Anybody who has seen some of these long drive hitters knows how much torque we put our bodies through in the golf swing.  In right handed golfers, the left knee, back and often the right shoulder take the brunt of the over-use.  Virtually everybody who has played a fair amount of golf has felt these issues.

I was fortunate to have played golf for 3 years in college at UC San Diego, where our home course was Torrey Pines.  My back knows when I have been swinging pretty hard or playing a few days in a row.  

Compression and sheer are what can cause knee issues as we rotate around the golf swing.  Meniscus tears and cartilage damage are the overwhelming issues when it comes to golf related knee injuries.  

The spine is not meant for high speed rotation and we see the intervertebral disks bearing the brunt of these forces, again through compression and sheer.  

Only so much of the disc is able to be removed before the “bone-on-bone” occurs bad enough to need a fusion of one of the levels. The right shoulder gets elevated in the back swing, essentially pinching the rotator cuff underneath a portion of the scapular bone known as the acromion.

Can we prevent these issues completely?  

Probably not. Remember, everything in moderation seems to work out.  To lessen the risk to the knee, limiting the number of swings in a day to 150-175 shots on the range or combined on the range and on the course is a good idea.  

The higher the velocity the swing, i.e. drivers and long irons, the more sheer our knee will be seeing.  The deeper knee flexion angles seems to put the meniscus at risk as well.  

We see  a whole bunch of people that tear their meniscus by simply reaching over and picking their golf ball out of the hole.  They can’t understand why this one time tore their meniscus when they have been doing this for 20 + years.  Unfortunately the cushion cartilage in our knee is only about half as elastic at 40 than it was at age 20 and is susceptible to tearing with much less torque than it once was.  Sorry!

So how do we lessen our golf related knee injury risks?  

Keeping the quadriceps and hamstring as strong as we can will help us rely on the muscular anatomy rather than the bony architecture for these twists.  Limiting or controlling the overall number of swings is important.

Work on your chipping and putting for 40% of your practice time.  We could all use more time on the short game.  You will save your knee and lower you handicap at the same time.

Next time, we’ll touch more on shoulder issues in golfers!

WILLIAM (BILL) STERETT, M.D. IS AN ORTHOPAEDIC SURGEON RESIDING IN VAIL, COLORADO. DR. STERETT IS THE HEAD TEAM PHYSICIAN FOR THE US WOMEN’S ALPINE SKI TEAM AND THE MEDICAL DIRECTOR FOR THE VAIL VALLEY SURGERY CENTERS.