Introduction
This neat little South African study was published a few weeks ago and reinforces what we service providers have been giving to golfers for years, pioneered by the work of the late great physiotherapist Ramsay Mcmaster. That is to free up the hip flexors with trigger point therapy, eg. Direct pressure, either by a therapist or with a solid massage ball yourself, and then follow it up with some stabilising rotational exercises, in this study they used a simple medicine ball standing rotational movement. It seems that following these two steps allows the pelvis to rotate further through impact as the iliopsoas and iliacus muscles exert less compression on the spine, whilst the medicine ball exercises would increase the muscle activation of the stabilisers around the pelvis, such as the gluteal muscles providing greater integrity and ability of this area to absorb force and move effectively under the load of the golf swing. The net result of this is to reduce the requirement of load through the lumbar spine at impact, where previous research has shown between 6 and 8 times our body weight in shear force is exerted on our lumbar spine with driver in hand! Enjoy the summary of this article below…
Article Title
Quinn SL, Olivier B, Wood W, Naidoo V. ‘The effect of trigger point therapy and medicine ball exercises vs trigger point therapy and stretching on hip rotational biomechanics of the golf swing’, South African Journal of Physiotherapy 2016, p73-82.
Background
Elite golfers sustain a large number of lumbar spine injuries. Poor rotational biomechanics, which may occur as a result of a shortened iliopsoas muscle, increase the incidence of lumbar spine injuries in golfers. Stretches and medicine ball exercises are often used as part of golf training programmes in an attempt to restore hip flexor length and improve rotational biomechanics. The aim of this study was to ascertain the effect of a combination of trigger point therapy and medicine ball exercises compared to a combination of trigger point therapy and stretching on rotational bio-mechanics of the golf swing. This is a randomised controlled trial consisting of two experimental groups (trigger point therapy and stretching vs. trigger point therapy and medicine ball exercises) and one control group (no intervention). Hip flexor length and 3D biomechanical analysis of the golf swing was performed at baseline and one week later.
Results: One-hundred elite male golfers participated in this study. Rotational biomechanics, specifically downswing hip turn in the group that received trigger point therapy combined with medicine ball exercises, showed statistically significant improvement at reassessment compared to the control group (p=0.0328).
Conclusion
Rotational biomechanics (downswing hip turn) improved following a combination of trigger point therapy treatment and a one week programme of medicine ball exercises. This is postulated to have occurred through neural reorganisation and not through improved tensile muscle strength. This improvement in rotational biomechanics has the potential to decrease lumbar spine injury incidence in elite golfers. This study advocates the use of trigger point therapy combined with medicine ball exercises in the treatment of golfers with shortened hip flexors.
Personally, I have found the most effective way to release the hip flexors yourself is face down with small massage ball either placed or taped to a foam roller (for greater elevation) and then dig into your hip flexors at the femur end. The other way is to lay face up and place a kettle bell on top of a massage ball on top your hip flexor, hold it steady and then move your leg to provide friction to your hip flexors, thereby reducing tension in them. Follow this up with glute activation in standing and rotation and your hips and back will feel great again!