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

More distance, greater consistency and better tournament results: the goals of modern golf performance are clear. The path to achieving them, however, is less straightforward. Performance is not created by technique alone. It is built through the interaction of a resilient body, intelligent athletic preparation, sound medical guidance, and thoughtful management of training and recovery.

For players, coaches and federations alike, performance should not be seen simply as the product of more practice or better coaching. At its most sustainable, performance is the result of a system. It depends on whether an athlete has the physical capacity to support the technical demands of the game—and whether that capacity can be maintained over time. In other words, performance is not only about how well a player swings, but whether the body can tolerate, repeat and sustain that swing. For individual players, this means asking not just “how can I swing better?” but “is my body actually ready to support the swing I’m trying to build?”

This becomes particularly relevant in ambitious players. Many golfers try to improve primarily through technical work. That approach can be effective in the short term, but only up to a point. Eventually, the body becomes the limiting factor. Restricted rotation, limited strength, reduced trunk control or insufficient load tolerance in the lower back, shoulder or forearm will place a ceiling on progress.

What is often overlooked is how athletic development shapes this ceiling. Players with a multi-sport background frequently bring a broader movement foundation, better coordination and more robust tissue capacity into golf. Similarly, early exposure to structured athletic training—developing strength, balance and neuromuscular control—creates the prerequisites for more efficient and repeatable swing mechanics. In contrast, early specialisation without this foundation may accelerate short-term progress, but increase vulnerability to overload and stagnation. For federations, this represents a clear opportunity: to prioritise athletic literacy alongside technical skill and embed strength and conditioning, movement quality and medical oversight into development pathways from an early stage.

A useful way to frame performance is through the interaction of three elements: capacity, technique and management. Capacity refers to the athlete’s physical foundation—mobility where needed, strength, power, control and robustness. Technique refers to movement solutions that are efficient and realistic for the individual body. Management refers to the structure around the player: practice volume, tournament scheduling, speed training, recovery, travel and sleep. When one of these elements is neglected, performance becomes unstable. When all three are aligned, development becomes far more predictable.

Importantly, this does not require increasing complexity. The most effective systems are often the simplest. A small number of relevant markers—such as hip and thoracic mobility, trunk and lower-limb strength, scapular control, and load tolerance in key regions—can guide meaningful decisions. These should complement, not replace, golf-specific outcomes such as clubhead speed, ball flight and dispersion. Every assessment should lead to action: adjusting technique, prioritising physical development, or modifying load.

For players and federations alike, the greatest opportunity lies in bringing different disciplines into one shared language. Medicine helps define what is possible and what is sensible. Physiotherapy focuses on function, tissue tolerance and return to play. Athletic training builds the capacity required to support the game—stronger hips and trunk, improved shoulder stability, and greater robustness under load. Coaching completes the picture by translating these physical capacities into efficient, individualised technique.

This interdisciplinary approach is not simply convenient; it is essential. When pain is treated in isolation, without understanding why it developed, the result is often temporary relief rather than lasting progress. A better model links symptoms to movement quality, physical limitations, load exposure and swing demands. Federations can create real value by embedding this perspective into their athlete pathways. For individual players, this means seeking support that works from one coherent framework—and ensuring that coach, physio and medical team are aligned.

Practical needs differ by level. Developing players benefit most from a simple, consistent structure: a pain-free physical base, a reliable warm-up, regular strength and mobility work, and a smarter approach to practice volume. Elite players require the same foundations, but within a more structured and periodised model, with close communication across all support disciplines.

Season structure also matters. Performance does not develop evenly across the year. There are phases in which capacity can be built more aggressively, and phases in which performance must be protected. Early phases may focus on movement quality and robustness; later phases on strength, power and eventually speed—introduced only where the athlete can tolerate it.

The key message—for players and federations equally—is simple: performance and health are not opposites. They are part of the same system. Prevention improves availability. Availability improves training quality. Training quality improves performance. Athletes who remain healthy enough to train consistently have a far greater chance of improving, adapting and performing under pressure than those repeatedly interrupted by pain.

Ultimately, that is the closing message of this series. Golf has exceptional potential both as a health-promoting activity and as a performance sport. The real opportunity lies in linking those two dimensions rather than separating them. First we understand health, then we manage risk, then we embed prevention into the system — and only on that foundation do we build performance that is not only effective, but sustainable.

Selected references

• Ehlert A, Wilson PB. A systematic review of golf warm-ups: behaviors, injury, and performance. J Strength Cond Res. 2019

• Ehlert A. The effects of strength and conditioning interventions on golf performance: a systematic review. J Sports Sci. 2020

• Uthoff A, Sommerfield LM, Pichardo AW. Effects of resistance training methods on golf clubhead speed and hitting distance: a systematic review. J Strength Cond Res. 2021

• Brennan A, et al. Associations between physical characteristics and golf clubhead speed: a systematic review with meta-analysis. Sports Med. 2024

• West S, Fern J, Canter L, Murray A. Beyond physical load in golf – the tip of the load iceberg. BJSM Blog. 25 September 2020.