Knee Pain While Golfing

By Western Berks Physical Therapy on May 2nd, 2020

Knee Pain While Golfing

Effective Knee Pain Treatments for Golfers

Golf is often viewed as a rather relaxed sport by non-players, but the reality of the game is that golf is exceptionally demanding on a golfer’s joints and musculoskeletal system. A 2017 study revealed that up to 18% of all golfers (professional and amateur combined) have experienced a knee injury related to golf. While there was no clear correlation between injuries and skill level, older players were at greater risk of injury. Regardless of age, all golfers can sustain injuries. When it comes to knee pain, Western Berks Physical Therapy is here to help you understand some of the underlying causes of knee pain in golfers and treatment options available to you.

Before we discuss causes of knee pain in golfers, it important to understand how the knee joint works. The knee is a hinge joint, formed where the thighbone (femur) and the shinbone (tibia) meet. It is the largest joint in the body. The knee joint is covered with smooth tissue and powered by large muscles.  Each bone end on the femur and tibia is covered with a layer of cartilage that absorbs shock and protects the knee. The knee joint absorbs stress and moves smoothly to allow you to walk, squat, and turn without pain.

Common Causes of Knee Pain in Golfers

Sprains or Strains: A sprained or strained knee ligament or muscle is usually caused by a sudden twist of the knee. Twisting sounds familiar when we talk about golfing right? Knee pain can occur from the strain placed on an already weak or injured knee to stabilize the rotation of the hip axis at the beginning of the swing. Symptoms often include pain, swelling, and difficulty in walking.

Arthritis: Osteoarthritis is the most common joint disorder in the United States and the most common form of arthritis found in knees. Osteoarthritis is a degenerative process where the cartilage in the joint gradually wears away. Remember what we said earlier about older golfers experiencing more knee injuries? Symptomatic knee osteoarthritis occurs in 10% of men and 13% of women aged 60 years or older. Osteoarthritis may be caused by excess stress on the joint such as repeated injury or being overweight. Those with arthritis may experience more knee problems because of having pre-existing knee pain. Bending, squatting to retrieve balls, and lots of walking puts stress on the weight-bearing knee joint.

Rheumatoid arthritis can also affect the knees by causing the joint to become inflamed and by destroying the knee cartilage. Rheumatoid arthritis often affects persons at an earlier age than osteoarthritis.

Injury to Soft Tissues: The extreme force placed on the knee joint can result in inflammation of tendons, torn ligaments, torn cartilage, or other soft tissue damage. The twisting motion of the knee while bearing weight on it during the swing can jeopardize the intricate soft tissues, resulting in pain. Trauma to the knee can tear the menisci (pads of connective tissue that act as shock absorbers and also enhance stability). Cartilage tears can often occur with sprains.

Overuse Injuries: Many knee injuries are the result of overuse and poor swing mechanics. Bad posture and form along with not warming up or cooling down before or after golfing can put you at an increased risk of injury. This is why it is important to use good body mechanics and to warm up and cool down properly to avoid such injuries. Your local golf professional can be an invaluable resource to address swing and body mechanics.

Preventing Knee Pain in Golfers

Many pain-causing injuries can be prevented by following these tips to keep you healthy and your joints happy as you continue to golf:

Warm up before playing. Stretch and warm up your muscles and joints prior to hitting the golf course. Western Berks Physical Therapy offers independent, at home, exercise programs designed for golfers. Your physical therapist can help increase the flexibility around your hips to reduce any pain or discomfort while preventing injuries.

Dress for success. A recent study of more than 4,000 golfers revealed 70% of golfers are wearing poorly fitted golf shoes. You can buy the best looking, lightest, most technologically advanced golf shoes on the market, but if they don’t fit properly you could be contributing to your own knee pain. The right shoes can increase your performance while limiting any foot or gait problems that may be contributing to knee pain. Testing has shown up to a 21% increase in performance for people wearing properly fit golf shoes! For more golf shoe fit information, click here.

