CHAPTER 84 • GOLFING INJURIES 499a. Counterforce bracing can help provide a reac-
tive force against the contractile muscle and
either spread the force over a wider area or
decrease the contractile pull on the epicondyle
(McCarrol, 2001).
b.Equipment changes such as graphite shafts can
help to decrease the force applied to the fore-
arm by decreasing the amount of vibration at
impact.
c. Physical therapy can focus on forearm muscle
strength, flexibility, and endurance (McCarrol,
2001).HAND AND WRIST INJURIES
•Tendonopathies are the most common problems seen
in the golfer’s wrist and are typically secondary to the
repetitive movements generated during the golf swing
and stress at impact.
- The lead wrist is injured more frequently than the trail
wrist because of increased stress with more forceful
contact with the ground at impact (McCarrol, Rettig,
and Shelbourne, 1990). - DeQuervain’s tenosynovitis involving the first dorsal
compartment is a common condition affecting golfers.
This results from repeated impact between the club
and the ground. The ulnar deviation of the leading
wrist at ball impact may stress the tendons in the first
dorsal compartment. Poor swing mechanics in which
a golfer may prematurely uncock the wrist at the
beginning of the downswing rather than during accel-
eration and ball striking may result in ulnar deviation
of the lead wrist too early in the swing. This prema-
ture ulnar deviation of the lead wrist can trap the lead-
ing thumb between the trailing hand and shaft, which
will stress the tendons in the first dorsal compartment
(McCarrol, 2001). - Other tendon groups that may be injured by improper
swing mechanics are the extensor carpi ulnaris of the
leading arm and flexor carpi radialis and ulnaris of the
trailing arm. Hitting a fat shot, which means that the
club head strikes the ground too far behind the ball,
specifically impacts these tendon groups.
•A traumatic cause of hand and wrist pain in a golfer is
a fracture of the hook of the hamate.- They account for 2% of all wrist fractures but 33%
of hamate fractures are found in golfers (McCarrol,
2001). - They are the most common fracture in golf.
- These occur with the club head striking a rock, tree
stump, or too much turf. The butt of the club then
impacts into the hypothenar eminence of the lead
hand.
4. Carpal tunnel view is the best X-ray view to visu-
alize this fracture. If it is not visible on plain film,
then computed tomography(CT) scan is the image
of choice (Metz, 1999).
- They account for 2% of all wrist fractures but 33%
- Preventive measures include proper club length with
the butt of the club extending slightly beyond the
palm of the leading hand rather than dig into the
hypothenar eminence.
HIP INJURIES- The most common hip problem seen in golfers is
trochanteric bursitis, which is an inflammatory condi-
tion of the bursa overlying the greater trochanter and
is usually caused by rotation of the hip during prac-
tice, overuse in the frequent golfer, and combined
with walking on uneven terrain.
•Treatment involves rest, physical therapy, anti-inflam-
matory medications, and possibly injection.
KNEE INJURIES- Knee injuries are not frequently seen in golf; however,
when they do occur, they are the result of a valgus
stress placed on the trail leg during downward swing
and acceleration. The valgus stress combined with
knee flexion and rotation can be a cause for meniscal
pathology. - Other knee injuries, such as strains, can be caused by
a combination of environmental factors, such as hilly
terrain and wet grass causing a player to slip while
walking.
SKIN DISORDERS- Skin cancer is more likely to occur in individuals
with fair skin, who sunburn easily and who have
increased exposure to ultraviolet(UV) light. Golfers
spend the majority of their time in sunny locations
and often play in the middle of the day when the UV
light is most damaging to the skin. Prevention rec-
ommendations are that golfers protect their exposed
skin with sunscreens and clothing that block these
harmful rays.
PSYCHOLOGIC DISORDERS- The yipsare an involuntary motor disturbance that
affects some golfers. This disorder is described as
jerking or spasm of the arms that primarily occurs