Your back can take a beating during nine holes of golf.
Figure 80 strokes, double that many practice swings preparing for each stroke, and another couple of dozen on the driving range for warm-up. Don't forget bending over to place the ball on the tee and yet again to retrieve it from the cup.
The result can be repetitive strain injury to your back muscles, the most common golf injury.
"It usually occurs because of tightness in the hips or shoulders. People compensate, they over-rotate and try and generate too much force," says Brandon Tilton, a physical therapist at Jackson County Physical Therapy in Medford.
Before you try to hit that first killer drive, warm up by walking and take light swings on the driving range.
"A lot of people will go out to the driving range and hit a couple of balls, then pull out their driver and hit it as hard as they can. They're just setting themselves up for injury," Tilton says.
Form is critical both for the swing and for something as seemingly trivial as how you pick up the ball.
When reaching for the ball, says Tilton, "Use the golfer's reach: kicking a leg out behind you and using your golf club to support yourself. That takes a lot of stress and strain off the low back. (This) allows you to keep a more neutral spine, a straighter back, rather than having a flexed spine."
Keeping the back straight is the key to a successful, safe swing. This form should be carried over to other parts of life, as well.
"The main thing is sitting on a chair with proper back support. Slumping in a chair or desk puts the same sort of stress on the back (as an incorrect golf swing)," Tilton adds.
When injury strikes, Tilton uses ice to decrease inflammation. Education is critical, Tilton says, in learning form for that first post-injury game. To reinforce proper form, he heads for the office supply closet.
"Sometimes we'll actually put tape on their back, two simple strips to keep them from flexing forward repetitively," he adds.
Preventing a back injury begins with a strong abdomen.
"The best way to avoid injury is to be strong. You use your core in your golf swing. The stronger your core, the easier it is to move the body," says Peggy Atwood, golf pro at the Centennial golf course in Medford.
Core, balance and arm strength are prerequisites to a successful golf game, according to Atwood. She recommends Pilates and yoga for core strength. Her personal regimen includes standing on a BOSU ball to develop balance and Kinesis weight training for arm and core strength.
Kinesis is a half-hour class that uses weights on pulleys in four different stations to develop a variety of muscles. Atwood takes Kinesis classes at Superior Athletic Club.
"I teach a lot of women. Their arm muscles are weaker then men's, so I recommend strength training. Same with older people, especially those who haven't kept up with strength training and fitness," Atwood adds.
Cardiovascular training is often overlooked by golfers.
"Cardio is good for endurance, especially walking. Most people by the seventh hole, they're tired. If they supplement with cardio training, they won't be as tired as they get to the end of the round," Atwood says.
If you've had a hip or knee replacement, you'll need to make adjustments to your swing.
"Be careful how much torque you put on the swing. If you flare your toes out slightly (in your stance), it relieves the stress on the knees and hips," Atwood says.
Like their tennis-playing friends, golfers often end up with sore elbows.
"I've seen people change their golf shaft; it actually helps relieve some of the stress and strain on their elbows while they're gripping, so they don't have as much vibration," says Tilton.
It's not so much the length of the club that's important; it's the construction. Tilton recommends a change to graphite shafts to dampen the force when club strikes ball. Properly fitted gloves can also make a difference, as can stretching the wrists and elbows as part of your warm-up routine.
Easing up on the grip and maintaining a smooth transition from backswing to downswing can also help avoid elbow pain, the second-most common golf injury.
Perhaps the best and easiest way to avoid golf injuries is simply to relax.
"We teach people to slow down. Don't hit the ball so hard. It's a finesse game," Tilton explains. "Some of your greatest shots are when you just relax and gently let the club do the work."
For more information on common golf injuries, visit http://golf.about.com/od/fitnesshealth/tp/commoninjuries.htm.