The Cervical Rotation Test

This week we are talking about neck mobility and its connection to the swing. It may seem like there is little that neck rotation plays in the golf swing, especially if we are doing a good job of keeping our head down into the follow through. Where cervical rotation comes into play for golfers is as we rotate the trunk below us, we are essentially rotating the head the opposite direction to keep that neutral position. So, as we pull back for the backswing, we are rotating our trunk to a position that requires nearly full cervical rotation range of motion in the opposite direction. The same is true for the follow through. If we don’t have this range, we not only mess with the visual plane and connection to the ball, but we also create compensations impacting our posture and create the conditions that increase our risk for musculoskeletal injury and disc injuries in the cervical spine. Let’s take a closer look at what we need from the neck in the golf swing.

The cervical rotation test for golfers.

TPI’s (Titleist Performance Institute) testing with tour players and amateurs shows what we need from the cervical spine in the golf swing. The test is done standing upright with arms at the side. Rotate the head as far as you can in one direction, then try to drop the chin down to the collarbone without opening the mouth. If you can rotate far enough to get the chin over the collarbone at about the halfway point and get the chin down, then you have enough cervical rotation and flexion for the golf swing. Here is a video of the cervical rotation test…

Significance of cervical rotation in the golf swing.

As you start the backswing, your hands and trunk start going back. Focus on the trunk as you continue going back and the head stays still looking down at the ball. If you kept rotating back, you’d reach the full backswing position, with your head still looking down over the ball. Now imagine doing that same thing, but halfway through, the facet joints in your neck and/ or the muscles of the neck reached their max ability to rotate or stretch, the head would start getting dragged along for the ride. If we cannot pass the cervical rotation test, these events would occur. Now, there are ways to hide poor cervical mobility in the swing, and just about everyone with lacking mobility will use a compensation to hide it. Moving your head off the ball would be a great deal more jarring than the other compensations we use to get to the backswing without having to rotate the head further. Examples of these compensations found by TPI include different loss of posture swing characteristics like early extension, flat shoulder plane, reverse spine angle, and more.

What causes us to lose cervical spine mobility?

There are many factors that go into how much neck rotation we can get. A thorough history usually will explain most of the loss in mobility. History of trauma, osseus deformity or genetic variations, and day to day living and posture all play a role. Overall, we can attribute these issues to tight superficial neck muscles being used to create stability instead of the deep neck muscles that are designed for stability. Now we lose some of the function of the superficial muscles to create movement at the neck. Also, changes to the spinal segments in the neck, like arthritis, can limit the movement at the neck and create pain.

What can we do to help limited cervical rotation in golfers?

It is important to understand first exactly what the cause of the limited rotation is in the first place. Like I mentioned above, we can mostly think in terms of osseus (bone) or muscle. If the limitation is due to bone, whether it be arthritis, facet joint dysfunction, or capsule tightness, we can use manual techniques like chiropractic adjustments to get the ball rolling quickly on opening this space. We then can use corrective and eventually performance-based exercise and activity to continue progressing and maintaining these changes.

If the issue is more muscular based, we can again address things with manual soft tissue techniques to start creating length in the tight muscles. It will be key though to also address the root cause behind this muscle tightness. Often times, it is associated with a dysfunction in where the deep neck muscles are no longer being used to create stability in the neck, forcing the bigger and more superficial muscles to take over and lose their ability to optimally create motion. We must address this with corrective exercise to influence the deeper muscles to begin doing their role again and teach the superficial muscles to now stop. Then we can retrain this motor control action of the neck movement.

Conclusion

The cervical rotation test is an important screen to show us if we need to take a closer look at neck mobility and stability. If the screen shows we have limitations, we need to figure out why, requiring a comprehensive physical exam that should also include the entirety of the body. The aim is to figure out and establish its ability to achieve golf positions with speed, consistency, and efficiency. Once we understand better what the body is capable of and what it is producing in the golf swing, we can then go about creating a plan to fix the different components impacting the swing, including cervical rotation.

-Dr. Nick DC, 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.