Stay hydrated. Water and sports drinks are good choices to stay hydrated on the course. If your drink of choice is water, you should also consider eating a snack such as salted nuts because sweat contains a high concentration of sodium. This helps to maintain electrolyte levels in the bloodstream. Healthy snacks such as fresh fruits or raisins will help keep energy levels going. Fruits are not only natural sources of healthy sugars, but they are rich in natural vitamins and minerals and plant specific nutrients called phytonutrients.

Always practice good body mechanics. To achieve correct golf posture, Leading Golf Instructor David Leadbetter says “think about what position your body is in when you’re bouncing a basketball. Without thinking about it, you achieve balance and coordination, and you’re ready to support an athletic movement. That’s what you need in golf, too.” This is what Leadbetter says a correct 7-iron posture should look like:

  • Feet about shoulder-width apart
  • Feet in a neutral position, with your toes not pointing inward nor flared out too far
  • Upper body bent over from your hips
  • Tailbone back
  • Chest and chin up
  • Shoulders back
  • Weight centered, so not too far out on your toes and not too far back on your heels. Think about keeping your weight centered under your shoe laces.

It is vitally important to your golf game that all your body parts work together toward your goal. This goes for the entire game, not just your swing. Be mindful while bending and squatting to pick up your ball.  These tips from Leadbetter are a small part of a video series called The David Leadbetter Essentials. It includes six lessons, all around 10 minutes long, and covers the essentials of what every setup and swing needs. You can view them here.

Knee Pain Treatment for Golfers

These six steps in knee pain treatment should help ease the pain and get you back to playing the game you love.

  1. Rest. If you are experiencing knee pain because of golf use the RICE method of rest, icing, compression, and elevation, before beginning a rehabilitating exercise program. Your doctor may also suggest using crutches for the first few days to reduce the amount of pressure put on the knee joint.
  2. Physical Therapy. After you have started step one (rest), call a highly rated physical therapy clinic near you and request an evaluation with a orthopedic therapist. Physical therapists help rehabilitate athletes who have sustained physical injuries. They diagnose problems and evaluate patient progress throughout a treatment plan. To help reduce and eventually eliminate the pain, your physical therapist should provide you with at home exercises for knee pain that improve strength and increase flexibility of the surrounding muscles.
  3. Transcutaneous electrical nerve stimulation, or TENS, involves attaching the wires of a handheld unit onto areas surrounding the pain. When turned on, the TENS unit sends electrical pulses to targeted areas to reduce pain. A physical therapist may use TENS on you or recommend purchasing a home unit.
  4. Manual Therapy. Manual therapy is considered the most effective approach to treating musculoskeletal dysfunction, including pain and disability. It is a clinical approach using skilled, specific, hands-on myofacial techniques to the muscles, tendons, ligaments and joints. Manual therapy can provide pain relief while also addressing any underlying issues that could cause the pain to reoccur. *This technique should only be administered by a manually skilled physical therapist.
  5. Building Strength. After taking a break from playing golf and seeing a physical therapist, the next step in knee pain recovery is strengthening the injured area. Creating a stronger muscle framework will make your body better able to absorb the strain involved in golfing. Discuss with your therapist which exercises are the best for strengthening the muscles around your knee and plan out a routine that works for you.
  6. Increase Flexibility. In any rehabilitating conditioning program, stretching and exercise go hand-in-hand. Ask your physical therapist about increasing the flexibility around your hips and knees to increase the speed of your recovery.

When treating golfers, it is important to have a good understanding of the biomechanics and forces of the golf swing to diagnose and manage the injuries incurred in this sport. This is where the therapists at Western Berks Physical Therapy can truly benefit those who are dedicated to playing golf. The explosive nature of the swing can put a tremendous amount of stress on the body and needs to be treated by those who have specialized expertise in this particular type of sports injury.

Knee pain from golf is a common occurrence and should be treated immediately before the pain and any corresponding injury worsens. The physical therapists at Western Berks Physical Therapy are specialists in diagnosing and treating sports injuries. For more information, please visit Western Berks Physical Therapy here or contact us at 610-589-2263.