The Real Cause of Chronic Low Back Pain in Golfers

Low back pain is the most common issue among golfers, followed closely by pain in the hips, knees, shoulders, and neck. But even if your hips and shoulders feel fine, could they still be contributing to your low back pain? Absolutely. The way your hips, spine, and core function plays a crucial role—not just in golf performance but also in injury prevention and long-term pain reduction. Let’s dive into why these areas are so interconnected and how you can optimize their function to stay pain-free and play your best.

Low back pain is never just the low back

Instead, the low back often bears excessive forces, moving into end ranges of motion and beyond, while lacking the necessary strength and endurance. Low back pain arises when the tissues—muscles, tendons, intervertebral discs, and ligaments—exceed their capacity to handle these forces. While strengthening and improving mobility in the low back is essential, the key is to address why it’s being overloaded in the first place. The answer lies in optimizing core stability, hip function, and overall spinal mobility.

What we really need from the core in the golf swing

When we talk about the core, what we mean is all the surrounding muscles of the trunk and abdomen, including the low back. These muscles include the transverse abdominus, external and internal oblique, the diaphragm, erector spinae muscles, quadratus lumborum, and more. Beyond using the core to create the critical rotation of the golf swing, we also need these muscles to work in unison to create stability around the low back and pelvis. A major cause of low back pain in golfers comes from unchecked forces making their way into the structures of the low back. Unchecked because the golfer is missing the strength OR motor control/ awareness to stabilize and resist forces acting on the spine. So, we must not just train the core to create rotation but train it to create intrinsic stability to resist shear forces. This means strength AND motor control.

How do we train the core to resist shear forces in the golf swing

The first thing we can do is train ourselves to use the diaphragm to create intrinsic stability in abdomen (core). Then, work to improve these qualities while challenging the core with rotation and power production. Try these drills below!

This drill works to teach us how to actually use the diaphragm to create stability of the lumbar spine. Then, we begin to challenge movement around the pelvis, lower extremity, upper extremity.

This is a great exercise for challenging core and pelvic stability while breathing and moving the lower extremity.

This helps us create force from the ground up while giving us the opportunity to challenge our core stability while rotating. 

But why are there excessive forces making their way to the low back in the first place? Now we need to look at the hips.

Hip mobility and strength in the golf swing

Excessive forces in the low back are due to compensations in the golf swing. This brings us to the hips. We need access to full hip mobility to allow us to pivot into the back side hip in the backswing and rotate into the lead side hip in the downswing. If we run out of space to rotate into the hips, then we force ourselves to compensate. This can be in standing up, losing posture, sliding or swaying, and turning more into the lumbar spine (low back). We also need strength through full hip rotation to make sure we can control these forces at the hip before they get to the low back and pelvis.

How to strengthen through the hips

To improve access to hip mobility AND strength to control it, try these drills and exercises below!

This is an important first drill to start fixing the orientation of the pelvis and getting TRUE hip rotation in the hip joint.

This is a great exercise to build strength into the rotation, specifically internal rotation.

This is a great drill to start incorporating a more dynamic strength and learning to create and absorb forces in the hips rapidly.

This is another great exercise for building reactive strength and power in the hips and lower extremity.

So, if we regain strength and mobility into the hips, we can take pressure and forces away from the low back. But what about spine mobility, the last piece to the puzzle? How does spine mobility effect low back pain in golfers?

How spine mobility affects low back pain

The spine is needed to maintain stability while also generating force through its full range of motion. To make sure we are not creating an environment for low back, we need to make sure the spine above the lumbar vertebrae are primed for accessing their full range of motion while also being strong enough to resist over rotation and adding torque to the low back.

Creating mobility and power in the spine

Here, we are mostly referring to the thoracic spine, though limitations in cervical range of motion will certainly impact the mechanics of the golf swing and therefore impact low back loading. To improve thoracic spine rotation, try the drills below…

This drill helps us improve our passive capacity to rotation through the thoracic spine. By placing the top side hip in 90+ degrees of flexion, we are limiting pelvic and low back motion, forcing the rotation to come truly from the thoracic spine. Now, how can we improve our strength and motor control over this rotation once we see passive mobility improve?

This drill forces us to stabilize the extremities and create trunk rotation under resistance.

This is a great drill to integrate lower body mechanics with the spine. We generate force through the ground and hips while also accepting and creating torque in the spine and upper back.

Conclusion

Low back pain is a common and persistent issue among golfers, often resulting from repeated stress and overuse rather than sudden injury. Addressing this effectively requires going beyond simple symptom relief techniques like cupping, dry needling, scraping, taping, and adjustments. While these methods can help manage discomfort, the true key to long-term relief lies in improving the mobility, strength, and endurance of the hips, thoracic spine, and lumbar spine. By analyzing the forces at play in your unique golf swing, we can develop a personalized, progressive plan that moves seamlessly from rehabilitation to peak performance—ensuring you stay pain-free and on the course for the long haul.

-Dr. Nick 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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