By Jennifer L. Warren
Originally published in Massage Bodywork magazine, April/May 2006. Copyright 2006. Associated Bodywork and Massage Professionals. All rights reserved.
It's one of the most popular sports in the world. In fact, between 28 million and 35 million people participate in golf worldwide. The United States alone tallies 12.8 million over the age of 18 playing it at least eight times a year. Whether it's spending a leisurely Sunday afternoon at the local par-3 course or intensely competing in a professional tournament, golfers can be spotted in impressive numbers these days. Not only have the participant numbers reached new levels, so too has the game itself. Once thought of more as a mental pursuit than a physical one, golfers have come to understand the increasing importance of the body's role.
"Today's golfers, especially the competitive ones, need to have a developed upper body," says Newburgh, N.Y.-based chiropractor John Fischer, a self-proclaimed golf junkie who works on a large number of golfers. "This whole phenomenon really started to be pushed around the time Tiger Woods came on the scene in the mid '90s and changed the game, making it a whole- body activity. Most involved in this sport are realizing if they don't lift weights and strengthen their core muscles, they will hurt themselves."
Not only can injuries surface from weak muscles, but poor technique and mechanics can wreak havoc on the golfer. The swing, requiring great rotation and compression, asks for the entire body's cooperation; if not heeded, disaster can strike. Fortunately for veteran golfers like former PGA member Jerry Impellittiere, there is a way to fight back.
"I went for massage initially because I had very tight muscles which were affecting my game," recalls the 53-year-old Impellittiere, who lives in Palm City, Fla., and plays golf almost every day, as well as takes part in tournaments like the recent Senior PGA. "The deep- tissue massage I got two to three times a week worked right away, elongating my muscles and really helping with my flexibility." Impellittiere, who has been swinging his clubs since age 10 and been a pro for the past 30 years, adds, "I would recommend massage for all golfers, as they suffer from so many different injuries which can be relieved by this means."Hot Spots on a Golfer
Germaine Jasinski has been a massage therapist at the Lansdowne Conference Resort in Leesburg, Va., for the past 12 years. During that time, she has worked on an assortment of golfers at all levels who have tested their abilities on the resort's Robert Trent Jones Championship 18-hole course. Whether it's the novice swinger or the aspiring professional, Jasinski detects some commonalities when it comes to golfer ailments.
"Golfers most commonly experience soreness around the head and neck (sprains as a result of tightening up and hitting too hard) and in between the shoulder blades," explains Jasinski, who has practiced massage therapy for the past 15 years. "Their hands, forearms, and rotator cuff muscles are usually tense, contracted, or inflamed from gripping and swinging the club."
Jasinski notes the susceptible areas of the golfer's lower body and explains how pectoral, arm, and hand muscles, along with the entire upper body, can get tense from gripping the club and rotating during the swing. The lower back, including the quadratus lumborum muscles and sacroiliac joint, are particularly vulnerable to spinal misalignment during the swing. Additionally, the golfer can be plagued by sore gluteals, piriformis around the hips that are affected by the twisting motion of the swing, tight hamstrings and calves, and sore feet from the high mileage logged walking a golf course. Knees, too, can be frequently injured areas when pressure is applied to that region while the golfer leans his weight on the front leg during pivoting. Finally, the lattissimus dorsi can take abuse when the shoulder and upper back region joins in for the rotation on the downswing and follow-through.The Golf Swing
In order to get a better idea of what the body endures, consider the proper way to hit a golf ball. Fischer, an avid golfer the past 40 years, describes the proper mechanics involved.
"You are in a neutral stance, and when you are ready to hit the centered golf ball, which is situated around mid-stance, you want to be parallel to the target line (where ball is headed)," says the 53-year-old Fischer who, despite his hectic schedule, manages to play the game at least once a week. "The first thing is to make sure to move your hands, arms, and club in one motion with a shoulder turn. Then rotate your hips while the head stays above the shoulders."
Fischer's description of the motion includes the need to bring the club up to the target line, smoothly hitting the ball in a fluid motion. Although appearing elementary on the surface, the swing itself is anything but simple.
"Most golf injuries result from poor technique and mechanics. The sport involves a great deal of rotation and compression," Fischer notes. "Therefore, it's a really good idea for any golfer new to the game to take lessons from a PGA teaching professional."
Fischer also advises mild stretching before and after play. This preparatory movement will assist with warming and relaxing muscles while helping to prevent injuries. Taking some solid, warm-up practice drives is also a necessary staple of the golfer's game, as well as an injury deterrent.
Techniques Applied to Golfers
As an increasing number of golfers are beginning to see the benefits of massage, therapists are not only discovering their susceptible areas to injury, but also the best methods of attack. One of those therapists is Glenda Chipperfield who practices out of her New Windsor, N.Y., office. Chipperfield is quick to cite three danger zones in these clients: lower back, gluteus maximus/piriformis, and shoulders.
For each, Chipperfield has an answer. When it comes to the lower back, specifically the quadratus region, she applies deep friction on the attachments, as well as assists with twisting stretches to target the quadratus lumborum. Gluteus maximus/piriformis issues are also addressed with those twisting stretches, along with compression and deep-tissue massage. Finally, shoulder ailments are counteracted with deep tissue around the shoulder girdles, rhomboids, and pectoralis attachment, along with ROM stretches and friction on attachments. On a more secondary level, foot issues typically are targeted via the toe joints, including applying range of motion (ROM)/ friction and working the fascia between the tarsal bones. Still another complaint Chipperfield sees frequently in this population is golfer's elbow. Unlike tennis elbow, which only affects the outside of the elbow, golfer's elbow leaves its mark
on the medial epicondyle.
