Getting a Grip on Wrist Injuries By Ramsay McMasters with Karen Palacios-Jansen From
Golf Fitness Magazine
A wrist injury can be devastating for a professional
golfer. Phil Mickelson had to withdraw from several tournaments this past
year because of a lingering left wrist injury he sustained playing a
practice round at Oakmont CC, the site of the 2007 US Open. The left-hander
failed to contend seriously in any of the four major championships, because
of the nagging wrist. Wrist injuries are common among golfers and normally
occur at the moment of impact of the club with the ball. Teen golfer
Michelle Wie also had a disappointing year on the LPGA Tour because of a
similar injury to her right wrist. Wie hit a shot off a cart path during
the women’s Samsung World Championship in 2006, the injury caused her to
withdraw from many tournaments and lead to a disappointing year in
2007.Because the grip is the body’s sole connection to a golf club, wrist
action is a critical part of the swing. The repetitive motions of golf and
the high speed of the typical golf swing, however, place wrists at a high
risk for injury. To begin with, let’s look at symptoms one might experience
with an injured wrist.
1. Hot Sensation in the wrist. 2. Swelling in the wrist after playing a round or
practice. 3. Wrist feels stiff and normal movements such as
opening jars, carrying
luggage or shaking hands are painful the day after a round of golf or
practice. 4. Finding a small lump on the back on the wrist
commonly known as a
ganglion. 5. Pressure on the top of the wrist that causes
severe pain. 6. Weakness in wrist and hand that increases with
time. 7. Severe pain in wrist and hand that leads to use of
non-dominate wrist
and hand. 8. Increased apprehension and anxiety when using hand
on a daily basis.
Normal activity such as turning a door handle, picking up a golf bag and
teeing up a golf bag cause pain and discomfort. 9. Quitting on golf shots at impact and to make a
complete golf swing.
If you are experiencing any of these symptoms before,
during or after, your golf game, the next step is to get a proper diagnosis
from your physician—this area of the body is very complex! An MRI is
essential to locate the injury and determine whether it is tendons, bone,
ligaments, nerves, joints etc. You must have a physician’s diagnosis in
order to properly treat your symptoms and to get the proper rehabilitation.
Many golfers that suffer from wrist injuries have
experienced a past injury to the wrist or forearm. These golfers are
extremely likely to suffer a recurrence of wrist pain. Prolonged wrist
injuries that are not treated can lead to more serious permanent damage in
the underlying structure of the wrist such as the joint discs or ligaments.
Many of the structures that are damaged in wrist
injuries, are not seen with a plain x-ray. That is why diagnosis from a
physician and an MRI are so vitally important when it comes to this type of
injury.
After you have confirmed your diagnosis, there are
several ways in which you and your physical therapist, or physician can
work together to rehabilitate your injury. However, one must note, that
many wrist injuries, as well as any other golf-related injuries, can be
prevented by a pre-season and year-round, golf-specific conditioning program.
The following are some of the ways in which wrist injuries are commonly treated
after proper diagnosis has been made:
• rest and ice
• muscular strengthening, flexibility
exercises • a short, practical, pre-game warm-up routine • the adjustment of an individual’s golf swing to
meet their physical capacities and limitations through properly supervised
golf lessons • the correct selection of golf equipment and an
awareness of the environmental conditions • on-going physical therapy in which your team of
therapists, physicians, your instructor and yourself work together to
diagnose, treat, and repair.
So we have evaluated your symptoms, and informed you
on some of the less complex treatments that are common for treating wrist
injuries, howewever, the question still exists-how did this injury happen?
The following is a detailed list of how most golf related wrist injuries
occur.
The Risk Factors for Wrist Injury:
1. Poor Neck Posture and Muscle Control The body as a
system is quite versatile in adjusting to adverse situations. Poor posture
and lack of muscle control can easily lead to compensations in the golf
swing. Instead of using large muscle groups to create power in the swing,
someone with poor neck posture and muscle control may compensate by
flicking the wrists and trying to help the ball up in the air putting
strain on the smaller muscles in the hands and wrists.
