You rested it. You iced it. You bought the brace, and for about two weeks, it helped. Then you walked 36 holes over a weekend, and the pain came right back.
That pattern is not necessarily bad luck, and it does not always mean you have a stubborn injury. It may mean that treating the painful area addressed the symptoms without addressing why that area was being overloaded in the first place.
In golf, the site of pain does not always identify the source of the problem. Sometimes it does. A painful structure may be injured and require treatment. But in many golfers, the larger question is why that particular structure keeps taking more stress than it can handle.
That distinction matters when the same elbow, the same low back, or the same lead hip starts hurting again every season.
Quick Answers, Before the Details
Why does my back hurt after I play golf? A round places repeated rotational and muscular demands on the body. You may tolerate those demands while you are playing but notice pain or stiffness afterward as irritated or fatigued tissues become more noticeable. When this happens repeatedly, it is worth asking why the same area is being overloaded each time you play.
Does recurring golf pain mean there is something wrong with my swing? Not necessarily. Swing mechanics can contribute, but they are only part of the picture. Hip and spinal mobility, strength, movement control, previous injuries, playing volume, and recovery capacity can all affect how your body handles the forces of the golf swing.
Why does the same golf injury keep coming back? Rest can give an irritated area time to settle, but it does not necessarily change what caused the overload. If you return to the same amount of golf with the same movement limitations or physical capacity, the same tissue may become irritated again.
When should I have golf-related pain evaluated? Consider an evaluation when pain is not clearly improving after two or three weeks, repeatedly returns when you play, or begins to interfere with your swing or normal activities. Numbness, tingling, significant weakness, pain traveling down an arm or leg, or a sudden loss of function deserves more prompt medical evaluation.
Can pain in one area be caused by a problem somewhere else? It can. The golf swing transfers force through a kinetic chain that includes the legs, hips, pelvis, spine, shoulders, arms, and wrists. When one part of that chain cannot provide the movement or control the swing requires, another area may take on additional stress. Finding that relationship is one of the central ideas explored in this article.
What Actually Goes Wrong
Golf is a repetitive, directionally asymmetric activity. A golfer rotates, loads, accelerates, and decelerates through essentially the same movement pattern and in the same direction, over and over again. That may mean dozens of full swings during a round, many more on the practice range, and thousands over the course of a season.
It is easy to assume that this asymmetry is the problem. It is not. The human body is very capable of adapting to one-sided activities. If repetitive movement in one direction were inherently harmful, we would not have healthy golfers, pitchers, tennis players, or fencers.
The issue is more specific. Problems can develop when the repeated demands of the golf swing exceed what an individual golfer’s body can provide. That includes adequate mobility, strength, coordination, and the ability to recover between rounds and practice sessions. The greater the mismatch between what the swing requires and what the body can consistently handle, the greater the opportunity for overload.
During every swing, force moves through a connected chain: from the ground through the feet and ankles, knees, hips and pelvis, trunk, shoulders, arms, wrists, and finally the club. Each part of this kinetic chain has a job to do at a particular time.
When one part cannot contribute enough mobility, stability, strength, or control, another part may have to compensate. One swing may cause no problem at all. But when that compensation occurs hundreds or thousands of times, the same tissues can be repeatedly exposed to more stress than they are prepared to handle. Over time, that repeated overload can contribute to pain and injury.
Following the Swing, Link by Link
The Lead Hip
For a right-handed golfer, the lead hip is the left hip. As the golfer moves through impact, the pelvis must rotate toward the target while the lead hip provides enough mobility to allow that rotation to occur.
When hip rotation is limited, the body still has to complete the swing. As a result, some of the rotational demand may shift to other parts of the kinetic chain, including the lumbar spine.
That matters because the lumbar spine is designed to flex and extend but has a relatively limited amount of rotation available. A small amount of additional stress may not matter during a single swing. Repeated over hundreds of rounds and thousands of swings, however, that added demand can contribute to cumulative low back stress.
Research has found an association between limited hip rotation and low back pain in golfers, which is also consistent with what we commonly see in the office. For this reason, when a golfer has recurring low back or lead-hip symptoms, evaluating hip mobility can be just as important as examining the area that hurts.
The Lateral Hip: Gluteus Medius, Minimus, and the TFL
The gluteus medius and minimus are located along the outside of the hip. Just in front of them is the tensor fasciae latae, or TFL, which connects to the iliotibial band, commonly called the IT band.
Together, these muscles help stabilize the hip and control the position of the pelvis when weight is supported primarily on one leg. During the downswing and through impact, that role becomes especially important as the golfer shifts weight onto the lead side while the pelvis continues to rotate.
