July 27th, 2017

Danny Willett and Back Injury – What are his Options?

Danny Willett and Back Injury - What are his Options?

Danny Willett is a fine British golfer and winner of the 2016 Masters’ championship. He is not yet 30 years old, and was most recently in the news because, according to a

Daily Mail (UK) article of 25 July 2017: “The L5 (disc) and the sacrum were out from the x-ray which is why it hurts when I rotate on it. I was on Voltarol all week and wasn't doing much practice. Asked if surgery could be the answer, Willett added: 'I don't know. I'd do anything that helped. I don't think it does need surgery, it's more just getting it in line and the only thing that irritates it massively is swinging poorly.'

What should Willett do next? Take a break to let himself heal, right in the middle of the golf season? Rely on temporary healing of an injury which may recur immediately the injury causing mechanisms are repeated? Have a chiropractor dedicated to him who adjusts his spine every few holes - if indeed that works for him? Have, heaven forbid, surgery? Or consult a movement-analysis expert who can explain not just his injury but also how he might get better consistency as well as improved ball-striking through an all-encompassing assessment? Only he can decide. However, this is what one movement-analysis specialist can offer (based on an extensive education in musculoskeletal anatomy, injury mechanisms in sport, motor control and even biomechanics; see more in the “about” section of this website):

Generic and golfer-specific analysis: What are the positions and movements of the human body that would cause injury in any golfer? What are this particular golfer’s specific joint constraints that need to be taken into account while helping him make an effective, efficient and safe(r) golf swing? While specific plans would need a detailed history, posture, gait, and swing analysis, the generic aspect would apply to all golfers with similar swing mechanics.

The first order of business would be to look at the etiology of the injury (it may have been caused by other factors and only exacerbated by golf, but that is bad enough). The only “history” available is that the L5-sacrum joint of the vertebral column was “out”; there was pain upon rotation; and “massive” pain when the swing was “poor”. (A highly-researched article on back injury in golf here: https://thegolfnewsnet.com/kirankanwar/2017/04/12/golfers-lack-spine-104621/). In the absence of any further information, the first reaction should be “no backswing which separates the thoracic from the lumbar rotations”! In addition, other positions which cause greater than normal compression or shear loads at the site of injury include excessive spinal forward flexion (see pics below) and a big “crunch” factor of lateral flexion (side bend) and axial rotation during the downswing, and past impact. So that explains the mechanisms of injury during the downswing, which takes place at high speed, excessively loading the spine. What next? Look at other golfers with similar issues and use solutions they might have hit upon? For instance Jason Day in an interview some months ago said he was reducing backswing length to reduce downswing “crunch” (which was the position when he felt pain)? No! 

The most scientific solution would be to work backwards from the requirements of the downswing and impact - in this case less forward flexion and less lateral bending during downswing axial rotation. Then one should figure out set-up and backswing positions that will permit a safer downswing (not forgetting such positions must still allow the club to arrive at the ball from the inside, and at speed, to fulfill good ball-flight requirements). Generic scientific solutions would include 1. a more upright posture, 2. keeping the right (Willett is right-handed) shoulder lower than the left throughout the backswing, and 3. changing the manner in which torso rotation happens.

These latter two solutions are unique and thus unusual, but absolutely vital, and even supported by what we know from basic musculoskeletal anatomy, neuro-anatomy and motor control. As regards 2. above, why have a right shoulder that is higher than the left at the top (see pic below of lower left shoulder, ie. higher right shoulder, at the top)? It creates  a far longer range of motion for the right shoulder to have to drop down through, than if it stayed down throughout the backswing. In addition, the core muscles and largest torso rotators - the abdominal obliques - would then have a forward (towards target) instead of downward (towards the ball), line of action. Should a golf downswing make the core move down towards the ball or forwards, towards target?

As regards 3. above, did you know the brain has an area of gray matter called the basal nuclei/ganglia which send motor commands to set-up the torso so that it can be positioned to better facilitate limb movement? And that there are separate pathways for commands going to the trunk and proximal parts of limbs to travel down, than there are for messages to distal parts of limbs? That means the brain itself tends to separate the movements of the proximal (eg. pelvis) and distal (eg. arms, forearms, hands) parts of the body. Suppose we were to simplify the brain’s job by consciously positioning the body so the brain has a less complex movement to supervise?

Modern motor control theory also suggests concepts that might support such ideas. A paper (this is a must-read paper written by the postulators of the concept:                   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2965031/ ) on a fairly new concept termed the “leading joint hypothesis”, tells us that, “Unraveling the principle used by the brain to organize human movements is one of the primary goals of motor control research. The need for a principle or a control strategy is apparent when the task can be performed via many different movements, yet a single movement needs to be produced.” In addition, the authors, while explaining their hypothesis state that, “The leading role is endowed to a joint that has mechanical advantage in the limb. Because of relatively high inertia and the increased musculature of the proximal limb segment, the mechanical influence of proximal joint motion on distal joints is much higher than the influence of distal joint motion on proximal joints. For this reason, the leading joint is often the proximal joint that acts similar to a whip handle, a single wave of which can cause complex motion of the cord.” All of these concepts might be said to argue for a  trail side of the body that stays down and does not rise during the backswing, as well as a pre-swing positioning of the pelvis, through desirable torso rotation.

Incidentally, any improvement in positions and movements that reduce the potential for injury will also improve ball striking and consistency because after all, if all joints are positioned based on their design capabilities, they do not get “stuck” in the middle of other joints moving “this way and that”. All body parts are then able to act in cohesion to produce a “domino-effect” downswing, which places the least possible loads them all, and allows a smooth-flowing, without-volition, downswing.

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