2. Prolonged Sitting then Excessive Practice Ball
Bashing Prolonged periods of inactivity followed by excessive periods of
physical activity like ball striking are a prescription for injury. Warming
up and cooling down and consistent moderate activity are extremely
important in reducing the risk of muscle and joint injuries especially in
the smaller muscles of the wrists.
3. Overuse of Small Muscle Groups This causes
fatigue. As with poor neck posture and weak muscle control, if you have
weak shoulders you tend to use other muscles to compensate for the lack of
strength and control. If the body cannot stabilize during a swing, other
parts of the body like the wrists will be overused and injured.
4. Over-Cocking of the Wrists All good players have
one position in the golf swing that’s similar despite their very
different-looking swings. This position is impact. Good players retain
their wrist-cock through the hitting area so that their left wrist is bowed
and the right wrist is flexed (for right-handed golfers), and both hands
are slightly in front of the golf ball at the strike. High-handicappers
tend to do the opposite at impact. Instead of a late hit, they actually
execute what’s called an early release. They scoop the ball at impact
because they lose the lag too early in the downswing. Instead of having a
bowed left wrist and their hands ahead of the ball at impact, they have a
collapsed left wrist and their hands are behind the ball. As such, they put
a tremendous amount of pressure on the muscles and tendons on the wrists
that could lead to injury. A player may damage their left wrist in attempt
to overdo the bowed left wrist at impact. Learning correct mechanics will
help prevent injuries.
5. Poor Swing Technique A steep angle of attack on
the ball at impact causes the leading wrist to dorsiflex or extend. As this
happens, the elbow’s flexor muscles are stretched excessively. If the
golfer hits the ground first (a fat shot), at the moment of impact, the
trauma may damage the tendons and muscles. Many high-handicappers
decelerate at the moment of impact to help the ball up in the air. This
maneuver puts a tremendous amount of strain on tendons. The result is the
lead arm looking like a chicken wing and a weak golf shot.
6. Excessive Ball Bashing Resulting in Poor Technique
and Wrist Fatigue, Then Eventual Injury of the Wrist Region. Generally, the
more often you play, the higher your risk of injury. Golfers who spend more
than six hours per week playing golf are at increased risk of overuse
injuries. Practice habits contribute significantly. The onset of club
championships or a new year’s resolution to improve your game may increase
your predisposition to injury.
7. Playing on Poor Quality Driving Range Mats or
Heavy Rough Causing Direct Traumatic Trauma Hitting balls off rubber mats
or hard surfaces will increase the likelihood of a wrist injury. The
constant pounding on the wrists combined with poor swing technique can
cause strain of the muscles. Improper swing technique dramatically
increases the risk of injury. Golfers who swing correctly and smoothly are
less likely to hurt themselves. Hitting out of heavy rough, buried lies or
making contact with immovable surfaces (tree roots and rocks) may also lead
to injury. Phil Mickelson’s wrist injury was caused from hitting a shot out
of rough during a practice round for the US Open. As the club head
approaches impact, the grass wraps around the club head and stops the club
head from sliding through the grass. If you do not break up your long game,
practice, train excessively on unforgiving surfaces, hit out of the rough
or buried lies, or make contact with immovable structures (tree roots and
rocks), you will decrease your likelihood of wrist pain.
8. Poor Predisposing Power and Functional Grip in the
Weak Golfer The golfer cannot maintain good muscle function in the hand
itself even with simple things like lifting bags or opening a jar. What
happens at the point of impact determines trajectory, the direction and the
distance the ball flies. The interaction between clubface and ball rests
largely upon the strength of the wrists. If a golfer has weak grip
strength, then they are at greater risk for injury while playing golf.
In conclusion, there are many different strengthening
exercises and stretches that can be done prior to play that can help
prevent the golfer from injury. These exercises and stretches can be
invaluable when it comes to protecting your wrist and even improving your
golf game.
