ONS on Spring Training

An article by  Tanya Kalyuzhny, DPT, MDT, director of physical therapy at ONS in Greenwich, was published recently in the Greenwich Sentinel.   Greenwich Physical Therapy

In Spring Training is Not Just for Pros, Tanya stresses the importance of building strength and flexibility before staring up seasonal activities to avoid many of the painful injuries that can crop up.  In the March 16 issue, she writes:

If you’re like me, you’re chomping at the bit for spring to arrive so you can tie up your sport shoes and head out in the sun with your racquet or golf club in hand.

Not so fast!

If you haven’t been using the muscles necessary for your sport in the past few months, you’ll need to start slowly and make sure you have the strength and conditioning needed to play before the season is underway.

A simple pre-season program using light weights or an exercise band can help protect against back strain, arm pain and worse. Start with daily stretching exercises, held for a minute, and move on to two sets of weight bearing or resistance exercises of 15 repetitions three to four times a week.


Common golf and tennis injuries are usually the result of muscle strain and fatigue, muscular imbalance, overuse, or any combination of the three. As with any physical activity, core muscle strengthening is essential to train your pelvis, lower back, hips and abs to work together to give you power, better balance and stability. Without core strength, the muscles in your back, neck and extremities will be strained taking you through your motions.

Beyond the core, your shoulders need to be ready for the demands of the repeated overhead, rotating motions required in tennis and golf. Conditioning that area is not only important to prevent tendinitis and rotator cuff problems, weakness in the joint’s surrounding muscles can also lead to pain elsewhere in your arm when smaller muscles are forced to overcompensate.

To avoid painful shoulder injuries, it’s important to strengthen the peri-scapular (shoulder blade) muscles as well as the four muscles that make up the rotator cuff. The rotator cuff helps stabilize the upper arm within the shoulder socket and manage the speed of your swing and follow through.

You can strengthen and increase flexibility in this region of your body by using light weights or an exercise band.

In general, exercises that involve the internal and external rotation of the shoulder are good for the rotator cuff. You can work on external rotation by alternating arms to rotate the band away from your body, starting with your arms waist level and forearms parallel to the floor.

For internal rotation exercise, tie your band to a door knob and hold it in one hand across your shoulder. Start with your arm bent at 90 degrees as though you are waving hello, and slowly stretch the band downward until your forearm is parallel to the ground. Slowly return to your starting position and switch arms.

It’s also important to keep your pectoral muscles and those in the back of your shoulder supple. A corner stretch is great for the pecs. Lean into a corner of a room with each of your forearms resting on the adjacent walls and hold the stretch.

Cross body stretches, achieved by moving your extended arm across your chest, will help prevent and reduce any tightness that may occur in the back of the shoulder.

These exercises will also help reduce the risk of elbow conditions such as tendinitis and golf and tennis elbow. Elbow injuries can occur because the wrist muscles, which originate in the wrist but attach at the elbow, become overused or lack proper strength to match the demand of each sport.

Exercises to help thwart this from happening involve wrist flexion and extension while holding a light weight. First, sit while you hold a weight, palm facing down. Raise the weight by pulling the hand upward, bending at the wrist. Next, rotate your arm so the palm of your hand is facing the ceiling and bend your wrist to move the weight upward.

Common sports-related lower extremity injuries, including calf strains and ankle sprains, can be avoided if the musculature is strong enough to support the acceleration and deceleration involved in walking, running and jumping. Ankles are particularly vulnerable to quick changes in direction. Single leg balance exercises are the best way to protect against ankle and calf issues. Try standing on one leg on a balance board, standing on one leg with your eyes closed, or standing on one leg on a pillow. Single leg heel lifts from the edge of a step, and slowly lowering the heels below the step are also good calf exercises.

When you do head out to the court or the greens, start slowly and be sure to warm up. Don’t play an 18-hole round of golf without a few days swinging at the driving range. Immediately before play, start with 5-10 min warm up with a light jog or walking briskly in place. When you finish for the day, cool down and gently stretch your muscles.

My last piece of advice is to have a professional evaluate your technique and equipment. An improper grip, ill-fitting racket or club, and/or faulty body mechanics can lead to an injury no matter how fit you are.



Golf Hazards and Injury Prevention

ONS PT Chalon Lefebvre demonstrates an effective golf stretch.

Often perceived as a low risk sport, golf is actually physically demanding and injuries from golf are on the rise.

One study showed that during a two-year period, 60 percent of golf professionals and 40 of amateurs suffered either a traumatic or overuse injury while golfing. Over 80 percent of the reported injuries were related to overuse.

“Many golfers incur injuries to the back, wrist, elbow and other joints,” says John Crowe, M.D., who specializes in treating hand and wrist conditions. “Newer players are often hurt because of poor mechanics, but avid golfers with years of experience frequently suffer from overuse injuries. As with many activities that involve repetitive movements, joint wear and tear is a major concern. Also the combined twisting of the spine and the torque that is absorbed in the hands while swinging and hitting the ball can create ideal conditions for injury.”

ONS physicians treat a wide variety of conditions in professional and amateur golfers. Of the aches and pains that commonly afflict golfers, low back pain is the most common injury or complaint in both groups. The rotation of the spine as a golfer swings his club toward the ball places considerable strain on the spine and surrounding muscles in the back. Players who lack ideal flexibility and strength are at particular risk for back strain, but professionals too are at risk due to the regular high demands imposed on their bodies. Most back/spine problems can be corrected by adjusting the dynamics of the players swing, anti-inflammatory medications or other conservative treatments.

Another great stretch to do before and during play.

Second to low back injuries are upper extremities injuries. A golfer’s wrist is particularly vulnerable to injury from overuse or poor wrist control during the swing. Unexpected accidents may also cause injury like swinging at a ball in high grass and colliding with a tree root.

Try these 10 helpful tips!

1. Train by repetitive motor learning specific to golf. Example: long distance runners are not trained by sprinting.

2. Never separate the torso from the hips while swinging.

3. For a more beneficial aerobic workout, walk outside, NOT on a treadmill.

4. Improving flexibility will result in fewer injuries, swing consistency, improved distance through less compensation and greater power.

5. Remember to stretch AFTER you warm-up your muscles.

6. To achieve a more powerful swing, strengthen your core through resistance training, yoga and Pilates.

7. Avoid surgery by taking care of your body on and off the course through exercise, healthy diet habits and minimizing stress.

8. Wrist weakness and radiating forearm pain could be “golfers elbow.” Be sure to maintain proper form and resist the temptation to play too much. REST is the best treatment for this injury.

9. Swimming, biking and using the elliptical machine are three of the most effective cross-training exercises.

10. When picking up your ball, always remember to bend with your knees.

11. Listen to your body and don’t play if you’re experiencing pain or are tired. If something is beginning to hurt, get it checked out.