6 RULES OF TRAINING FOR INJURY PREVENTION
A little while ago we published this article examining the perceived link between strength training and injury in golfers and how the research shows pretty unequivocally that strength training in fact reduces injury rate. The caveat frequently seen in the research is that training must be ‘appropriate’.
This begs a pretty obvious question - What exactly is appropriate training?
Golf fitness is a relatively new field, what is considered appropriate training volume, frequency, intensity, load, etc has not been fully established. However, there are some well established patterns and protocols in strength and conditioning research we can utilise to give the broad outline of injury prevention best practice.
As a general starting point appropriate training should help prepare an individual for the demands of the sport while also minimising risk of training injury.
This article discusses a few rules of training that can help us with this goal.
Rule #1 - Train foundational movement patterns
There are some foundational movement patterns that every single golfer should be seeking to develop, load and master - namely the squat, hinge, upper body push, upper body pull and carry/ locomotion exercises.
Training these key movements in the correct ratios will allow for balanced strength development, this is important to injury prevention as it helps prevent the buildup of asymmetries. Indeed many notable strength coaches including Mike Boyle have espoused the benefits of balanced upper body pushing and pulling strength for shoulder health - you should be able use as much weight on a chin-up (including body weight) as you can on a bench press. However, this is often far from the case with most people’s pushing strength being far greater than their pulling strength, as such we will often program pulling to pushing in a 2:1 or even 3:1 ratio in order to balance out this discrepancy. Strength developed in these patterns also allows the body to cope with the eccentric stress of the golf swing, reducing the prevalence of overuse injuries.
This also highlights the problem of training with a high degree of specificity - golf is inherently an asymmetrical pattern and by training in a highly specific manner you may end up reinforcing the asymmetries as a result of the golf swing and opening yourself up to potential injury.
As Eric Cressey puts it “specificity works great until you're so specific that you wind up injured and have forgotten how to do everything else.”
Obviously training specificity is important for performance and seeing carryover from the gym to the course, but this must play second fiddle to injury prevention - after all you can’t train, practice or compete when you are injured. This is particularly pertinent when you consider overuse is typically the most common mechanism of injury for golf. As such, we do not want to spend a huge amount of gym time stressing the joints in the same specific way we do on the course already.
When training for golf, then, it is better to train qualities that translate to the golf swing rather than seeking to mimic golf swing itself.
The image above shows the movement patterns and planes required in the golf swing and the exercises that can therefore be used to develop these patterns - as we can see this takes us full circle back to our general movement patterns.
Rule #2 - Train core intensive movements for spinal health
The core muscles help safeguard the lumbar spine during sports, gym, and everyday activities and are therefore crucial in preventing back pain. If the core is weak, then other muscles will have to overcompensate in order to stabilise the pelvis and spine, leading to faulty movement patterns, asymmetries and injury.
Golfers, for example, are more susceptible to lower back pain due to rotating at the lumbar spine. The rotation should occur through the pelvis and thoracic spine, and the lumbar spine should remain in a fixed position. A strong core, in addition to the glutes, and stretching out the anterior hip muscles will help stabilise the pelvis back in more a neutral position, preventing the lumbar spine from over extending and rotating into ranges of motion it is not designed for.
Additionally, the core muscles link the upper and lower body. If a link in the body chain is broken, performance will suffer. Much of the power in the golf swing actually comes from the ground, in order to effectively transfer this ground reaction force through the body and to the club, the pelvis and spine need to be stable. This stability is achieved when the core muscles and glutes are strong and highly functioning.
However, many train the core suboptimally.
In short, you should train the function of the core - not it’s anatomy. This generally means training 4 patterns:
Rotational core strength
Anterior core strength
Lateral core strength
Hip extension strength
Hip extension strength is usually covered in the hip hinge and bridging exercises that make up hip dominant lower body work so we tend not to worry too much about incorporating them into specific core programming. Carries will usually cover one or more of these categories and unilateral work (particularly upper body) has a high degree of anti-rotation work. Our direct core work will therefore usually focus on anti-extension, anti-lateral flexion and anti-rotation - as this is especially important for golfers. If you train 3x a week then you can simply rotate between the three, completing each once per week.
Rule #3 - Train plyometrics for lower body health
Although there is little study with golfers specifically at this time, there is significant evidence plyometrics have the ability to reduce lower-extremity injuries, especially in female athletes. This may be as a result of positive adaptations in bone development and changes in the muscle-tendon unit that has been shown in certain populations. Research has also suggested that plyometrics maybe useful for enhancing performance by increasing lower extremity strength, rate of force development, mechanical power, and stretch-shortening cycle function of the muscle (Markovic & Mikulic, 2010).
For these reasons plyometrics represent a solid addition to any program for performance enhancement or injury prevention. The key to successful plyometric training, particularly from the point of view of injury prevention, is utilising a sensible progression strategy.
