Have you ever got halfway through a round and had to stop because of back pain? From amateurs to pros, back pain can be the curse of many golfers and often feel like a bomb waiting to go off. The good news is that you have the power to change your body’s reaction. 

Today’s blog is filled with lots of tips and info to help you understand how your golf, back pain and breath are all connected. But most importantly, I want it to inspire you to take an active role in keeping your body golf-fit. My ideas may be things you already do, or may seem a bit out there, but bear with me! What I have learnt from the years of treating amateurs to professional golfers is that it’s not a one size fits all model, and you need to experiment to find the optimal solution for you. 

Golf and Anxiety

This week, I was treating an ex-professional golfer who reminded me that we can believe back pain is normal and suffer through it. He’s had pain in his back for the past 15 years – ever since he started playing pro golf in the USA. Playing sports also caused him to suffer from anxiety, particularly when it came to competing, and ultimately the reason why he ended his professional career.

Back Injuries

When I dug down deeper, his breathing pattern was creating other symptoms and linking his body to be stuck in a stressed state. Before playing, his stomach would get upset and he’d lose his appetite. He needed over 9 hours of sleep a night and would often need to nap after working out and training. He never woke up feeling refreshed and reported developing a snoring habit in the last few years. He also had sleep studies done with no results.

Golf and Back Pain

When I looked at him clinically, there were some clear signs of an altered breathing pattern. His pattern was anxiety hyperinflated, which meant he’d stuck holding the breath on the inhale – like a balloon not being able to deflate. By not having the intraabdominal pressure, created by his diaphragm to help provide core stability, the other muscles around the back compensated.

This can lead to trigger points in muscles which cause pain and can refer down from the back to hips and legs. He’d been stuck in this pattern for years and without realising it, the change in breathing pattern also caused him to experience shortness of breath and feeling like he had to take a big breath in. 

After changes to his breathing pattern, within 12 hours he reported having more energy and less back pain. Once you start joining the dots between breathing patterns, anxiety and back pain – it truly is a game-changer. But like resetting any habit, it takes awareness and conscious practice. Plus, like any muscle, your diaphragm, needs to be loaded over time for the function you want to achieve. If you are experiencing anxiety in sport, it’s not enough to take a few slow breaths at the end of the day.

Lower Back Pain 

Back pain is the number one ailment for golfers.  Golf is an unusual sport that our body really isn’t designed for. An asymmetrical, rapid intense load with high levels of torque on our lumbar spine done repetitively, which when performed incorrectly over time, can have a huge impact on the body. Many people are not fit for the sport or haven’t got the range, as most of the time they are sitting at a computer or haven’t warmed up the body to perform the extreme rotation and force required. 

Back pain can occur if you are over rotating, side bending excessively, have limited hip and thoracic rotation, poor stability endurance and dysfunctional movement patterns. Muscle tightness, weakness, loss of range, trigger points and bad habits can all lead to a change in your biomechanics, so while you need to work on swing mechanics, you also need to make sure your body has the range, strength and endurance for the movement required. Seeing a physiotherapist that specialises in assessing biomechanics and can work alongside your pro can make all the difference to help you reduce pain and ultimately improve performance. 

Back Pain and Breathing

The geek in me loves that more research has been conducted on the relationship between breathing and back pain, and now what we are seeing clinically, is showing up in the results. When compared with normal populations, people with non-specific back pain have alterations in their respiratory function, reduced diaphragm mobility and endurance. Researchers have also looked at the position of the diaphragm with people that have lower back pain and found that the diaphragm sits in an altered, steeper position which means it can’t activate as well. 

Getting the right exercises for your breathing pattern and back pain is important as it isn’t a one size fits all model. Breathing exercises compared to a control group have been shown to increase core muscle activation can be increased over 6 weeks of training. A research review into using breathing muscles in chronic back pain patients supported the use of breathing exercises as prescribed by a physiotherapist.

Golf Swing and Core Stability

The force required to be generated through your core and torso with a golf swing, can end up having a positive or negative impact on the body. A lot of that depends on the way you breathe, your movement patterns and endurance. Research has shown a link between poor core stability and back pain. Core stability has had some bad press in the past and often both the gym and pilates studios were teaching the wrong methods of getting people to brace or tighten the core.

One of the best quotes I have heard on the core was by one of my geeky research crushes, Professor Paul Hodges, who said “Core stability is getting the balance between movement and stiffness”. When it comes to the golf swing, you need to find that sweet spot of movement and stiffness to generate the force required, as well as work on accuracy. That doesn’t mean sucking and hollowing your core. Instead it means smiling, inhaling to activate the diaphragm and connecting with your movement.

Smiling and Golf

Yes, I did say smiling and I want you to work on it when you are playing golf. It may feel like a weird concept, but what I know clinically is the emotions that we experience impact our breathing pattern (more on that soon) and one of the ways to override them and find the best pattern, is by smiling. 

It’s like hijacking your nervous system for good, and when you’re playing top level golf, you need everything to help reset the nervous system and mind to calm. Smiling influences and overrides the body stress response and teaches it that you are safe, which means it won’t tense up the muscles as if it was running away from a threat. This is crucial to your golf as too much tension in your muscles with your golf swing can stop you from being in flow and alter your movement pattern. 

It’s the simple things when it comes to performance that add up, like smiling. I know this can be challenging particularly when you’ve had a bad day or are under a lot of pressure to perform at top tournaments. But the good news is, you can fake that smile and a good trick I like is putting a pencil sideways between your mouth when you’re waiting for your shot. This will activate your smiling facial muscles and trick the nervous system into releasing its happy hormones which will help you stay more relaxed.

