Physical therapists are increasingly helping golfers improve their game through addressing biomechanical issues that can cause injuries or impair swing technique. Therapists described in the article have received specialized golf certification and conduct functional movement screens and video analysis of clients' swings to identify areas for mobility, flexibility or strength improvements through custom exercise programs. These programs aim to optimize clients' biomechanics and alleviate underlying issues that could be exacerbated by the motions of golf in order to lower scores and avoid injuries related to swing flaws.

2. COVER STORY
11 ADVANCE for Physical Therapy & Rehab Medicine May 4, 2015 www.advanceweb.com/pt
Swing
It’s All
in the
PTs teach golfers nationwide
how optimizing biomechanics
can lower scores By Brian W. Ferrie
W
hen Rory McIlroy swings a golf club, awed observers marvel
at the power and precision. A child prodigy, he began playing
soon after learning to walk and cultivated his natural ability for
hours each day on the beautiful windswept courses of Northern
Ireland. Now 26 years old, McIlroy is the undisputed best
golfer in the world, winner of four major championships, and proud practitioner of a
swing even fellow tour pros can only watch in wonder.
The title of a recent New York Times Magazine article declared simply, “Rory McIlroy
Has the Best Swing in Golf.” He stands just 5-foot-9 and weighs maybe 170 pounds, yet
once launched the ball an astounding 436 yards.1
How? It’s all in the swing.
Can the average golfer replicate McIlroy’s flawless form through sheer practice and
focus? Probably not. He’s too rare a talent, honed by a lifetime devoted to mastering
his craft. But can any golfer improve his score by addressing biomechanical issues that
impair proper swing technique? Absolutely. That’s how an increasing number of physical
therapy professionals nationwide are making their mark in the game.
Taking Lessons
Christopher T. Wickel, PT, DPT, Cert. MDT, senior therapist at Conshohocken
Physical Therapy outside Philadelphia, achieved Level 1 certification from the Titleist
Performance Institute (TPI) in 2011, and earned certification as a Medical Level 2
practitioner the following year.
“The Level 1 gets all professionals who take the course on the same page,”
Wickel told ADVANCE. “You could be a fitness instructor, golf pro or medical
practitioner. Level 2 focuses more on golf-specific injuries, injury-in-
ducing swing mechanics, advanced swing faults, and the medical
evaluation and screening procedures specific to golfers.”
In the years since earning certification, Wickel has gradually
implemented many of these principles with his patients.
“It’s like anything else as a PT,” he said. “You’re constantly eval-
uating and analyzing how people move, then using your knowl-
edge of the musculoskeletal system and body mechanics, in this
case applying it to the golf swing.”
Wickel typically discusses the concepts with patients who come to
the clinic for other reasons.
“So as I work with patients who have injuries, I’ll find out
KYLEKIELINSKI

3. what they like to do and want to get back to.
If they’re golfers, I’ll look at their swing, do a
functional movement screen including video
analysis, and incorporate specific exercises
based on that.”
Among these patients is a construction
worker with lateral epicondylosis, Wickel noted.
“He’s had the condition for years, just can’t
calm it down, and in his history he mentioned
having a net in his backyard where he hits
50-75 golf balls a couple days each
week. I thought that was relevant, so
we did a quick video of his swing and
saw he demonstrated a swing charac-
teristic known as ‘chicken-winging,’
as well as early extension. Meaning
that on his downswing, he moves
closer to the ball, causing him to com-
pensate with his arms. This pattern
ultimately leads to excessive stress on
the lateral elbow of the lead arm.”
Wickel also diagnosed limited hip
mobility as part of the problem.
“Because his hips don’t rotate the
way they should, he sways and slides.
For someone like this man who really
loves golf, practicing into the net is a
huge part of his week. So we added a
couple exercises to help him get back
to it, altering the excessive stress and
pressure going through his elbow with
that activity.”
Fairway Form
Across the country in Idaho, Rob
Barnes, PT, DPT, OCS, has suc-
cessfully integrated golf education with his
client base as well. The director of Therapeutic
Associates-Boise State Street, Barnes recently
achieved Medical Level 2 certification from
TPI after earning Level 1 in 2009. He esti-
mated 10-15 percent of his patient popula-
tion either presents with golf-related injuries
or seeks to improve their golf biomechanics.
“A lot of these clients are referred to me by
a local golf instructor,” said Barnes. “I work as
a team with him. So I’m not teaching people
to play golf specifically, but rather focusing
on their injuries, mobility, flexibility, strength,
and motor-control aspects.”
The most common golf-related injury
Barnes encounters is low-back pain, followed
by shoulder pain. These ailments are often not
caused by golf, but rather tend to be latent con-
ditions that become aggravated by the sport.
“I think so many of the injuries we see in
golf are due to underlying issues, either pre-
vious orthopedic injury or chronic poor pos-
ture,” he related. “Golf inherently can lead
Christopher T. Wickel,
PT, DPT, Cert. MDT,
senior therapist
at Conshohocken
Physical Therapy
outside Philadelphia,
conducts a functional
movement screen with
video analysis for this
golf client, integrating
targeted exercises to
optimize sport-specific
biomechanics.

