by Eeric Truumees, MD

While for some of you, winter continues its icy reign, here in Austin it’s been in the mid-seventies and we are reaping the reward of our three months of 100° heat in the summer.  But soon enough, even in the Northern latitudes, your patients will be suiting up for golf.

In this issue we present an article from our occasional series Spine in Sports.  Eugene Y. Roh, MD, Michael C. Geraci Jr, MD, PT, and Matthew Smuck, MD offer recommendations for “Preseason Training for Golfers with Low Back Pain.”  The authors review the incidence of back pain in both professional and amateur golfers.  They delineate important biomechanical factors in the golf swing and note significant changes in spinal loading from the classic to the modern swing styles.Next, Roh et al provide a step-by-step clinical assessment system for golfers with back injuries.  They highlight the importance of testing the entire kinetic chain.  Then, specific rehabilitative treatment and return-to-play recommendations are given.

I’ve often recommended that golfers under my care undergo formal physical therapy and assistance with a golf pro to assess their swing mechanics before full return to play.  This paper offers an even more detailed approach.   As I read their paper, I wondered how the average physician could incorporate these ideas into practice.  Working closely with rehab specialists makes sense, but I suspect not all therapists will be adept in these techniques.  How do we identify proper therapists to meet our patients at their level of need?  The authors and I would appreciate any comments from the readership about their own experiences of back pain with golf and effective remedies and rehabilitation protocols.
In a world of decreasing reimbursements and increasing time constraints, how many physicians or therapists could or would take the time for this type of detailed assessment in the amateur athlete? As more physicians become hospital employees, they will lose even more control over the therapy services their patients receive.  The payers may see decreased utilization and some cost savings, but, outcomes may suffer…

View the entire message at www.spineline-digital.org