Because the golf swing repeatedly loads the hips in the same pattern, the demands placed on these muscles are different from one side to the other. If the lateral hip muscles cannot adequately control the pelvis during this transition, movement elsewhere in the kinetic chain may have to compensate. That can increase the demands placed on nearby structures, including the low back and lead knee.
The Lumbar Spine and the Quadratus Lumborum
The quadratus lumborum, or QL, is a deep muscle on each side of the low back. It connects the top of the pelvis to the lowest rib and lumbar vertebrae. Among its roles, it helps control side-bending and stabilize the lumbar spine, pelvis, and lower rib cage during movement.
In the golf swing, the QL helps control the relationship between the pelvis and trunk as the body rotates, shifts, and then slows down. If limited hip or trunk mobility places greater demands on the low back, the QL may have to work harder to stabilize and control that movement.
Repeatedly asking the muscle to manage those forces can contribute to fatigue, increased muscle tension, and tenderness. Golfers often describe this as a persistent band of tightness along one side of the low back. It may loosen temporarily with stretching or movement, only to return after a round or feel worse the following day.
When that pattern keeps returning, the QL may be the structure producing the symptoms without being the only reason those symptoms developed.
The Thoracic Spine
The thoracic spine is the middle section of the spine, where the ribs attach. Unlike the lumbar spine below it, the thoracic spine is capable of a significant amount of rotation, making it an important part of the golf swing.
When thoracic rotation is limited, the golfer still has to create enough movement to complete the backswing and follow through. That additional movement may come from other parts of the kinetic chain, including the lumbar spine, hips, and shoulders.
Over time, repeatedly asking these areas to make up for limited movement through the thoracic spine can increase the stress placed on them. This is why a stiff mid-back may show up as pain somewhere else, including the low back or shoulder.
The Shoulders Do Not Share the Work Equally
The two shoulders perform different jobs during the golf swing.
At the top of the backswing, the trail shoulder requires external rotation while the shoulder blade moves along the rib cage to help position the arm. As the golfer moves through impact and into the follow-through, the lead shoulder must accommodate a different combination of movement, including motion across the body.
These different roles place different demands on each shoulder. If either shoulder lacks the mobility, strength, or control required for its part of the swing, the golfer may compensate elsewhere in the shoulder complex or farther along the kinetic chain.
This helps explain why shoulder problems in golfers are not always the same on both sides. Repeated compensation can gradually increase stress on structures such as the rotator cuff and the muscles that control the shoulder blade, sometimes long before the golfer becomes aware of a problem.
The Elbow: The End of the Chain
The elbow sits near the end of the kinetic chain, which can make it especially vulnerable when force is not transferred efficiently through the rest of the body.
Golfer’s elbow, or medial epicondylitis, causes pain around the bony prominence on the inside of the elbow, where several of the forearm tendons attach. It is commonly described as an overuse injury, and that description is accurate. The more important question, however, is why those tendons are being repeatedly overloaded.
Ideally, much of the speed of the golf swing is produced and transferred through the legs, hips, pelvis, and trunk before reaching the arms and club. When that sequence is disrupted, the upper body may have to contribute more effort to produce or control the swing. This can increase the repeated demands placed on the elbow, forearm, and wrist.
That is why treating the painful elbow may be only part of the solution. If limited hip rotation, poor trunk control, or another problem earlier in the kinetic chain is contributing to the overload, the elbow can improve with rest and treatment only to become irritated again when the golfer returns to the same movement pattern.
Why It Keeps Coming Back
There is another part of this mismatch that deserves just as much attention: recovery capacity.
A 68-year-old golfer who plays four rounds a week may put roughly the same number of swings through the body as a 38-year-old playing the same schedule. What may differ is how well each golfer is prepared to tolerate that workload and recover from it. Strength, tendon capacity, conditioning, previous injuries, sleep, overall health, and age can all influence how the body responds between rounds.
This is not necessarily an argument for playing less. It is an argument for building enough physical capacity to meet the demands of how much you want to play.
That is very different from rest. Rest temporarily reduces the demand placed on an irritated tissue, which can allow symptoms to settle. But rest alone does little to increase the body’s ability to handle that demand when golf resumes. If the golfer returns to the same workload with the same underlying capacity, the symptoms may return as well.
For golfers who want to continue playing frequently as they get older, maintaining strength, mobility, and physical conditioning is not simply a general health recommendation. It is part of preparing the body to tolerate the repeated demands of the game.
What Has To Change
Golf-specific movement screening can help identify limitations in mobility, stability, balance, and movement control. Several commonly used assessments for rotational athletes have been developed specifically for golfers, including screening methods from the Titleist Performance Institute (TPI), which has contributed extensively to the study and teaching of golf biomechanics.