"For golfer's elbow, I use deep transverse friction work, digging in against the tendinis attachment at the medial epicondyle of the humerus," Chipperfield explains. "It is paramount to use friction and not pressure; six to 12, 20-minute sessions every other day have a great effect on fixing this problem."
Jasinski, like many therapists who work at golf courses, includes a golfers' massage in her offerings. First assessing and prioritizing the locations of the golfer's overall pain, she proceeds to relax the head and neck muscles, working on the back with long up and down strokes, as well as moving horizontally along the sides of the spine. She concludes by vertically fanning outward from the center to the sides of the body. Moving to the arms, Jasinski strokes them from the top of the shoulders, all the way down to the fingers. She then moves from the palms up to the top of the arms, applying long, sideward, and kneading strokes. Pointing to the lower back muscles around the top of the pelvis as an area where golfer's typically torque left and right, Jasinski indicates the integral need to apply pressure to this region. Citing many of the core muscles mandatory to a golfer's game, Jasinski adds, "The feet, lower and upper legs, gluteals, and back muscles are all connected and can affect the stability and power of the stance and swing. The aim is to get the nerve signals to the brain to relax the contracted muscle fibers and to move the blood and lymph to heal the soreness, cool the body, and carry away some of the heat after a long game."
Theresa Glancy, a massage therapist at Pinehurst Golf Resort (where golf began in America in 1895), located in the Sandhills of North Carolina and home of the 2005 U.S. Open Golf Championships, observes distinctions amongst the injuries traditionally endured by golfers in the amateur and weekend ranks, as opposed to the professional ones. The less seasoned players tend to suffer primarily from strained muscles, golfer's elbow, calf, and hip issues from walking, as well as muscle strains connected to carrying heavy golf equipment.
In contrast, higher caliber players primarily possess strength imbalances in the pelvic girdle. "These level golfers typically want you to maintain these muscles, and this usually involves the movement rotation of the body; one side is tighter than the other," Glancy says. She's been practicing massage therapy for the past five years and more than half of her clients are golfers. "As a result, you want to make sure to relieve any discomfort in the back area without changing the muscular structure and affecting the swing."
Glancy notes still another trend she detects among the professional golfer ranks. "In the middle of a tournament, they tend to stick with the more relaxing type of massage," Glancy says. "Off season, they can get deeper work."
Glancy's golf resort, like Jasinski's, features a special golfer's massage option. A full-body, 50-minute session, the golfer's massage is typically a deep one that targets the client's problem areas. Including both trigger point and passive stretching, the bodywork further focuses on the lower back and scapula area, as well as the pelvic and calf regions. Recommending massage to all golfers prior to their entrance onto the course, Glancy sees such work, even when isolated to the chair venue, as a necessary way to warm up muscles while offsetting potential injuries.
It was 1984, and golf-lover Michael Gesmundo thought his chances for playing the game had come to a crashing halt after 10 years on the green. As the result of a collision, Gesmundo was thrown through the windshield of his car. Both knees were hurled into the dashboard and Gesmundo's middle and lower back also took a great impact, abruptly sidelining him. Afterward, he endured a seven-month physical therapy regime, but never really recouped. That is until his chiropractor suggested massage therapy.
"I see the massage therapist every week," Gesmundo says. "She works on all musculature that affects my golf game, such as neck, shoulders, mid- and lower back, hips, arms, legs, glutes, and hands for an hour and a half." The 62-year-old resident of Town of Newburgh, N.Y., says, "As a result, my game has greatly improved. It really alleviates the pain, especially deep-tissue massage. I may start out a bit sore when I first begin playing, but after a little bit of stretching, I can pretty much play pain-free."
As a regular player in seniors' tournaments, Gesmundo is acquainted with many others who take the massage therapy route and says he's heard nothing but positive feedback from them on their bodywork experiences. An appropriately trained therapist is key though. "You need to make sure to find the right one," he adds.
For Gesmundo, that right one was Kim Fischer -- John Fischer's wife and a licensed massage therapist for the past eight years. In fact, about 40 percent of her clients are golfers. Initially she analyzes the clients first to locate the origin of their pain and stiffness, then Fischer follows a typical massage protocol of effleurage and petrissage to warm and increase circulation to tissue (musculature). She then proceeds with muscle stripping (parallel friction) to lengthen tissue, while breaking down any adhesions the client may possess. The session concludes with good stretching applied to each worked area.
Fischer is a strong advocate for yet another technique when it comes to golfers. "I am a big fan of jostling when working on the gluteals, sometimes for as long as 15 minutes on each side, she says. Fisher is also a firm believer in post-massage ice application to alleviate any resulting soreness and inflammation. "Jostling really helps tire out those muscles, sometimes even evoking a total release."
Her husband, John, is a regular, appreciative recipient of her work. "Massage has increased my flexibility and prevented injury; when I had tight hamstrings, strained lower back muscles, as well as
rotator cuff and hand issues, it substantially quickened my healing time," he says. "For example, rather than a sprain/strain lasting 14 days, I was good to go and play golf comfortably in just two days as a result of the increased circulation to those affected muscles."Ahhhh, Golf
Speak to enough golfers and you will begin to understand why the sport is so popular. Golf welcomes participants of all ages and abilities and offers them beautiful outdoor settings and plenty of exercise. The four to five hours needed to play a typical round provide an ideal platform for socializing, networking, and just plain entertainment. Although every swing, whether a drive, putt, or chip, requires great concentration, the sport provides a level of challenge we are all seeking in one way or another.
"The No. 1 reason people play golf is for the relaxation it offers," John Fischer explains. "It is a wonderful stress-reducer that is very addictive and just plain fun."
Of course, players will do whatever it takes to play as pain-free as possible. Is it any wonder they're turning to massage? Jennifer L. Warren is a New York-based freelancer writer who shares a special interest in bodywork and wellness.