Patient Case Study: How Tom Put An End To His Lower Back Pain

If you live in Southwest Florida, you know how popular the sport of golf is to the area. From the youth athlete, to a group of businessmen closing a deal, to the retired couple picking up a new hobby together, golf is a game for everyone at every level.

It can help relieve stress (or cause it after a bad round), keep you active, and it’s a great way to socialize with your friends.

However, golf can be and often is a source of injury and pain. Many golfers have to take time off from playing or play less frequently than they would like to, due to pain. Some who love the game have had to avoid it all together because of injury.

Have you ever heard someone you know say “If it hurts, just stop doing it?”

Well, if that something is golf or another activity that you really enjoy, I say “don’t stop; let’s find out why it hurts and fix it, or at least find a way around it, so you can keep doing what you love”.

Back In Motion Physical Therapy & Performance can help you find the right way to get back in the swing of things and back out on the course without the pain.

Here is the story of how one of my clients, Tom, was able to put an end to his chronic low back pain while golfing.

Tom Had Lower Back Pain Every Time He Played Golf…

Tom is retired, a member of a local golf club here in Fort Myers, and an avid golfer.

Tom plays in his men’s league and has a low handicap, which means he’s a very good golfer.

As with any sport, golf requires repetitive and efficient practice to maintain a good score. This requires a lot of muscle strength and endurance, as well as really good mobility of the joints in the hips and the vertebrae of the spine.

Since golfing can be an explosive and torque-producing activity, it puts a lot of stress on the spine, and incidences of injuries and joint pain are quite common among golfers.

In golf, the hips and thoracic spine can become extremely tight, forcing the lower back to compensate for this loss of motion and increased torque. This makes the golfer more susceptible to low back compression and torsion-related injuries.

Tom was one of those golfers. Tom would have lower right back pain every time he played.

The pain wasn’t terrible when he started the round, but by the time he was on the turn (after 9 holes), the pain would start causing him to change his swing, take a few shots off, or sometimes even force him to quit altogether.

Tom was not ready to give up golf because of his back pain. He tried physical therapy, chiropractic, and injections from MDs.

He said all of those options helped in the short term, but nothing solved his pain when he got back out onto the course.

Without prior specialized knowledge and experience, it can be difficult to pinpoint the exact cause of this type of condition and provide appropriate treatment to deal with it.

That’s what Back In Motion Physical Therapy & Performance was able to provide to Tom: Specialized care, unlike the generalist approach that other healthcare providers had offered him in the past.

Tom knew something had to be out there that could help him. He knew he could find the right professional. Tom contacted Back in Motion, hoping it would be what he was looking for. He found out that he was in the right place at his very first appointment.

Initial Evaluation

Back in Motion has its own diagnosis and treatment process called the Gray Method™, named after its well-known founder, Dr. Scott Gray.

It starts with a general and then expands to a specialized evaluation, to provide an accurate diagnosis of the patient’s issue. This method does not stop with the diagnosis; it digs deeper to find the precise root cause for the condition.

The thing with muscle and joint injuries is that they can be caused by a lot of different incidents or physical conditions. A back problem can be caused by things like muscle strain, tendonitis, stenosis, discs, ligament strains, arthritis, and fractures.

In Tom’s case, it was right-sided facet compression and arthritis.

Facet arthritis refers to the deterioration or breakdown of the relevant joint in the spine that connects two vertebrae together. There is one facet joint on the left and right sides of each spinal segment.

Tom’s lateral facet joint was inflamed and that was the reason he couldn’t golf as freely as he wanted to.

Fixing the Cause

After the extensive evaluation process by Back in Motion, we found that Tom’s cause for pain was due to increased compression and torsion of the right side facet joints of the lower lumbar spine during the golf swing.

This was due to compensation in Tom’s swing that actually stems from immobile and weak hips.

Tom showed what in golf we call early extension and sway, during his swing. These two swing faults cause a golfer to side bend and extend too much in the spine, creating a significant increase in compression.

With someone like Tom, who already has arthritis in his spine, this increase in compression can irritate the joint and create pain both during and after golf.

The treatment was, therefore, designed in a way to help him strengthen his gluteal muscles and improve his hip rotation to allow for a more freely moving golf swing and providing some decompression of the spine, which allows the joint to heal properly.

Stretching exercises of the antagonistic muscles (the abductors) and exercises to strengthen the lateral hips were also prescribed.

Facet joint injuries can be tricky to deal with. They are usually caused by increased compression, lack of synovial fluid movement, and inadequate mobility/stability of the spine. These joints’ well-being depends on proper movement mechanics and stabilization of the surrounding musculature.

Resting the joint is only going to reduce the pain and heal the tissue until it is put into that provocative position again.

Facet injuries usually need careful examination and continuous observation to keep the treatment consistent with the level of progress being made.

At Back in Motion we are well aware of and have considerable experience with these technicalities. We have designed specialized exercises that are focused on strengthening the hip muscles, increasing trunk stability, and attaining enough mobility to let golfers like Tom keep golfing.

We started the process with a logical sequence of low load and higher repetitions to advance the progress and then evolved the program to become more dynamic and explosive with time, to support Tom’s favorite sport – golfing.

By identifying and dealing with the root cause of the hip problem, i.e., the muscle weakness, we were able to ensure that the hip pain would not recur under the same circumstances.

How is Tom Doing Now?

After about 8 weeks of thorough Physical Therapy and care, Tom is now back to golfing pain-free!

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He now has the toolset to maintain his health, stay active, and remain competitive on the course.

Are you suffering from a problem like this or something similar?

Check out how you can hit the ball longer, more consistently, and pain-free…. So you can bomb it down the fairway past your friends! (Even if you've never held a golf club in your life!)

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