Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2004. 1 v. (various pagings) / Background: Back pain among the golfing population is considered endemic as it has been recommended to golfers that they should attempt to use a state of maximal spinal rotation in their golf swing in order to achieve maximum ball distance. Evidence suggests that maximum spinal rotation range of motion will be more restricted in the golfers with low back pain, even though this maximum rotated position has been considered ideal for developing optimal Club Head Velocity (CHV). Research has demonstrated an approximate 1:3 relation between CHV and air travel (i.e. distance) of the golf ball. An increase in 1mph in CHV would increase air travel of the golf ball by approximately 3 yards. If one considers that CHV is primarily influenced by the strength and power of the torso (low back and abdominal muscles), muscle balance and flexibility, which are responsible for the static and dynamic postural stability of the golf swing, it stands to reason that low back pain, which has been identified as the most common problem affecting amateur golfers, will affect CHV. Objective: The purpose of this investigation was to evaluate the immediate effect of spinal manipulative therapy on club head velocity in amateur golfers suffering from mechanical low back pain in terms of subjective and objective measures.

Thesis (M.Tech.: Chiropractic)-Durban University of Technology, 2008. xviii, 83, [29 ], 25 leaves / Golfing literature today recommends to both the amateur and professional golfers to try and achieve maximum performance with each golf club (Seaman, 1998 and Bulbulian, Ball and Seaman, 2001). This encourages golfers to use a state of maximum spinal rotation in their golf swing in order to achieve optimal performance (Seaman, 1998), thus resulting in back pain becoming endemic in the golfing population. Thus if it is considered that performance, in terms of the golf swing, is mainly influenced by; • the strength and power of the torso, i.e. the low back and abdominal muscles (Chek, 2003), • as well as muscle balance and flexibility, i.e. those muscles which are responsible for the static and dynamic postural stability of the golf swing (Chek, 2003). It then stands to reason that any decrease in the range of motion of the lumbar or thoracic spine of the amateur golfer, in terms of biomechanics, could affect their performance (Nordin and Frankel, 2001). In this regard it is hypothesised that altered biomechanics could be that of asymptomatic segmental joint dysfunction . In terms of interventions Kirkaldy-Willis and Burton (1992) explained the effect of SMT in the treatment of low back pain, similarly Bergmann et al. (1993) and Vernon and Mrozek (2005) further proposed the following effects of spinal manipulative therapy (SMT): • SMT may stretch or break intra-articular adhesions that form from immobilised facet joints due to acute synovial reactions. • SMT allows entrapped menisci to exit the facet joint in which it became entrapped. • If the capsule of the facet gets lodged between two adjacent articular surfaces, the process of SMT could allow this to be freed. • SMT re-aligns misaligned spinal segments to conform to the centre of gravity. It was thus assumed that if these mechanical and reflex mechanisms occur in the symptomatic amateur golfer, they should also occur in the asymptomatic amateur golfer. Currently however very little is known about the effects of spinal manipulative therapy (SMT) on asymptomatic segmental joint dysfunction. Objective: Therefore, the purpose of this study was to evaluate the immediate and short term effect of spinal manipulative therapy (SMT) on asymptomatic amateur golfers in terms of performance indicators. Methods: Forty three asymptomatic participants were randomized to four equal groups consisting of ten participants each (and three drop outs). Three of the groups received a single intervention, i.e. spinal manipulative therapy (SMT) while the last group acted as a placebo control group and received no intervention. Objective measurements were taken using the EDH Sports-FlightScope Pro Electronic Swing Analyser. All objective data collection took place pre and post SMT. Statistical analysis included various statistical methods and correlation analyses, by means of the latest version of SPSS. Results and conclusions: The main findings were that certain outcomes seem to be better with lumbar manipulation alone (smash, horizontal azimuth) and others better with thoracic manipulation alone (CHV, vertical azimuth, distance), but none are better with both lumbar and thoracic manipulation. Therefore in terms of future studies of this nature the treatment groups should be analysed separately and the research powered for such analyses (e.g. larger sample sizes).

