Introduction to Golf Rehabilitation and Performance: 90 Percent Mental, 90 Percent Physical: Summary 42
CASE STUDY Background: Golfer A plays 2 times a week at local public courses. His handicap is 25. His typical miss is a push. He wants to minimize bad shots and improve ball strike. Patient intermittently struggles with low back pain and has a prior history of bilateral shoulder arthroscopy and lumbar microdiscectomy. Swing Analysis • Set up: Right elbow bends early; club head
First Session • Exercises: Hooklying breathing, standing heel rockers, wall hinge • Swing Integration: ○ Reach: Create width in the takeaway ○ Hands high: Improve left side bending and thorax rotation ○ Belt buckle left: Improve downswing rotation • Results: Inconsistency in golf performance continues but more good shots overall; less low back pain during and after rounds Progression 1 • Exercises: Wall hinge walk, declined frog on elbows, box squat with 45 reach • Swing Integration: ○ Reach ○ Side bend ○ Belt buckle to the left • Results: More consistency with ball striking, scoring better; no low back pain during or after golf Progression 2 • Exercises: front foot elevated split squat with toe reach, side lying screwdriver, backward walking cross connect • Swing Integration: ○ Reach ○ Side bend ○ Belt buckle to the left • Results: Happy with progress in consistency, seeing an increase in fairways hit and greens in regulation, lower scoring; no reoccurrence of low back pain; would like to continue to hit further Progression 3 • Exercises: single leg deadlift, landmine press, medicine ball rotation wall toss • Swing Integration: ○ Reach ○ Side bend ○ Skip the rock
inside the hands early in the backswing • Top of Backswing: Knee is collapsing in; reverse spine angle with body leaning toward target; does not have a lot of left side bend (potentially standing up too much); left arm goes through R shoulder but triangle space between hand and shoulder (indicating rotational limitations); left shoulder has not turned fully and is pointing in front of the ball • Impact: Has some flip instead of a flexed wrist and hands are a little behind the club; no flexion of trunk with minimal rotation • End Position/Follow Through: Cannot see the full bottom of foot; decreased rotation through shoulders Strength and Range of Motion • SLR: 60/80 • Hip: ○ ER: 70/80 ○ IR: 0/0 ○ Flexion: 100/130 • Adduction drop test: +/+ • Passive abduction raise test: +/+ • Foot: ○ Subtalar eversion—limited bilateral • Shoulder:
○ ER @ 0: WNL ○ ER @ 90: WNL ○ IR @ 90: 80/70 ○ Horizonal Abduction: 20/30 • Cervical:
○ Lower cervical rotation: 10/20 ○ Cervical side flexion: 10/10 • Intervention: Visits every 2 weeks; compliant with HEP
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