Shoulder Pain in Golfers

Shoulder pain is one of the top three most common complaints among both amateur and professional golfers. It often shows up in the lead shoulder, especially during the top of the backswing—right when that shoulder is forced to move across the body under load. But what's really causing this discomfort? And what about the trail shoulder—how does that one end up in trouble too? Let’s break down the “why” behind shoulder pain in golf and explore how we can prevent and address it.

Shoulder pain in golfers

Shoulder pain during or after golf and exercise can come from many different structural injuries. Old or new labrum injuries, rotator cuff tears and strains, biceps tendon injuries, and referred pain from the neck are among the most common. If your shoulder is bothering you during or after a round, it is important to get it evaluated to better understand the diagnosis of the structural cause of the pain. From there, we can create a realistic set of options for improving pain and function.

How to address shoulder pain in golfers

When treating shoulder pain, it is obvious that we need to understand the diagnosis. Then we can use techniques to help address the pain specifically while planning how to offload and re-load the painful structures. It is important to understand that this is only the beginning. The structural diagnosis of the pain is only a small part of the rehab process. We also need to address the function of the shoulder, what I would argue to be even more important than the diagnosis.

How to address shoulder function in golfers

Compensations, imbalances, and poor motor control and function are all critical components to address if we are going to improve pain, stop recurring injury, and improve performance. This process requires us to test and assess for the qualities of movement at the shoulder complex as a whole, even assessing for the ability to create core stability and thoracic spine mobility. Overall, we need the scapula, glenohumeral joint, rib cage, thoracic spine, and pelvis to work together to create stability and movement.

Improving scapular stability

This is key in any shoulder rehab treatment plan. The shoulder blade and humorous bone are intimately connected in creating motion at the shoulder. The way the shoulder blade moves and is capable of moving is critical in the outcome of shoulder activity and shoulder health and longevity. How do we work to improve the connect between the scapula and the rib cage to allow for full shoulder joint range of motion. We can use these positions below to help specifically address the muscles that control shoulder blade activity…

1.        Serratus prayer

This exercise helps drive awareness to the muscles that work to keep the shoulder blade held to the rib cage as it moves.

2.        DNS crowbar

This position helps cue the same muscles that control the shoulder blade, but now we are moving through a closed chain range of motion at the shoulder. This challenges the stability system around the scapula through movement.

Improving shoulder capsule mobility

This is an important quality to maintain and improve through the shoulder. If the non-contractile tissue that holds the head of the humerous into the socket of the scapula is tight and restricted, we will not be able to access full range of motion at the shoulder joint. Try these drills to help address shoulder capsule mobility…

1.        Banded shoulder joint distraction

This is a great drill to get right into the passive tissue of the shoulder complex.

2.        Heavy banded shoulder distraction and rotation

This is a great golf specific drill to help create shoulder capsule mobility through golf positions. We also get to incorporate shoulder separation from the trunk and trunk separation from the pelvis, two big qualities essential for the golf swing.

Thoracic spine mobility

Thoracic spine mobility (including rib cage) plays a major role in creating the conditions for full shoulder range of motion by creating the surface that the shoulder blade slides on top of. Also critical is the role the thoracic spine plays in creating extension and up righting of the torso. When we try to flex our shoulder overhead (think reaching toward the ceiling), if the spine cannot create a fully upright position (extension), then the shoulder will have to flex beyond 180 degrees to achieve the full overhead position. This places extra stress on the structures of the shoulder. If we have other mobility or stability issues around the shoulder, going beyond 180 degrees of flexion will already be difficult enough. Try these movements below to help improve thoracic spine mobility in rotation and extension…

1.        Kettlebell assisted thoracic spine rotation

This is a great drill that uses the help of the kettlebell and gravity to get into greater degrees of thoracic spine rotation.

2.        FRC thoracic spine controlled articular rotations

This is a great drill for building back active range of motion to thoracic spine extension and rotation. Here we do it in an open chain while bringing core stability into the mix.

Core stability for golfers

This is a critical component. Without core stability, any mobility gained at the extremities will be short lived and unlikely to translate to the golf course. Core stability creates the environment for thoracic spine and shoulder complex to move. Try the movements below to begin addressing core stability without creating more compensations.

1.        DNS 3-month supine

This is an essential starter drill to learn what it means to create intrabdominal pressure, or true core stability. This strategy for core stability create a stable lumbar spine, tucked and neutral rib cage position, and neutral pelvis position without adding excessive compression to the low back. Learn more about intrabdominal pressure with this article here “How to use your core in the golf swing.”

2.        Heavy banded takeaways

This is a great drill to incorporate many different joints from the ground up in the golf swing while cueing us to use our core musculature. Here we have to be strong through the ground, pelvis, and trunk to rotate without breaking posture.

Conclusion

Shoulder pain in golfers is rarely a simple issue—it’s often the result of multiple underlying dysfunctions. To effectively treat it, we need to look far beyond just the symptoms and get to the root cause. A truly comprehensive approach includes improving scapular stability, shoulder capsule mobility, thoracic spine mobility, and core stability. Just as importantly, motor control, dynamic stability, and neuromuscular coordination around the shoulder must be assessed and addressed. When all of these elements come together, the result is not only a pain-free shoulder, but a more powerful and efficient golf swing.

-Dr. Nick Curtis DC, MS, TPI, CSCS

If you would like to learn more about your body, pain, and performance, send Dr. Nick an email at contact@integratedrpc.com or call at (585)478-4379, or schedule a FREE discovery visit at Contact.

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