Name | : | Marwa binti Abd Malek. | | | | Title of article | : | The Lumbar Spine and Low Back Pain in Golf: A Literature Review of Swing Biomechanics and Injury Prevention. | | | | Author and Brief Background | : | 1) George S. Gluck, MD. * Works as an Orthopaedic Surgeon at Hand Center of Nevada, Comprehensive Upper Extremity Care from Hand to Shoulder * Member of the American Academy of Orthopaedic Surgeons. 2) John A. Bendo, MD. * Works as a Clinical Associate Professor and Vice Chair Clinical Affairs at Departments of Orthopaedic Surgery (Ortho-Spine Surgery Div) and Hospital for Joint Diseases. 3) Jeffrey M. Spivak, MD. * Works as an Assistant Professor at Departments of Orthopaedic Surgery (Ortho-Spine Surgery Div) and Hospital for Joint Diseases NYU Orthopaedic Surgery Associates. | | | | Journal Title and Vol. Number | : | The Spine Journal 8 (2008) 778–788. | | | | Date of submission | : | 3rd January 2013 |

MY REVIEW
Introduction
The article informs readers that golf swing causes great impact to lumbar spine and it lead to low back pain (LBP) among golfers. It also educate readers the details of the study on less injury swing technique, causes of LBP among golfers, the treatment and prevention techniques. It stated that the prolapsed intervertebral disc (PID), muscle strain and facet joint capsule trauma will occur when the spine is given loads of 5,448N in flexion extension movement together with rotational movement. During golf swing of amateurs, about 6,100N of compression loads are transferred to the spine, while professionals produce about 7,584N. Therefore, the golf swing technique is definitely the major cause of LBP among golfers. There are generally two types of swing techniques which are “modern” swing and “classic” swing. The modern swing is commonly used as it produces more distance, power and velocity for the ball, however, the technique causes pressure to the spine. It increased lateral bending (“crunch factor”) of the spine and exaggerated hyperextension (“reverse C”) on follow through, hence lead to LBP. Moreover, this technique causes hyperextension and lead to spondylolysis. In contrast, the classic golf swing emphasizes balance of the both shoulder and trunk muscle, promotes upright form, and reduces the “crunch factor”. Thus, this technique is good as it is proven to not cause LBP. Instead of ice, rest and medication, the important treatments for LBP among golfers are flexibility exercise and conditioning exercise of the core muscles. The treatments should focus on multifidus and transverse abdominis muscle. For multifidus muscle strengthening, in prone and quadruped position, do alternately forward flexion of one shoulder and extension of the opposite hip simultaneously. For transverse abdominis muscle strengthening, in supine lying position, do contraction with the knees bent. Also in supine position, slowly pull the umbilicus towards the spine without contracting the rectus abdominis muscle. Those should be done in 3-4 sets of 10 repitition and hold for 5 seconds (gradually increase until 30 seconds hold). Other than that, the flexibility and strengthening exercise is necessary to prevent loss of flexibility and prevent degenerative joint disease. It should be done to all muscle involve during golf swing, which are erector spinae, rectus aabdominis, external oblique, internal oblique, latissimus dorsi, quadrates lumborum, psoas major, pectoralis and gluteus maximus. If those treatments are not working, lumbar discectomy and lumbar fusion will be the last choice. To prevent LBP, golfers should practice the classic technique. The technique involves shortened, front heel raise and increase hip turn during backswing. It also has reduced “crunch factor”, erect “I” finish and balanced shoulders during acceleration and follow through. If modern golf swing technique is necessary to be used, golfer should do more flexibility exercise and lumbar stabilization conditioning exercises. Secondly, golfer should have more upright stance by standing closer to the ball to prevent LBP. Thirdly, always warm up prior playing. The warm up should involve movement like jumping jacs and slow jog, stretching, swinging and hitting balls before play. Fourth, avoid carrying the golf bag as it can cause injury to lower back, shoulder and ankle. Last but not least, always do flexibility and lumbar stabilization conditioning exercises.

Development
Key points: The key points for this article are lumbar spine, low back pain, injury prevention, golf swing and biomechanics. I found those key points are really striking and interesting because I thought that golfers is not in high risk of getting injury. Previously, I was thinking that medial epicondylitis (also known as golfer’s elbow) is the only repetitive injury happening among golfers. Moreover, I assumed that golf is relatively simple activity and less physically demand of movement compared to most sports. However, I realized that my perception is definitely wrong as I read this article. The most common musculoskeletal problem among golfers is LBP. Furthermore, the force generated during golf swing is really high, thus, improper technique will cause back pain. In addition, the golf session done during Sports Acivity: Individual subject a few weeks ago causes ache and uncomfortable movement at my back for few days. It shows that the right posture, technique and core muscle conditioning are necessary for golf sports. The key points are really relevant to my role as a teacher as it gave a really beneficial information which are the common musculoskeletal complains among golfers, causes, the right technique, treatment and prevention of LBP. As I know much about that, I can apply it in future as a teacher. Instead of golf, the key point information is really helpful for other sport as well. I am strongly agree with this article as it is an eye-opener for readers on matters that interferes golfers. The methods used in finding the right technique for golfer is really accurate. The data and examples given are quite clear and easily to understand. Besides, ample references were used in finding causes. However, I recommended that the writer should put much more techniques used by golfers so that they will know which one is harmful and which one is not. By reading this article, it influenced me in thinking more deeply about my assumptions in sports injury. Previously, I thought that ligament tear and sprain might be the most avoidable injury as it is common among sports people. I also thought that golfers do not have that high risk of injury compare to other aggressive sport. However, this article taught me that LBP is such a serious case among athlete and it could totally ruin their performance. Thus, prevention of it is really important. The information given in this article helps me in enhancing my teaching and learning strategy. I can use the information given while I become a teacher or school coach in future. Instead of golf, the information can be used in other sports as well. Most amateur athlete is a school student and they really need much assistance and guidance. Injury may interfere their sports performance, hence lower their passion towards sports. Thus, educating them the right skills and injury prevention technique is my necessary job. Furthermore, always educate them the injury risk, causes and treatment of required sports. Conclusion In conclusion, I had found such a useful insight related to my role as a teacher in future. For whatever sports that I involve in future especially golf, I need to know the consequence and risk of it. Instead of getting to know the skills of each sport, I also need to take care of the related injury that might happen. Thus, the training programme will be much more effective and probably less trauma happen. The knowledge will definitely be used in future and so to other sport. I will keep on remind myself and my students prior to training. For example, badminton player is at risk to get tendon achilles rupture, football player mostly at risk of ACL tear and hiking may cause chondomalacia patella. Thus, by thinking of that risk, I will be more aware in reminding my students to not doing any unsafe movement as well as always practicing the right techniques. To expand my knowledge in relation to this article, I need to find further information about other injuries might happen to golfers, such as medial epicondylitis, lateral epicondylitis, hamate fracture, De Quervain’s tendinitis, adhesive capsulitis of the rotaor cuff as well as other sports related injury.