4. to injury anyway because of the nature of the motion, with all the
high-speed rotational forces. But for somebody who sits at a desk all
day and then goes out to try and perform a golf swing, it can really
set you up for injuries.”
When patients come to Barnes seeking biomechanical adjustments to
improve their game, he initially conducts video analysis. Based on the
findings, he might offer stretching programs, both static and dynamic,
as well as golf-specific functional mobility exercises and manual therapy,
which could include soft-tissue techniques and joint mobilizations.
Barnes noted that early extension is the most frequent swing flaw
among his golf population. “It’s the number-one flaw related to most
injuries, and also a lot of bad golf shots,” he said.
Overall, Barnes indicated golf has been the most successful treatment
niche at his practice, drawing three distinct groups of clients.
“I have some highly competitive junior golfers who come here regularly
for group training,” he related. “Then there are people who come for one
visit and just want a home exercise program to work on their biomechan-
ics. The third tier would be clients who come in, get my assessment, then
return maybe every couple weeks for eight to 10 sessions.”
On Course
Meanwhile in the Sunshine State, another therapist has taken his own
distinctive approach to golf fitness. Matt Laporte, BS, DPT, works full-
time for a large hospital system in southwest Florida, but on the side
he runs the Laporte Golf Fit Institute, which doesn’t have a physical
location. Rather, Laporte sees clients at meeting points of their choice.
“There are a lot of golfers in this area, mostly older people who retire
down here,” said Laporte, who achieved Level 1 certification through TPI
in 2011. “A lot of them actually live on golf courses, so I might meet them
at a course, local fitness facility or in their community. But the great thing
about the functional movement assessment, and golf fitness in general, is
we don’t need a lot of equipment and can really meet anywhere.”
Another aspect differentiating Laporte’s practice is that a golf club
plays very little part in it.
“I’ll have clients swing a club at first just for me to get an idea of what
their swing looks like,” he told ADVANCE. “But the functional screen I use
doesn’t involve a club. It basically just takes them through different motions
such as trunk and pelvic rotation, and is very head-to-toe oriented so we can
uncover where they’re limited in terms of mobility or strength. That helps
us develop a plan of attack for what they need to work on.”
Laporte receives great feedback about the effectiveness of his service.
“Golf fitness I would say is a fairly new concept,” he concluded. “A lot
of people don’t realize how much simple exercise can improve their game.
They think it’s all about lifting weights, taking lessons from a golf pro,
or buying the latest new club or device on the market. But really they
need to learn how to move their bodies better and which weaknesses to
target. I find it’s mostly a lack of core strength and stretching. So I think
having a golf fitness evaluation opens their eyes to a whole new world.” n
Reference
1. Siebert C. Rory McIlroy Has the Best Swing in Golf. The New York Times Magazine.
April 5, 2015. Retrieved from www.nytimes.com/2015/04/05/magazine/rory-mcil-
roy-has-the-best-swing-in-golf.html?_r=0
Brian W. Ferrie is on staff at ADVANCE. Contact: bferrie@advanceweb.com
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