and weight off your back. Normally, the pain will subside in a couple of days. Whether the pain is moderate or severe, you should stop the game and take rest. However, if the pain is very little you can take paracetamol to start with. If you still feel discomfort, you can try anti-inflammatory drugs such as ibuprofen (400 mg). But if you continue to feel pain even after 2 or 3 days, you should, without wasting further time, see your doctor