Article by Nils Horn MD, Head of Golf Institute at Balgrist University Hospital

Golf is widely considered a safe sport. Yet recurring pain in the lower back, shoulder, and elbow remains common. The reason is rarely one dramatic event, it’s usually a mismatch that builds over time.

Most recognize the pattern: a stiff lower back after a heavy practice week, a shoulder that feels “tight” during a busy season, an elbow that nags when you work on strike. The response is practical: rest, some stretching, maybe quick treatment, and symptoms settle. But weeks later, they return. That repeating cycle is an important clue: the pain improved, but the driver remained.

Many golf complaints don’t start with one dramatic incident. They build quietly—through repetition, fatigue, and compensation. That’s why the best solution is rarely a single “fix.” It’s a team process connecting medical clarity, athletic capacity, and swing decisions—designed not just to calm symptoms, but to identify and address root causes.

Golf is generally considered a relatively safe sport, complaints are common—most often in the lower back, but also in the shoulder, elbow and wrist. The pattern varies with playing level and exposure. yet the underlying theme is consistent. Research shows that these are recurring patterns rather than not rare exceptions.

Why Symptom-Only Care Often Fails in Golf

Golf is a repetitive rotational sport. Over hundreds or thousands of swings, small mismatches accumulate. If the hips don’t rotate well, the hamstrings are tight, or thoracic mobility is limited—often influenced by modern posture and work habits—the body still finds a way to create speed and deliver the club. Frequently, that means the spine absorbs more load through sway-slide and side bending movements, or the lower body creates “room” through foot and pelvic strategies. In long hitters, creating space in the follow-through can be a performance asset. But when it compensates for underlying limitations, tissue stress can rise. 

This is the body–swing connection: the swing you can repeat is shaped by the body you have today. Some golfers bring limitations into the sport: previous injuries, restricted hips, reduced trunk endurance. Others develop them over time through repetitive training without matching the body’s capacity to training load. Either way, pain often becomes a signal that the balance between load, capacity, and technique is no longer sustainable.

Two triggers show up again and again:

1) Load spikes
Golf hides load because it doesn’t always feel “hard” in the moment. But the body counts everything: extra balls on the range, more rounds, extra speed work, new technique blocks, dense competition schedules, travel, and less recovery. 

2) Body–swing mismatch
A technical change can be perfectly sensible. But if the player lacks the mobility, strength, control, or endurance to repeat it—especially under fatigue—the body compensates. That compensation may shift stress to the lower back, shoulder, elbow, or wrist. The sore spot is often the victim, not the cause. 

This is why treating the painful area alone is often only temporary. If the back hurts, the back is not automatically the root cause. Symptom management matters—calming irritability, restoring function—but lasting improvement comes from asking: What started this? And what keeps it going? In golf, the answer often sits at the intersection of body limitations, swing demands, and training load.

The Key: An Interdisciplinary Model of Medical, Athletic and Golf Coaching

In golf, performance and health are rarely improved by one discipline operating alone. The strongest outcomes come from an interdisciplinary model—not because it has to be complicated, but because each discipline sees something the others might miss. Research and expert practice increasingly support collaboration between golf coaching and strength & conditioning. The next step is consistent integration of a structured medical layer into performance support—closing the loop between symptoms, function, capacity, and technique.

That’s where symptom-only care becomes root-cause care.

A Concrete Example: Low Back Pain – The Classic Body–Swing Conflict

Low back pain is one of the most common complaints in golf, according to epidemiology and reviews. A typical pattern is a golfer who increases volume or speed training while chasing a technical goal, like more rotation. If hip rotation is limited and hamstrings are tight—especially core stability is insufficient—the lower back often becomes the “extra joint” supplying the missing motion. This can lead to recurring stiffness after practice, flare-ups during tournament blocks, and a risk of overuse injury over time.

A symptom-only approach may calm the back, but it won’t change the mismatch. An interdisciplinary approach does:

• Medical: clarifies diagnosis and assesses the body's capabilities and limitations.

• Athletic training: builds missing capacity —hip mobility, core stability, rotational power, control — and manages load progression.

• Golf coaching: adapts swing and practice to reduce spinal overload while the body is being upgraded.

When these pillars work together, solutions arrive faster, performance is protected, compensations are reduced, and the return to play becomes more stable. Turning the body–swing connection into a long-term advantage.

Final Thought

Golf can promote health—but it can also aggravate complaints when load, physical capability and technique don’t match. The good news: golf is highly “steerable.” With an interdisciplinary approach, players receive support beyond simple relief. Root causes are identified through the body–swing connection. Limitations are addressed with targeted capacity building and smarter load management, while swing decisions become realistic and sustainable. The result is fewer relapses, improved performance, and more healthy years on the course—exactly the balance emphasized in the international consensus on golf and health.

Coming next: prevention in practice—simple routines and club-friendly habits that help golfers stay healthy over the season without turning golf into a medical project.

Selected references

1. Williams A, Murray AD, Sorbie GG. Epidemiology of injuries in UK based golfers: a retrospective study. The Physician and Sportsmedicine. 2025.

2. Murray AD, Archibald D, Murray IR, et al. 2018 international consensus statement on golf and health to guide action by people, policymakers and the golf industry. Br J Sports Med. 2018.

3. Horn N, Kreuzpointner F. Lower back pain in golf – could your hips be the problem? World Golf Fitness Summit, Orlando, 2018.

4. Edwards N, Dickin DC, Wang H, Phelps V. Low back pain and golf: A review of biomechanical risk factors. Sports Medicine and Health Science. 2020.

5. Ferguson C, Collins D, Carson HJ. Developing the Interdisciplinary Scope of Golf Strength and Conditioning Coaching… Applied Sciences. 2025.

6. Bliss A, Langdown B. Integration of golf practice and strength and conditioning in golf… International Journal of Sports Science & Coaching. 2024.