Thesis (M.Tech.: Chiropractic)--Durban University of Technology, 2008 / The core stability, club head velocity and ball carry in golfers with and without low back pain – a comparative study. Objective: The aims of this study was to establish whether an observable difference exists in the abdominal core stability of two comparable groups of golfers: one asymptomatic and the other suffering from low back pain, and whether an observable reduction of performance, expressed as club head velocity and ball carry can be observed in those with low back pain. First Objective was to differentiate the groups at baseline with respect to core stability strength between asymptomatic golfers and golfers suffering from low back pain. Whereas the Second Objective was to establish whether a relationship exists between abdominal core stability, CHV and ball carry in the two population groups under study. Following the above the Third Objective was to establish which other factors besides core stability strength have an effect on CHV and ball carry. And lastly the Fourth Objective was to establish the correlation between CHV and ball carry. Design: A comparative study was carried out between the two sample groups. A sample of forty patients were selected for this study, where twenty patients were asymptomatic and had no current episode of low back pain and were able to maintain a core contraction; and the other twenty patients low back pain and could not maintain a core contraction. Because the patients presented in a random manner, the patients were matched as close as possible according to age, so as to have better comparative value between the groups (the maximum age difference of a year was instituted). This allowed for comparisons among similar ages, with the difference being their low back pain and core contraction status. Outcome Measure: Each golfer was required to hit 5 balls using a standard club (in this study, a standard driver was used), after which an average value v was calculated for CHV and ball carry. All measurements were carried out using the Flightscope Pro machine at the Durban Pro Shop. Results: Core stability and low back pain did not influence CHV. However there was a non significant trend which indicated higher ball carry in the group with better core stability and no low back pain than in the group with low back pain and poor core stability. Increasing age and handicap reduced the CHV and ball carry values significantly. Ball carry and CHV were positively correlated together in both groups.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at the Durban Institute of Technology, Durban, 2006. / The purpose of this study was to evaluate the immediate and short term effects of spinal manipulative therapy on the club head velocity of amateur golfers suffering from mechanical low back pain. This purpose was identified as low back pain which has been noted as the most common musculoskeletal problem affecting amateur and professional golfers. In the right handed golfer the golf swing produces a distinctly asymmetric trunk motion, involving a combination of left axial rotation and right lateral bending. The significant lateral bending, shear, compression and torsional forces that the lower back contends with during the golf swing causes a peak compression load of more than eight times the body weight. In addition it is found that at the end of the follow through phase the golfer's lumbar spine is rotated and hyperextended. This is known as the reversed C position, in which the facet joints approximate and in addition torsional stress is placed on the annular fibers of the disc. With repetitive swings and incorrect form the lumbar facets bear the brunt of the abnormal forces on the lumbar spine. IV In addition to this, during the downswing phase of a golf swing the role of the multifidus is to limit flexion whilst the external oblique muscle induces rotation of the lumbar spine. Together both muscles produce rotation in the lower lumbar spine. Thus the golf swing, particularly during the downswing phase, places a tremendous burden on the multifidus muscle and may cause; o muscle injury which will contribute to the golfer's low back pain and I or o joint injury as a result of muscle fatigue. Furthermore the resultant uncontrolled contractions of the multifidus muscle produces torsion to the facet joints and disc. It is therefore likely that facet syndrome may be the main cause of low back pain in golfers, as modern golf publications urge golfers to use a maximum state of spinal rotation to generate a high club head velocity. / M

Thesis (M.Tech.: Chiropractic) -Dept. of Chiropractic, Durban Institute of Technology, 2004. 1 v. (various pagings) / Background: Back pain among the golfing population is considered endemic as it has been recommended to golfers that they should attempt to use a state of maximal spinal rotation in their golf swing in order to achieve maximum ball distance. Evidence suggests that maximum spinal rotation range of motion will be more restricted in the golfers with low back pain, even though this maximum rotated position has been considered ideal for developing optimal Club Head Velocity (CHV). Research has demonstrated an approximate 1:3 relation between CHV and air travel (i.e. distance) of the golf ball. An increase in 1mph in CHV would increase air travel of the golf ball by approximately 3 yards. If one considers that CHV is primarily influenced by the strength and power of the torso (low back and abdominal muscles), muscle balance and flexibility, which are responsible for the static and dynamic postural stability of the golf swing, it stands to reason that low back pain, which has been identified as the most common problem affecting amateur golfers, will affect CHV. Objective: The purpose of this investigation was to evaluate the immediate effect of spinal manipulative therapy on club head velocity in amateur golfers suffering from mechanical low back pain in terms of subjective and objective measures.