Like any habit, smiling and breathing requires practice, so next time you’re on the course, observe your behaviours and mood, and notice if you can shift it.  By making a few small changes, you can impact more than just your distance on your drive. 

Breathing and Golf

One of the simplest things you can do when playing golf, is learning to exhale. I know it may sound crazy that by simply exhaling for longer, it can make a difference to your performance, but here’s why. Your diaphragm, your major breathing muscle, is like a dome. But if your breathing pattern gets stuck in an inhaling pattern – which can happen when you are anxious, have back pain or fearful – then you change the position and ability of your diaphragm to function. Your rib cage can become hyperinflated and instead of your diaphragm sitting in a dome position, it’s lifted and flat. This was the issue for the ex-pro golfer I was working with and what was keeping him in a state of anxiety.

The problem is, it can’t activate easily in that position – descending into your abdomen and less intraabdominal pressure is generated. That may sound a bit geeky, but the crux of it is, if you are stuck with the chest over inflated like a balloon, then your muscles don’t sit in the right position and therefore can’t do their job. This has a knock on effect on many systems, like the quality of your sleep, your gut and keeping you in a stressed state. For golf, it means you can’t generate the correct intra abdominal pressure and stability that is needed for driving the ball, and your body will often cheat to move in a different way. Long term this can show up with other areas of pain and dysfunction. 

So remember, without fail on the golf course, exhale. 

Strengthening your breathing muscles 

The first step to resetting your breathing when you experience lower back pain, is to find the right calm pattern for you.  To learn more about that, and the stress response, you can start my online breathing course here today. 

Once the pattern is reset, you can start to strengthen the main breathing muscle which can be done in several ways. One study showed, by practicing breathing exercises, not only did the diaphragm muscle thicken, but the other core stability muscles also developed. 

Remember to breathe when you lift

Another research article showed that people with back pain breathe differently when they lift. The amount of times you can lift golf clubs and bags over a round of 18 holes can add up so you need to do it right. Other research showed that while breathing patterns might be fine at rest, people with back pain can have altered patterns when functioning, creating altered movement patterns. The pattern of being stuck in a hyperinflated high volume pattern is common with people with back pain and this can then flow on to the golf course. Another reason to focus on the exhale is so your body can stabilize for the movement required and train your breathing to be sport specific. 

Injury Prevention: Get Golf Fit

One of the key things golfers can do to both reduce back pain and improve performance is get fit for golf. Golf fitness needs to cover a lot of areas as there’s the long and short game that require different movement patterns and strength requirements. One of the best tools is working with a personal trainer – that has an interest in golf – alongside your golf pro and Physiotherapist. 

While this may seem a bit lavish if you’re a social golfer playing several times a week and want to improve your handicap, you need to have problem solvers as part of your golf team that can work together. 

Yoga and Golf

One of the best tools that many of the top professional golfers use, is yoga. Yoga is a great form of exercise from a physical point of view as it works on hip and spinal flexibility, strength and posture as well as breathing. All the components that are required for great golf performance. Don’t worry, you don’t need to be wearing lycra, drinking smoothies or be a vegan to get the benefits of yoga. It’s all about finding a style of yoga that works for you and giving it a go. 

Work with a Golf Pro

One of the leading reasons for back pain in golf is poor swing mechanics. This is probably the number one reason why you should work with a good golf pro to coach you on your body. We don’t know what we don’t know, and even at the top level of sport we can’t see or sense what isn’t moving right. When you work with a great golf pro, they empower you to move in a way that is efficient and safe for your body. 

The Chicken or the Egg

I learned from the amazing golf pro Ian Godleman – who works with New Zealand Pro Golfer, Josh Geary – is that it’s all about finding the right coach for your stage and progression in golf. Getting the right coach to assess your mechanics can make a huge difference to performance and most importantly, when it comes to being on tour – consistency. When it comes to your golf swing, your movement pattern may be making it hard to breathe or your breathing pattern may be contributing to it. 

What you need to look at is working with the right team to figure out what came first. The Chicken or the Egg or the poor biomechanics or poor swing?

Golf and Bad Habits

Back pain can occur for several reasons, but as we are looking holistically at golf performance, we need to look at how stress impacts golf. It can also be a perpetuating pattern where you’re fearful and worried about your shot off the tee or your performance. When we are nervous, scared or worried, we get stuck on an inhale breathing pattern, often breathing a more 1:1 ratio (ie inhale for 2 seconds and exhale for 2).

This breathing pattern links into being in freeze mode (one of the 5 f’s, fight, flight, friend, flop and freeze, that can occur with the stress reaction in our body) and we know from the research that inhale freeze is a fear/anxiety breathing pattern. 

Make a Change

For me, the most powerful thing any person I work with can do, is to commit to making a change. When it comes to improving your golf, you may have realised from my blog that the back pain you experience may be a result of the way you’re breathing, stress or biomechanics. Either way, you have some options to change and it all starts with learning more about your muscles, mind and sport. 

To help you make a change, comment below with the one action that you’re going to take to improve your golf and back pain. And remember small changes, have a big impact. 

Emma Ferris is a breathing coach and physiotherapist working to create change in how golfers perform and manage stress.  Emma has travelled and worked on the European and Challenge Golf tour with a top New Zealand golfer. Drawing on a 15-year career in physiotherapy, conditioning, and stress management, she is teaching the world to find their calm and stress less at The Breath Effect. Emma works both in her clinic, runs workshops around New Zealand and the world and works online teaching golfers how to breathe. One of the best ways to improve your golf is to look at your breathing pattern.

You can connect with Emma online in one of her retreats or join her online Transform course now to start learning the tools to help reset the body through times of change, grief and uncertainty.