Golf After Spine Surgery: Part 1 of 2
Part I: Hitting the Links after Lumbar Disectomy
The golf swing imparts a tremendous amount of stress to the lumbar spine. This is related to the torque that is generated in the windup and follow through of a long iron or wood shot. Injuries to the lower spine are quite common in both amateur and professional golf. In fact, back injuries are the most commonly reported ailments of frequent golfers.
Learn 11 easy golf exercises to prevent back pain in our golf and back pain slideshow.
Many a great pro has been hampered by low back problems during their career, the likes of which include Freddy Couples, Rocko Mediate, Ken Venturi, Lee Trevino and others. Some of these talented professionals have even undergone low back surgery for their problems.
The good news is that despite the high incidence of spine injuries among golfers, the majority of these people have returned to swing again and swing well. This article is the first in a series that addresses how one can return to golf after having spine surgery.
Interestingly, very little has been described in the literature specifically on golf and the spine. The points and recommendations in this article are only guidelines for you and your physician to discuss. They represent an amalgam of protocols that spine surgeons experienced in treating amateur and professional golfers have created based on their experiences.
It is important to emphasize that every patient is unique and some patients may have specific limitations or anatomical pathology that does preclude returning to golf altogether. Fortunately, the majority of patients can return to the links after spine surgery provided they have an adequate recovery time.
What Type of Surgery Was Performed?
Recovery periods and activity limitations vary greatly depending on the type of surgery performed. In general, the two most common operations performed on the lumbar spine are discectomy and lumbar fusion operations. These two procedures vary greatly in terms of the length of recovery and how quickly one can return to sports activities.
Recovery after Lumbar Discectomy or Microdisectomy
Because a lumbar discectomy removes the pressure on a pinched nerve, and does very little disruption of the spine joint, one of the main guides to returning to the links is how the patient feels. Typically, if a patient is experiencing a good recovery they can begin flexibility and strength training for their low back and abdominal muscles at about four weeks after surgery.
These exercises should be supervised by a physical therapist that understands the mechanics of the golf swing. Depending on the level of the player, easy swinging with short irons can commence at about 6 weeks after surgery.
Arthur Day MD, a neurosurgeon at The University of Florida who has treated many professional golfers, points out that his recommendations regarding return to play differ significantly between the weekend warrior and the professional player.
“Because the pro imparts such a tremendous amount of torque on their spine compared to the amateur, I tend to keep pros from even touching a club for about 3 months," he says. "The average golfer tends not to transmit the same kinetic energy to their spine, and therefore can return to swinging earlier, provided they are making a good recovery.”
Once the patient has mastered low back flexibility and strengthening exercises and has returned to light swinging with short irons, they can proceed with advancing to a full swing. “I always emphasize to my patients that they must develop good stretching habits before and after playing.” Says Peter E. Sheptak, M.D., Vice Chairman at the University of Pittsburgh Department of Neurosurgery and well-known surgeon for professional athletes.
He adds “Also, in the first three months of their recovery I never let them hit a rough or sand shot. The point is when they are recovering, they have to avoid hitting the ball fat which can result in a re-injury.”
Regis W. Haid, Jr., M.D., a neurosurgeon at Atlanta Brain and Spine Care, also imparts several rules to his patients when they return to golf after lumbar discectomy. “I tell my patients walk, don’t ride a cart, and don’t hit off the tee until about 12 weeks after the surgery. Haid points out that by doing the above recommendations his patients get more exercise and avoid swinging too hard, yet still can enjoy the golf outing.
At 12 weeks after surgery most sport medicine oriented surgeons will allow their patients to return to the links but only for shorter nine hole outings. It is important for patients to understand that endurance must be regained prior to embarking on a full round of eighteen holes. Usually by 16 weeks after surgery patients can return to a full round of golf.
If a patient at any time experiences a flare-up of symptoms they should put their regimen on hold for at least 4 weeks and then begin back at step 1 with strength and flexibility exercises. In the next issue, we will discuss returning to golf after lumbar fusion operations.
Important Points to Remember
1. Always warm-up and warm-down with stretching exercises prior to any round of golf or range practice
2. Move your ball out of angled lies, thick rough, and pot bunkers rather than take the shot
3. Stop playing if you experience a flare-up of symptoms and do not resume your activities for at least a month
4. Always speak with your doctor prior to initiating any activities, particularly golf after spine surgery