Thesis (M.Tech.: Chiropractic)-Durban University of Technology, 2008. xviii, 83, [29 ], 25 leaves / Golfing literature today recommends to both the amateur and professional golfers to try and achieve maximum performance with each golf club (Seaman, 1998 and Bulbulian, Ball and Seaman, 2001). This encourages golfers to use a state of maximum spinal rotation in their golf swing in order to achieve optimal performance (Seaman, 1998), thus resulting in back pain becoming endemic in the golfing population. Thus if it is considered that performance, in terms of the golf swing, is mainly influenced by; • the strength and power of the torso, i.e. the low back and abdominal muscles (Chek, 2003), • as well as muscle balance and flexibility, i.e. those muscles which are responsible for the static and dynamic postural stability of the golf swing (Chek, 2003). It then stands to reason that any decrease in the range of motion of the lumbar or thoracic spine of the amateur golfer, in terms of biomechanics, could affect their performance (Nordin and Frankel, 2001). In this regard it is hypothesised that altered biomechanics could be that of asymptomatic segmental joint dysfunction . In terms of interventions Kirkaldy-Willis and Burton (1992) explained the effect of SMT in the treatment of low back pain, similarly Bergmann et al. (1993) and Vernon and Mrozek (2005) further proposed the following effects of spinal manipulative therapy (SMT): • SMT may stretch or break intra-articular adhesions that form from immobilised facet joints due to acute synovial reactions. • SMT allows entrapped menisci to exit the facet joint in which it became entrapped. • If the capsule of the facet gets lodged between two adjacent articular surfaces, the process of SMT could allow this to be freed. • SMT re-aligns misaligned spinal segments to conform to the centre of gravity. It was thus assumed that if these mechanical and reflex mechanisms occur in the symptomatic amateur golfer, they should also occur in the asymptomatic amateur golfer. Currently however very little is known about the effects of spinal manipulative therapy (SMT) on asymptomatic segmental joint dysfunction. Objective: Therefore, the purpose of this study was to evaluate the immediate and short term effect of spinal manipulative therapy (SMT) on asymptomatic amateur golfers in terms of performance indicators. Methods: Forty three asymptomatic participants were randomized to four equal groups consisting of ten participants each (and three drop outs). Three of the groups received a single intervention, i.e. spinal manipulative therapy (SMT) while the last group acted as a placebo control group and received no intervention. Objective measurements were taken using the EDH Sports-FlightScope Pro Electronic Swing Analyser. All objective data collection took place pre and post SMT. Statistical analysis included various statistical methods and correlation analyses, by means of the latest version of SPSS. Results and conclusions: The main findings were that certain outcomes seem to be better with lumbar manipulation alone (smash, horizontal azimuth) and others better with thoracic manipulation alone (CHV, vertical azimuth, distance), but none are better with both lumbar and thoracic manipulation. Therefore in terms of future studies of this nature the treatment groups should be analysed separately and the research powered for such analyses (e.g. larger sample sizes).

Thesis (M.Tech.: Chiropractic)--Durban University of Technology, 2008 / The core stability, club head velocity and ball carry in golfers with and without low back pain – a comparative study. Objective: The aims of this study was to establish whether an observable difference exists in the abdominal core stability of two comparable groups of golfers: one asymptomatic and the other suffering from low back pain, and whether an observable reduction of performance, expressed as club head velocity and ball carry can be observed in those with low back pain. First Objective was to differentiate the groups at baseline with respect to core stability strength between asymptomatic golfers and golfers suffering from low back pain. Whereas the Second Objective was to establish whether a relationship exists between abdominal core stability, CHV and ball carry in the two population groups under study. Following the above the Third Objective was to establish which other factors besides core stability strength have an effect on CHV and ball carry. And lastly the Fourth Objective was to establish the correlation between CHV and ball carry. Design: A comparative study was carried out between the two sample groups. A sample of forty patients were selected for this study, where twenty patients were asymptomatic and had no current episode of low back pain and were able to maintain a core contraction; and the other twenty patients low back pain and could not maintain a core contraction. Because the patients presented in a random manner, the patients were matched as close as possible according to age, so as to have better comparative value between the groups (the maximum age difference of a year was instituted). This allowed for comparisons among similar ages, with the difference being their low back pain and core contraction status. Outcome Measure: Each golfer was required to hit 5 balls using a standard club (in this study, a standard driver was used), after which an average value v was calculated for CHV and ball carry. All measurements were carried out using the Flightscope Pro machine at the Durban Pro Shop. Results: Core stability and low back pain did not influence CHV. However there was a non significant trend which indicated higher ball carry in the group with better core stability and no low back pain than in the group with low back pain and poor core stability. Increasing age and handicap reduced the CHV and ball carry values significantly. Ball carry and CHV were positively correlated together in both groups.