But a movement screen has limits. It can identify that a golfer cannot perform a movement well. It cannot, by itself, determine why that limitation exists, whether it is related to the golfer’s symptoms, or what treatment is appropriate.
That is where a clinical evaluation begins. At Performance Sport Care, Dr. Douglas F. Cancel, D.C. evaluates both the painful area and the movement patterns that may be contributing to it. The goal is to identify the injured or irritated tissue, determine why it is being overloaded, and address the factors that can be changed.
Depending on what the examination finds, treatment may include manual therapy to restore needed mobility, exercises to improve strength and movement control, and progressive loading to rebuild the golfer’s ability to tolerate the volume and intensity of the sport.
That is very different from simply handing someone a list of stretches. If a muscle repeatedly becomes tight or painful because it is compensating for a limitation elsewhere in the kinetic chain, stretching may temporarily change how it feels without changing why the problem keeps returning.
Golf in Walnut Creek
Walnut Creek golfers have access to several courses, and the physical demands can vary considerably depending on where and how often they play.
Boundary Oak is an 18-hole course with significant elevation changes, so a golfer who walks the course is adding several miles of uneven terrain to the demands of the golf swing. Diablo Hills is a shorter nine-hole course, making it practical for golfers who prefer to play more frequently or fit shorter rounds into the week. Rossmoor’s Dollar Ranch and Creekside courses serve a community where many golfers have the opportunity to play regularly throughout the year.
These differences matter because total workload is more than the number of swings a golfer takes. Walking distance, hills, frequency of play, consecutive rounds, practice sessions, and recovery time all contribute to the physical demands placed on the body.
A golfer walking 18 holes at Boundary Oak twice a week may have a very different loading history from someone playing shorter rounds four times a week. Age, strength, previous injuries, and physical conditioning add another layer. Understanding those differences is one reason a recurring golf injury deserves an individual evaluation rather than simply being treated according to where it hurts.
Performance Sport Care is a sports chiropractic and supervised strength rehabilitation clinic on Ygnacio Valley Road in Walnut Creek, about 250 yards from Diablo Hills Golf Course. Our evaluation of an injured golfer takes into account not only where the pain occurs, but also how that golfer moves, how much golf they play, and what their body is being asked to tolerate each week.
When Pain After a Round Needs Evaluation
Some muscle soreness after a round of golf can be normal, especially after playing more than usual. Persistent, recurring, or neurological symptoms are different.
Consider having the problem evaluated if you experience:
- Pain that lasts more than two or three weeks without clearly improving
- Pain that returns in the same place each time you play
- Grip weakness, numbness, or tingling in the hand or forearm
- Low back pain that travels down the leg, particularly below the knee
- Sudden, sharp pain during a swing, especially if it is followed by an immediate loss of strength or function
Recurring pain should not simply become part of playing golf. If symptoms repeatedly improve with rest and return when you resume playing, an evaluation can help determine what is being injured, why it is being overloaded, and what needs to change.
Symptoms involving new or significant weakness, numbness, loss of function, or severe radiating pain deserve more prompt medical evaluation rather than waiting several weeks to see whether they resolve on their own.
Stop Treating the Same Injury Like a New Injury
If the same elbow, low back, hip, or shoulder keeps flaring when you return to golf, another round of rest may settle it without explaining why it came back.
A clinical evaluation can identify what is injured, what may be contributing to the repeated overload, and what needs to change so your body is better prepared for the amount of golf you want to play.
Find Out Why It Keeps Coming BackFrequently Asked Questions
How long does golfer’s elbow take to heal?
Recovery time varies. Mild cases may begin improving within several weeks with appropriate load management and rehabilitation, but tendon recovery can continue well beyond the point when pain starts to decrease. Symptoms that have been present for months or repeatedly return may take longer to resolve.
Recurring golfer’s elbow also deserves a broader look at why the tendon continues to be overloaded. Swing volume, forearm strength, technique, recovery, and limitations elsewhere in the kinetic chain may all contribute.
How do I fix golfer’s elbow fast?
There is no reliable shortcut for a tendon that has been repeatedly overloaded. Reducing or modifying the activity that aggravates it can help settle symptoms, but recovery should also focus on gradually rebuilding the tendon’s ability to tolerate load.
For golfers, it can also be useful to determine whether movement or strength limitations elsewhere are increasing the demands placed on the forearm. If the hips and trunk are not contributing effectively to the swing, for example, the arms may have to work harder. Treating the elbow while ignoring those contributing factors can leave the golfer vulnerable to another flare-up.
What are the symptoms of golfer’s elbow?
Golfer’s elbow typically causes pain and tenderness around the bony prominence on the inside of the elbow. Symptoms are often aggravated by gripping, resisted wrist flexion, or activities that load the forearm. In golfers, impact with the ball or turf may also provoke pain.
