Golf is a sport practiced all over the world which is rapidly gaining more and more popularity.
Recently, following the increased interest, numerous scientific studies have been carried out aiming to identify the key factors influencing golfing performance and the main risk factors of injury.
In this regard, golf is considered a low-impact sport and many golfers practice this discipline as a form of exercise at a recreational level.
The social environment also carries a great importance amongst participants practice at this level. Golf is very popular for more older generations, and it is often recommended as a means to increase activity levels, and to help recover following a total knee arthroplasty (TKA) (McGrory et al., 1995).
However, the incidence of knee injury in golf is comparable to that of high-performance impact sports such as basketball (Borowski et al., 2008). In fact, the situations in which elevated loads occur on the joints, directly relates to the lower limbs. However, chronic and acute injuries are frequently reported in golf, involving in particular the lower back and the knee (Gosheger et al., 2003).
From the literature, a general consensus seems to be emerging regarding the likely association between accidents in the golf and poor or inconsistent techniques repeated over time. Most scientific studies on golf injuries have dealt with those related to the knee.
The main injuries for golfers
Studies have shown that older amateur players are at greater risk of knee injuries compared with younger players (Fradkin et al., 2005). The idea that players may be subject to trauma as a result of the aggravation of previous pathological conditions is consistent with the results of multiple studies. In fact, Gosheger et al. (2003) reported that 31.3% of the players who experienced chronic knee pain before golfing, reported that the practice made the symptoms worse.
The effects of golf on young golfers
Since most of the studies carried out so far have focused on adult golfers, the effects of the game and its practice at a young age have not yet been well documented. According to Cabri et al. (2009), younger players are rarely exposed to conditions that promote injuries to the skeletal muscles or joints; however, this is not the only way to prevent these injuries.
Short review of golf literature
Golfers examined by Batt (1992) attributed their injury to incorrect knee swinging, to a technique of wrong shot or irregular support on the ground. Other authors reported that 95.7% of the players felt that their knee injury was due to excessive practice. Additionally further studies have shown that the impact with the ball (30.4%), the follow-through (38.5%) and the swing phases were the most common points in which injuries occurred.
- Rapid extension of the knee that occurs at a flexed joint between 0° and 30°
- Remarkable internal tibial rotation
- At low flexion angles, the activity of the posterior muscles of the thigh is ineffective in the actively curbing anterior tibial displacement and thus contributes primarily to increased joint compression
- strong quadriceps activity contributing to a high joint load
In several surveys, the average age of injured golfers was very high, with a survey revealing that players between the ages of 60 and 65 were at the top of the list risk of injury to the lower limbs compared to other younger practitioners (Baker et al., 2017).
Unfortunately, information on the dominant limb has not been reported in this survey and in general it could be assumed that the sample examined was right-handed and that these lesions were are then verified in the opposite (left) knee.
Finally, the effects of fatigue should also be considered when attempting to identify risk factors during golfing. Vandervoort et al. (2012) highlighted that walking to cover the game distances provides an opportunity to maintain a certain level of cardiovascular fitness, however, during a game, this can contribute to a better greater tiredness, especially in older players.
Golf and injuries related to arthroplasty
Some studies show that amateur golfers active after TKA, about 15.7%, have mild pain while playing golf, while 34.9% only experience pain after playing. In a studio conducted by Mallon et al. (1996) 3 professionals and 39 amateur golfers with TKA were interviewed after returning to golf. In this analysis, professional players did not report pain or pathological conditions in the next 4 years.
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