Aching Back: Stretch It Out?

aching back in golf: stretch it out?
By: Dr. Jordan Mackner, DC
To help improve a person's golf game at Golfstretch Therapies, I provide them with adequate exercises and stretches to improve their mobility. I will even provide clients with stretches that will be beneficial for their diagnosis if they suffer from some kind of pain-related condition. Stretching is something we advocate at Golfstretch Therapies, but it seems to me there is a common theme in the golf industry to have a specific stretch for a common diagnosis (i.e. back pain). 
For instance, I recently read in a well-known golf magazine that if you have back pain you should do three specific stretches (for the purpose of this article, we’ll call them X, Y, and Z) before or after your round to help your pain. As a physician who an area of expertise in musculoskeletal pain and sports performance, I sometimes cringe when I see these articles. If you go back to my previous statements, I said, “I will even provide clients with stretches that will be beneficial for their diagnosis if they suffer from some kind of pain-related condition.” 
The key to this statement is that the person in pain actually received an adequate exam from a licensed professional and had a diagnosis for their pain. Simply stating that stretches X, Y, and Z will help an extremely broad term such as “back pain” without a correct diagnosis for why the person has pain is not only ridiculous, but possibly dangerous. 
One of the great things about the game of golf is that it allows us to play well into our middle-aged years and beyond. Many of my patients and stretching clientele are currently 60+ years of age. This makes generalized stretching advice for these players comparable to playing Russian roulette. The older population in this sport is bound to have musculoskeletal pain (with back pain being the highest % of pain and injury in golf). Since this pain is so common, many people want to jump on the marketing bandwagon and be “the expert” on what stretches will help your low back pain during golf. 
The problem is the following list also causes back pain in this same demographic of people: vascular disease, arthritis, metastatic cancer, prostate disease, tumors, pancreatitis, gallstones, sciatica, disc herniation and the list goes on! Every single golfer that comes into my office that is on a stretching or strengthening plan for his or her golf game has already received a history, exam, and consultation prior to being put on that routine. 
If they are cleared of any possible diagnosis that would require a triage of care, then they can begin treatment. Or, if they do have an alternative problem, a referral can be made upfront without jeopardizing the person’s own health by prolonging treatment initiation. But, I have to say stretching out your prostatitis or malignancy will probably not cure your back pain! It also should be noted that even if the pain is found to have a muscle or joint origin, there should never be a cookie-cutter approach like the magazine stated. Unfortunately, it’s not that easy. If, after the exam, it is deemed that the pain is truly muscle and joint-related, I will always help the client progress using the correct protocols for what they have been diagnosed with. 
Furthermore, almost all of my athletes looking to improve their game will receive a full upper-quadrant and lower-quadrant functional screen to tease out any physical limitations they might have (i.e. Titleist Performance Institute-style screens). This will further guide individualized care for that person. I wanted this piece to serve as a reminder for those out there giving advice and also receiving advice when it comes to knowing their own pain. Generalizing can be dangerous and no diagnosis should receive a cookie-cutter answer like the one I saw in a widely read golf magazine. Getting a correct diagnosis from a physician or licensed professional first should always be the gold standard of care.