Submitted in compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2017. / Background Performance of the golf swing is mainly influenced by the strength and power of the torso i.e. the low back and abdominal muscles (Gluck, Bendo and Spivak 2008). As rotary velocities increase, muscle force is absorbed by deforming connective tissue, allowing for increased rotation (Gluck et al. 2008). Therefore any decrease in range of motion of the spine in the golfer, could affect performance (Nordin and Frankel 2001). The cause of poor range of motion is often a result of a physical restriction or mechanical dysfunction within the joints (Blanchard 2004). Spinal manipulative therapy (SMT) has been found to bring about biomechanical effects such as an increase in range of motion (ROM) (Millan et al. 2012) by releasing trapped meniscoids and connective tissue adhesions (Pickar 2002). A lack of core muscle strength is also thought to result in an inefficient technique, which predisposes individuals to poor performance (Asplund and Ross 2010). According to Kibler (2006) core muscle strengthening (CMS) is essential for efficient biomechanical function, to maximise force generation and minimise joint loads in all types of activities. The effects of SMT on golfing performance are well documented (Jermyn 2004; Delgado 2006) however, the effects of CMS on golfing performance are unknown. By improving physiological and biomechanical function through CMS, performance indicators maybe maximised (Pickar 2002; Kibler 2006). Aim Therefore, the purpose of this study was to determine the effectiveness ofSMT compared to CMS on performance indicators club head velocity (CHV) and ball carry (BC) in asymptomatic amateur male golfers. Methods Fifty-two asymptomatic amateur male golfers were recruited for this study, but seven withdrew leaving a final sample size of forty-five. Participants were randomly allocated to either the Core Muscle Strengthening (CMS, n=20) or the spinal manipulative group (SMT, n=25). The SMT (n=25) group received a single session of SMT while CMS (n=20) underwent a four week CMS exercise program. Core muscle strength and indicators of performance were taken before and after the intervention using the Bio-pressure feedback unit (BPU) and GC2 Foresight (swing analyser) respectively. Statistical analysis included paired t-tests to assess change in duration of contraction in the CMS group, Pearsons correlation analysis was used to assess the correlation between changes in CHV and BC intra-group and profile plots were used to show direction and trend of the effect by means of the latest version of SPSS software. Results The main findings show that CMS will improve following a four week CMS program (p= <0,001).When compared over time both SMT and CMS have the same effect on CHV (p= 0.127), whereas CMS has a more profound effect over time compared to SMT on BC (p=<0.001). Conclusion Core muscle strengthening appears to have a positive influence on CHV and BC in asymptomatic amateur male golfers, however it is still uncertain which intervention is more effective. Therefore future studies of this nature should look to increasing the duration of the study or the sample size. / M

Aim The aim of the study was to examine the wrist angles at impact when striking from two surfaces common in golf. The research question was: is there a difference in ulnar/radial deviation or flexion/extension at the wrists when striking from a mat placed on a steel platform compared to striking from grass.   Method Six male elite golf players (Handicap: +0.6±2.2) were recruited for the study. An optoelectronic system containing 12 infrared cameras captured reflective markers placed on the participants and on a golf club when they performed three shots from a mat and three shots from grass. The markers were identified in the Qualisys Track Manager software and the marker trajectories were imported into Visual 3D. Reflective markers were placed bilaterally on the medial and lateral epicondyle of the humerus, the radial and ulnar styloid processes, and the 2nd and 5th metacarpophalangeal joint. In addition, an elbow joint marker was calculated as the midpoint of the two elbow markers. The local frames were defined from these markers giving the proximal and distal ends of segments and the frontal plane.The wrist angles were defined as the orientation of the local frame of the hand segment relative to the orientation of the local frame of the forearm segment. Flexion/extension and ulnar/radial deviation of the wrists were calculated at impact.   