Establishment of sound epidemiological data on injuries and illnesses related to training and playing golf based on the IOC Consensus on Injuries and Illnesses in Sport (2020)
Golf is a sport played by more than sixty million (Sports Marketing Surveys, 2017) people of all ages and abilities. It is played in over two-thirds of countries and on six continents (The R&A, 2019).
The best available evidence suggests golf is associated with overall improved health and well- being benefits (Murray et al. 2017, Murray et al. 2019). Golf can provide moderate aerobic physical activity, helps decrease non-sedentary time, and may have muscle strengthening and balance benefits (Luscombe et al. 2017). However, injuries and illness related to golf can occur. In the scientific literature, papers related to musculo-skeletal injuries and accidents comprised the largest group of studies identified by a scoping review (Murray et al. 2017) assessing the associations between golf and health.
The available evidence, including a systematic review (Cabri et al. 2009) describes golf as a moderate-risk activity for injuries compared to other sports. Prospective, longitudinal studies report low injury rates per hour played compared to other sports, at 0.28 to 0.60 injuries per 1000 hours in amateurs (Pakkari et al. 2000, Pakkari et al. 2004, McHardy et al. 2007). The scoping review by Muray et al (2017) described epidemiological studies (both prospective and retrospective) reporting incidence of injury in amateur golfers to be between 15.8% and 40.9% annually (McHardy et al. 2006, McHardy et al. 2007, Lee et al. 2013, Eisenhart & Fradkin 2011, Fradkin et al. 2007, Fradkin et al. 2005, Theriault et al. 2013).
Generally, research reports volume of repetitive practice and suboptimal swing biomechanics as leading causes of injuries in amateurs.
For professional players, a systematic review noted the most frequently injured regions to be the spine (lumbar>cervical>thoracic) and then the hand and wrist (Robinson et al. 2018). However, the principal findings were that the definition of injury in included studies often varied, and the nature of injury, injury mechanism and time to return to sport are not well described. Annual injury rates (31-90%) in professionals are higher than amateurs, perhaps reflecting an increased volume of play and practice (Robinson et al. 2018, Theriault et al. 2013, Barclay et al. 2011) but low compared to other sports professional athletes when studied at the 2016 Olympic Games (Soligard et al 2017). Sugaya (1997) analysed the relationship between low back pain and radiological changes in professional golfers, i.e. significant degenerative facet joints on the right side suggesting a mechanical etiology related to the motions occurring during the golf swing.
This conclusion is supported by Walker et al. (2018) who demonstrated a repetitive traumatic discopathy as the key driver of early lumbar degeneration in modern era golfers. In general, risk factors for injuries and illnsesses in golfers are far from conclusive. Hip morphology has previously been analysed and shown that the trail hip exhibits a higher prevalence of labral tears (Dickenson et al. 2016a). The presence of increasing alpha angle and increasing age were significant predictors of reduced hip-related quality of life (Dickenson et al. 2016b).
Existing studies for amateurs, and for professionals vary considerably regarding the reporting of definition of injury, nature of the injury, injury mechanism, time to return to sport and potential causative factors. In addition, almost all of the epidemiological studies studying injury in golf are over a decade old. During this time sports epidemiology has advanced with more focus on causative factors and management of load, amongst other things. Data collection methods have also advanced, and data is being collected for pre-defined epidemiological or intervention studies in settings, ranging from recreational to elite sports.
Consensus statements, injury forms, diagnostic coding and protocols for data collection have been developed by key stakeholders in other sports (for example cricket, football, rugby union, rugby league, aquatic sports, tennis, athletics, horse racing) to ensure consistency and enable comparison of data across studies.
To our knowledge there is no study on efficacy of a prevention programme to reduce injury incidence and illnesses in golfers in different age categories and level of skills.