Some golfers notice forearm or grip fatigue, and discomfort may extend a short distance down the inside of the forearm. Numbness, tingling, or significant weakness should be evaluated because those symptoms can suggest something other than, or in addition to, golfer’s elbow.
Do golfer’s elbow braces work?
A counterforce strap may reduce pain during activity for some people by changing how forces are transmitted through the forearm muscles and tendons. That can make a brace useful for short-term symptom management.
A brace does not correct the underlying reason the tendon became overloaded, however, and it should not replace appropriate rehabilitation. Think of it as one possible part of a treatment plan rather than the treatment itself.
Should I see a chiropractor for golfer’s elbow?
A sports chiropractor with experience treating golfers can be one appropriate choice, particularly if the evaluation includes both the painful elbow and the rest of the kinetic chain.
A thorough examination should determine what structure is causing the pain and look for factors that may be contributing to the overload. Depending on the golfer, that may include forearm strength and tendon capacity as well as movement through the shoulders, thoracic spine, hips, and trunk.
The important question is not simply which type of provider you see, but whether that provider can accurately diagnose the problem, identify relevant contributing factors, and provide a meaningful progressive rehabilitation plan.
Why does my back hurt after a round of golf?
There are many possible causes of low back pain after golf. One common contributor is the repeated combination of rotation, side-bending, and force involved in the golf swing.
Limited movement through the hips or thoracic spine can sometimes increase the demands placed on the lumbar spine. Muscles that stabilize the low back and pelvis, including the quadratus lumborum, may also become fatigued or overloaded during repeated swings.
Because low back pain can have many causes, recurring symptoms should be evaluated rather than automatically attributed to tight muscles or limited rotation.
Where is Performance Sport Care located?
Performance Sport Care is located at 1776 Ygnacio Valley Road, Suite 106, Walnut Creek, CA 94598. Call (925) 945-1155. We serve Walnut Creek, Lafayette, Danville, Concord, Pleasant Hill, and greater Contra Costa County.
Selected References
McHardy A, et al. One-year follow-up study on golf injuries in Australian amateur golfers. Am J Sports Med. 2007;35(8):1354-1360. Prospective one-year follow-up of 588 amateur golfers; the lower back was the most commonly injured site, followed by the elbow and forearm.
Vad VB, et al. Low back pain in professional golfers: the role of associated hip and low back range-of-motion deficits. Am J Sports Med. 2004;32(2):494-497. Cross-sectional study of 42 male professional golfers; lead hip internal rotation and lumbar extension deficits correlated with a history of low back pain.
Murray E, et al. The relationship between hip rotation range of movement and low back pain prevalence in amateur golfers: an observational study. Phys Ther Sport. 2009;10(4):131-135. Observational case-control study of 28 amateur golfers with low back pain and 36 controls; the authors report association without establishing causality.
Kim S, et al. Lumbopelvic kinematic characteristics of golfers with limited hip rotation. Am J Sports Med. 2015;43(1):113-120. Controlled laboratory study of 30 asymptomatic male professionals; limited lead hip internal rotation was accompanied by greater lumbar motion during the swing.
Smith JA, et al. Risk factors associated with low back pain in golfers: a systematic review and meta-analysis. Sports Health. 2018;10(6):538-546. Systematic review and meta-analysis of 19 studies; age, body mass, and prior pain were associated with golf-related low back pain, while swing characteristics were not.
Hamada Y, et al. Immediate effects of foam roller and stretching to the lead hip on golfers’ swing: a randomized crossover trial. Healthcare (Basel). 2023;11(14):2001. Randomized crossover trial with motion analysis; combined soft-tissue work and dynamic stretching increased lead hip internal rotation during the swing and was associated with reduced lower lumbar rotation.
Murray A, et al. Cross-sectional study of characteristics and prevalence of musculoskeletal complaints in 1170 male golfers. BMJ Open Sport Exerc Med. 2023;9(1):e001504. Survey of 1,170 non-professional male golfers, mean age 55; 37.3% reported low back pain within the preceding seven days.
Robinson PG, et al. A prospective study of injuries and illnesses among amateur golfers during one season. BMJ Open Sport Exerc Med. 2024;10(1):e001844. Prospective cohort of 910 amateur golfers, median age 60; lumbosacral spine, shoulder, and knee carried the highest injury burden, with risk rising alongside age, osteoarthritis, and previous injury.
This article is educational and not a substitute for personal advice from a licensed health care provider. Exercises or recommendations that are appropriate for one person may not be appropriate for another, particularly if a history of pain or injury exists.
If you have persistent or worsening pain, pain that radiates into an extremity, pain that is accompanied by fever, or any other unusual symptoms please consult a qualified provider for an individual evaluation or dial 911 in case of emergency.