Results There were no significant differences (p &gt; 0.05) in ulnar deviation or flexion/extension at impact for either wrist between the two conditions.   Conclusion No significant differences in the wrist angles at impact between the two conditions indicate that the wrist position did not change significantly between the two conditions. This may be positive from a learning perspective since the technique does not change irrespective of the condition. Furthermore since there was no significant difference in ulnar deviation at impact between the two conditions, the ulnar deviation at impact is presumably not a reason for why players and researchers suggest that playing from mats is more injurious than playing from grass. The reason could be due to differences in the loads on the wrists when striking from the different surfaces. Future research should therefore be conducted to examine the differences in loading of the wrist joints between the two conditions. / Syfte och frågeställningar Syftet med studien var att undersöka handledsvinklarna vid träffögonblicket vid slag från två vanliga underlag i golf. Frågeställningarna var: finns det en skillnad i ulnar/radial deviation eller flexion/extension vid handlederna vid slag från en matta placerad på en stålställning jämfört med slag från gräs.   Metod Sex manliga elit golfare (Handikapp: +0.6±2.2) rekryterades till studien. Ett optoelektroniskt system innehållandes 12 infraröda kameror registrerade reflekterande markörer som var placerade på försökspersonerna och på en golfklubba när försökspersonerna utövade tre slag från matta och tre slag från gräs. Markörerna identifierades sedan i mjukvaran Qualisys Track Manager och markörbanan importerades till Visual 3D. De reflekterande markörerna placerades bilateralt på mediala och laterala epikondylerna av humerus, stydoliderna på radius och ulna, samt på andra och femte metakarpofalangealled. Utöver dessa markörer så beräknades en armbågsmarkör som mittpunkten mellan de två armbågsmarkörerna. De lokala koordinatsystemen var definierade från dessa markörer vilket gav de proximala och distala änderna av segmenten samt frontal planet. Handledsvinklarna var definierade som positionen av det lokala koordinatsystemet på hand segmentet i förhållande till positionen av underarmssegmentets lokala koordinatsystem. Flexion/extension och ulnar/radial deviation av handlederna beräknades vid träffögonblicket.   Resultat Inga signifikanta skillnader (p &gt; 0.05) upptäcktes för ulnar deviation eller flexion/extension vid träffögonblicket för någon av handlederna mellan de två underlagen.   Slutsats Att det inte upptäcktes några signifikanta skillnader i någon av handledsvinklarna vid träffögonblicket mellan de två underlagen visar på att handledens vinkelposition inte skiljer sig signifikant mellan de två underlagen. Detta kan vara positivt ur ett inlärningsperspektiv eftersom tekniken inte ändras om man byter underlag. Att ulnar deviationen inte skiljde sig mellan de två underlagen tyder på att ulnar deviationen troligtvis inte är en orsak till varför forskare och spelare föreslår att slag från matta är mer skadligt än slag från gräs. Anledningen till detta kan vara på grund av skillnader i handledsbelastning vid slag från de olika underlagen. Fortsatt forskning bör därför undersöka skillnader i belastningen på handlederna mellan de två underlagen.

Title: Issues of the motion apparatus injuries among golf players Objectives: The goal of the work is to find out the most common health problems among golf players and possible preventative measures against their formation. Methods: The work is structured as a research, which has been created on the basis of an analysis of relevant sources. The literature, printed and electronic monographs and periodical were obtained from library catalogues and the Internet. The foreign studies were obtained from databases PubMed and SPORTDiscus. Results: The most common vertebrogenic difficulty among both amateur and professional golf players is low back pain (LBP). It appears more often among men than women. Specific issues are the overload of the paravertebral muscles, occurrence of the osteophytes and degenerative changes in the area of the facet joints and intervertebral disc. Other health problems among golf players are inflammation of the rotator cuff tendons, posterior glenohumeral subluxation, acromioclavicular disfunction, shoulder joint arthritis, stress fracture of the ribs, epicondylitis, and in the area of the wrist and arm of the golf players occur especially fractures, subluxation of the joints and overload of the tendons (especially adductors, flexors and extensors). Almost all the studies...