Posted by: Duke Raleigh Hospital | April 5, 2013

Hitting the Links? Read This Before You Tee Up


By Dr. Kevin Speer, Southeastern Orthopedic Sports Medicine & Shoulder Center

Attention, golfers: Don’t hit the links without first taking time to warm up.

Don’t give it short shrift, either. Taking a few practice swings isn’t enough. Practice swings can be part of a warm up, but they do not make for a full warm up. Effective pre-game prep will involve at least 10 to 15 minutes of stretching and include multiple parts of the body. Even using the golf club like a cane to help you stretch will benefit you. The older we get, the more important the warm up becomes.

We’re all overcommitted these days and have limited time to dedicate to physical fitness. But being a weekend warrior on the golf links, and not doing anything else for exercise the rest of the week, is asking for trouble. You’ve got to exercise at least a couple of times a week to be in shape for your Saturday golf game … and to be in shape for life.

How you lift the bag matters, too. A golf bag can weigh up to 30 or 40 pounds, so lifting and lugging it is no easy task. Just as with your swing, technique matters.

If you’re sore after 18 holes, the most readily available, over-the-counter anti-inflammatory remedy is also the most effective. Paying for a brand name isn’t necessary; taking the generic equivalent is fine. The best dosing for ibuprofen (Advil) would be 400 to 800 mg. up to three times daily. For naproysn (Alleve), the best dosing is 440 mg. once or twice daily. Take these medicines with food;  the most common side effects are stomach upset and heartburn.

Most aches and pains related to golf are tendon-based. When tendons are inflamed and bursitis develops, you need an anti-inflammatory. Applying ice to the painful area can also help.

If you’re stretching, exercising during the week and taking anti-inflammatory meds when you feel pain yet you’re still hurting, talk to a golf pro. The mechanics of your golf swing are important. A pro can evaluate your swing (and the way you’re lifting and carrying your bag) and make recommendations for subtle shifts that may make a world of difference.

These simple steps – warming up, staying fit and toned and taking over-the-counter pain relievers– will work for more than 90 percent of golfers dealing with pain.

The other 10 percent have a choice. Some people give up the game rather than have more formal treatment like physical therapy or surgery.

For diehards who will never give up their clubs, an X-ray or MRI is usually the first step. Physical therapy and occasional cortisone injections may be sufficient for the pain and provide adequate relief. You and your physician should consider all alternatives before discussing surgery.

Golf isn’t too strenuous a sport, so people who do require surgery can have predictably good results. If you do take a break from golf, my best advice for returning to the course is not to take a big divot. “You’re not playing PGA golf,” I remind a lot of my patients. The shoulder and elbow can easily be harmed when your club face decelerates suddenly – when you’re taking a divot or when your club head hits a rock or root.

Golf should be enjoyable. Take care of your shoulders and the rest of your body, and you’re more likely to enjoy your time on the green.

Kevin Speer, MD, Medical Director for the Duke Raleigh Orthopaedic & Spine Center, specializes in shoulder and sports medicine surgery. Learn more about Southeastern Orthopedic Sports Medicine & Shoulder Center here.

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