Does low back, hip, or other pain keep you from achieving all you can on the course? Do you lose consistency on the back nine due to soreness and pain?

The golf swing is all about efficient energy transfer: lower body into the hips joints of the spine into the shoulder girdle down the arms to the golf club and finally released into the golf ball. If any one of the joints involved is injured, or not moving effectively, your handicap will suffer.
Many avid golfers contort their bodies into oddly twisted postures, generating a great deal of torque. Couple this motion with a bent-over stance, repeat 120 times over three or four hours, add the fatigue that comes with several miles of walking, and you’ve got a good workout... and a recipe for potential lower-back trouble.

“Most golfers go until they get hurt, then look for help,” says Dr. David Stude, member of the ACA Sports Council and founding fellow of the National Golf Fitness Society. “Back pain is a warning sign that there is an underlying problem responsible for a symptom that will likely get worse. Doctors of chiropractic look for the cause of the symptom and help reduce the likelihood of future injury.”

If you take the chiropractic approach, you’re in good company. According to Dr. Stude, Tiger Woods says that lifting weights and visiting his chiropractor regularly have made him a better golfer. When you consider the spinal rotation that goes into a golf swing and the fact that the speed of the club can reach 160 km/hour, it’s easy to understand that golf puts significant stress on the body.

I’ve added a few tips to Dr. Stude and the American Chiropractic Associations suggestions to help you avoid back pain or injury and improve your game:

Every golfer should include strength-training exercises in their routine. Strengthening all major muscle groups is essential to maximizing your performance. Core body strength and flexibility helps breathing and oxygen flow, as well as preventing injury to your back. Muscle is also an important shock absorber that helps prevent strains and sprains.

Purchase equipment that fits. Don’t try to adapt your swing to the wrong clubs: A six-footer playing with irons designed for someone five inches shorter is begging for back trouble.

For the women in golf: If you have “inherited” your husband’s or significant other’s golf clubs, they might be difficult for you to use. Not only are the clubs often too long, but the shaft is often not flexible enough for a woman’s grip. Women typically play better with clubs that are composed of lighter, more flexible material, such as graphite.

It is a good idea to spend some extra time performing quality stretches-before and after your game-to increase your trunk flexibility. Flexibility will maintain a more even and consistent swing plane and thus improve the likelihood of more consistent performance.

For senior golfers: If you show some signs of arthritis in the hands, consider a larger, more specialized grip for added safety and performance.

Take lessons. Learning proper swing technique is critical. At the end of the swing, you want to be standing up straight the back should not be twisted.

Wear orthotics. These custom-made shoe inserts support the arch, absorb shock, and increase coordination. “Studies show custom-made, flexible orthotics can improve the entire body’s balance, stability and coordination, which translates into a smoother swing and reduced fatigue,” Dr. Stude says. While the upper part of a shoe may score style points, what the foot rests on affects your game.

Golf requires long periods of standing. Frequently alternate your weight from one foot to the other or rest one of them on your golf bag or cart.

Avoid metal spikes. They tear up greens and can increase stress on the back. Soft shoes or soft spikes allow for greater motion.

Warm up before each round. “Stretching before and after 18 holes is the best way to reduce post-game stiffness and soreness,” says Dr. Stude. Take a brisk walk to get blood flowing to the muscles then do a set of stretches. To set up a stretching and/or exercise routine, see a doctor of chiropractic or golf pro who can evaluate your areas of tension and flexibility.

Push, don’t carry, your golf bag. If you must carry your golf bag, use both shoulders straps. This will spread the weight across a greater area. If there is only one strap, alternate sides frequently. Carrying a heavy bag for 18 holes can cause the spine to shrink, leading to disk problems and nerve irritation. If you prefer to ride in a cart, alternate riding and walking every other hole. Bouncing around in a cart can also be hard on the spine.

Keep your entire body involved. Every third hole, take a few practice swings with the opposite hand to keep your muscles balanced and even out stress on the back.

Drink lots of water. Stay hydrated. Dehydration causes early fatigue, leading you to compensate by adjusting your swing, thus increasing the risk of injury. Drink plenty of fluids before, during and after your game. Sorry, beer does not count. Remember that once you are thirsty, you are already starting to dehydrate. Dehydration affects your energy level and your physical functioning.

Take the “drop.” One bad swing-striking a root or a rock with your club-can damage a wrist or jar your spine. If unsure whether you can get a clean swing, take the drop.

Lastly, have fun. The right attitude is good for your performance and your overall health! And remember, always shout, “fore”!