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Case study
Abstract
Providing information regarding the use of physiotherapy or related musculoskeletal conditioning to improve a sporting technique requires
experience of the sport in question, and knowledge of relevant research evidence and functional anatomy and their application to the sport.
Physiotherapists and other rehabilitation providers working with athletes must also ensure that they are working to the specific requirements
of the athlete and coach.
This case study outlines the effect of physiotherapy intervention over a 2-year period on the swing of a professional golfer. The essential
components required to produce a good result when treating sports injuries are highlighted. Such components include a detailed discussion
between the golfer, coach, and physiotherapist, the use of digital performance analysis, and the application of relevant musculoskeletal
profiling. Taking this approach provides a platform on which to devise an appropriate exercise intervention.
q 2005 Elsevier Ltd. All rights reserved.
Keywords: Golf; Musculoskeletal profiling; Sports injuries; Sports skills
1. Introduction
After 7 years experience of working with regional,
national, junior, and adult elite amateur golfers, I was
approached by a Professional Golf Association (PGA)
coach to provide an opinion on whether any aspect of
physiotherapy or related musculoskeletal conditioning
could improve the swing technique of a 30-year-old female
professional golfer.
The golfer, a naturally right-handed player who played
with right-handed clubs, played on the Womens European
Tour and frequently received physiotherapy treatment and
massage, mainly for the upper limbs and cervico-thoracic
spine, from physiotherapists working on the Tour and in her
local region. Due to the constant travelling to competitions,
however, the golfer was seldom at home long enough for
underlying causes of injury to be identified and adequately
addressed.
* Tel.: C44 7770 236 226.
E-mail address: physiolynn@aol.com.
1466-853X/$ - see front matter q 2005 Elsevier Ltd. All rights reserved.
doi:10.1016/j.ptsp.2005.01.003
The golfer and her coach had decided that the priority
during the winter (non-competitive) training season would
be to modify her swing, in particular to develop a better
swing plane. Observing the golfer work with the coach,
followed by a musculoskeletal profiling session, highlighted
several areas that might benefit from physiotherapy
intervention. In general, these were a kyphotic thoracic
posture, reduced thoracic mobility, reduced stability and
control of scapulothoracic and lumbopelvic regions, and
weak lateral rotator cuff and abdominal oblique muscles.
These areas of concern are detailed more specifically under
the assessment section of this paper. In order to fully
understand the relationship between the golf swing and
physiotherapeutic methods a brief review of relevant
literature follows.
2. Review of literature
Reviewing relevant papers on common golf injuries (e.g.
Batt, 1992, 1993; Brendecke, 1990; Burden, Grimshaw, &
Wallace, 1998; Burdorf, van der Steenhovenm, & TrompKlaren, 1996; McCarroll, Rettig, & Shelbourne, 1990;
Metz, 1999; Nissinen et al., 2000; Seaman, 1998; Theriault
98
3. Initial contact
3.1. Assessment
The golfers local physiotherapist had suggested that the
golfers posture was too kyphotic, that she had poor weight
99
3.2. Treatment
A regime of exercises was developed to address the
issues found on assessment. In particular, emphasis was
placed on the importance of improving trunk rotation
(Booth & Forrest, 1999), lumbar/pelvic control, and
scapulae stability and control (Moseley, Jobe, Pink, Perry,
& Tibone, 1992). Moseley et al. (1992) used EMG analysis
on nine healthy subjects with no shoulder pathology to
evaluate exercises in their ability to strengthen the scapular
muscles. For this golfer, the exercises suggested by Moseley
et al. (1992) were modified to avoid glenohumeral flexion
above 908 to reduce the risk of impingement of the humeral
head against the anterior labrum. The range of shoulder
flexion was slowly increased as the concentric lateral rotator
cuff strength improved. A resistance cord was also used to
strengthen the lateral rotator cuff muscles, in order to
develop the posterior biased shoulder described by Davies
100
5. Conclusion
The golfer has resumed competition on the European
Tour, has had no reported recurrence of the shoulder
problems, and has performed well during tournaments.
101
Acknowledgements
This case study was written as part of the authors
submission to the British Olympic Associations (BOA)
Physiotherapy Register.
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