Practically, this means selecting a progression (and number of sets and reps) that mean each jump and landing displays good mechanics - Good mechanics should always be a major emphasis with plyometrics.
When beginning plyometric training we recommend a sub-maximal technique phase to teach proper landing mechanics - maximal jumps should not be performed until landing mechanics are solid to reduce injury risk. This phase often features landing on a box, removing any countermovement with the arms and sticking landings for a count between jumps.
Once solid technique has been established with sub-maximal unloaded jumps, max effort jumps can begin. At this point the athlete can begin to string jumps together continuously, they could also begin to progress to some loaded, lateral or rotational plyo as well.
Rule #4 - Gradually increase training load/ intensity
In the cliff note version of adaptation, the body adapts to a stressor (for our purposes lifting weights) the body adjusts to this stress (by improving force output qualities), compensating so it can deal with the stress if it happens again. This means that if we want to continue to create adaptation the stressor we use must get greater over time.
This doing more over time is what is meant by progressive overload. At its simplest, utilising the rule of progressive overload means adding weight to the bar or doing more reps each session, each week or each month. It is the most important law in strength training and vital if you want to get stronger.
However, it is worth noting that research has suggested rapid increases in training load are responsible for a large proportion of soft tissue injuries (Gobbett, 2016). As such it is important the we take a slow and gradual approach to increasing training load. I like to use the NSCA guideline of not increasing intensity by greater than 5-10% per week, this will allow for improvement over time while also managing risk of stressing the muscles and joints too much.
Whilst it may lead to quicker short term gains you really aren’t doing yourself any favors by rushing into loads/volume that you aren't ready for!
Further to sensible use of the progressive overload principle we must make sure that training intensity is appropriate for the current training session and exercise set.
When resistance training a set can be taken to mechanical failure - the point at which you literally cannot complete another rep, the weight just won’t budge anymore. Or alternatively technical failure - the point at which technique is first altered or degraded by fatigue. In other words, the point at which your reps are no longer perfect. Training to mechanical failure is not appropriate for golfers - who are chasing improved movement quality, strength development and improved CNS function. They should instead train to technical failure.
Rule #5 - Appropriate exercise selection and progression
If, as discussed in the first rule, we should all be doing the same foundational movement patterns every or almost every session then exercise selection is not a concern right?
The key to unlocking the benefits of the foundational movement patterns and long-term success in your training is to emphasise movement development and pick variations/ progressions of each movement to suit you rather than sticking to dogmatically programmed exercises that may not fit your body, your current training experience and goals.
In really broad terms this probably equates to selecting the most difficult exercise progression you can do technically perfectly for the desired number of reps.
Getting the exercise selection and progression right is where a full injury history and movement assessment becomes really valuable. For example, if an athlete comes in, talks about a history of shoulder problems and demonstrates limited shoulder flexion range of motion overhead pressing progressions are probably (read definitely) not appropriate for that individual.
Rule #6 - Appropriate load and volume
Golfers are not strength athletes and other measures out of the weight room (quality of sport practice or general wellness/soreness/fatigue) and the key indicators of training such as clubhead speed or power output also need to be considered when deciding on appropriate training load and volume.
Getting more with less is better, particularly when training is aimed at improving performance in a sport/ activity outside the weight room. Getting less with less might also be better, if you can then divert time to other valuable things like sport skills practice.
Our goal then is to be as efficient with our training as possible to target the physical qualities the golfer needs most.
For most beginners it is vital to focus on getting stronger, and the most effective way to do this is still heavy (relative to the individual) barbell lifts. As the athlete becomes more advanced it may not be practical or indeed required for their total golf development to further develop strength in this manner.
The higher loads stronger athletes are capable of handling represent a more stressful event on the body and thus takes much greater reserves to recover from. Additionally, continued strength gains may require more volume, effort and time in the gym to achieve and by this point the athlete likely has a good enough strength base built for it not to limit their performance potential. In this case, we would focus on strength maintenance (lower total volume), then any extra gym time beyond that can be focused on things like mobility and recovery.
It should be noted though that advanced athletes - at least in a strength training sense - are rare in golf. As such the vast majority of golfers will belong to that beginner category, where the loads they are capable of using are not generally heavy enough to compromise recovery capacity and therefore the diminishing returns of strength training are less of a consideration.
For the vast majority of golfers strength training will probably be no more 2 or 3 times a week, training each of the foundational movement patterns with around 15-25 reps. This can be done with each session lasting under an hour, including a proper warm-up and any cool down/ recovery work.
Spending 2-3 hours per week on fitness and all of its potential benefits is well worth the time, but those who feel the need to spend hours and hours in the gym may be better suited using that time for practice, or at very least active recovery work.
Check out this fancy infographic:
This article is the best representation of our thoughts and practices for training golfers right now, there are certainly many other ways to train effectively and safely for injury prevention. If you have anything you think we've missed or need to add please comment below - we'd love to hear from you!