Original article
Effect of spinal manipulative therapy with stretching compared with stretching alone on full-swing performance of golf players: a randomized pilot trial

https://doi.org/10.1016/j.jcm.2009.06.002Get rights and content

Abstract

Objective

There has been a steady growth of chiropractic treatment using spinal manipulative therapy (SMT) that aims to increase the performance of athletes in various sports. This study evaluates the effect of SMT by chiropractors on the performance of golf players.

Methods

Golfers of 2 golf clubs in São Paulo, Brazil, participated in this study. They were randomized to 1 of 2 groups: Group I received a stretch program, and group II received a stretch program in addition to SMT. Participants in both groups performed the same standardized stretching program. Spinal manipulative therapy to dysfunctional spinal segments was performed on group II only. All golfers performed 3 full-swing maneuvers. Ball range was considered as the average distance for the 3 shots. Treatment was performed after the initial measurement, and the same maneuvers were performed afterward. Each participant repeated these procedures for a 4-week period. Student t test, Mann-Whitney nonparametric test, and 1-way analysis of variance for repeated measures with significance level of 5% were used to analyze the study.

Results

Forty-three golfers completed the protocol. Twenty participants were allocated to group I and 23 to group II. Average age, handicap, and initial swing were comparable. No improvement of full-swing performance was observed during the 4 sessions on group I (stretch only). An improvement was observed at the fourth session of group II (P = .005); when comparing the posttreatment, group II had statistical significance at all phases (P = .003).

Conclusions

Chiropractic SMT in association with muscle stretching may be associated with an improvement of full-swing performance when compared with muscle stretching alone.

Introduction

Participation in sports is a growing social phenomenon that profoundly influences daily life.1 One's sport of choice is decided according to each participant's profile, matching one's affinity, desire, facility, and viability.2 There has been a steady growth of chiropractic treatment for various sports for the maintenance of athletes in optimal competitive conditions. Various therapeutic modalities have been used, with an emphasis on spinal manipulative therapy (SMT). With athletes, chiropractic treatment often aims at increasing performance, rather than treating specific conditions such as pain. It is argued that the maintenance and improvement of joint function, muscle balance, and the speed of neuromuscular reflexes obtained through this treatment may help optimize performance.

Given that SMT is known for pain reduction and enhancing spinal mobility, many professional and high-level amateur golfers in the United States depend on their doctor of chiropractic to prevent them from disorders that may threaten their careers. These athletes want to improve their performance and manage pain in a conservative way and in a short amount of time.3, 4, 5, 6, 7, 8, 9, 10, 11

Golf sport requires a person to strike a small ball with a club from the teeing ground into a distant hole while following the rules. Golfers may swing the club head as fast as 100 mph in about 0.2 second as they downswing. After they hit the ball, they make a smooth transition from this rapid acceleration to deceleration. To move the golf club going to a high rate of speed, right-handed golfers rotate their knees, hips, trunk, shoulders, and arms clockwise during the backswing, turning away from where they want the ball to go. Afterward, as they unleash their downswing, they quickly uncoil counterclockwise toward the target. In the classic swing, the hips turn about as much as the shoulders. The follow-through ends in more or less a straight up-and-down position. Today's golfers twist more, rotating their shoulders back by as much as 90° and their hips by about 45°. This golf swing puts a higher compressive load on the low back (8 times body weight) than running (3 times) or even rowing (7 times). That is why a single swing can produce a herniated disk or even a compression fracture of one of the vertebral bodies. Although these injuries are extremely painful and can be quite serious, they are rare. Muscle strains, however, are quite common because of the twisting that is required for a good swing.12, 13, 14, 15, 16, 17, 18, 19

The present study evaluates the effect of SMT on the performance of golf players with a handicap between 0 and 15 during their full swing using a driver club at 2 golf clubs in São Paulo, Brazil.

Section snippets

Methods

A questionnaire was given to associates of 2 golf clubs in São Paulo, Brazil, to those who met the inclusion criteria. The inclusion criteria were as follows: men between 18 and 55 years of age, with a handicap from 0 to 15, practicing golf at least once a week for a 4-hour period. The purpose of the research was clarified; they signed an informed consent and were admitted. Subjects were randomized by lottery to 1 of 2 groups: Group I was a stretch program, and group II included the stretch

Results

Forty-three subjects were admitted from February to April 2006. All subjects completed the 4 sessions that comprised the protocol. Twenty participants were allocated to group I and 23 to group II. Average age, handicap, and initial swing at each group were comparable, as follows: age—I, 37.15; II, 32.1 (Table 1); handicap—I, 11.95; II, 8.17 (Table 2); initial swing—I, 205 m; II: 219 m (Table 3).

Group II demonstrated values significantly greater at all evaluation moments (P = .003), just not

Discussion

This study assembled homogeneous groups as demonstrated on Table 1, Table 2, providing to the present research a credible population with the same characteristics. By observing Fig 1, each day had an improvement on the ball's scope. Furthermore, the increase of performance on the fourth day of treatment was statistically significant (P = .005), according to the Student t test. The same graph demonstrates a golfer's performance improvement on group II, despite being without statistical

Conclusions

Spinal manipulative therapy in association with muscle stretching seems to be associated with an improvement of golf players' full-swing performance when compared with muscle stretching alone.

References (21)

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Cited by (18)

  • Immediate Effects of Spinal Manipulative Therapy on the Performance of Elite Brazilian Soccer Players: A Pilot Randomized Controlled Trial With an Internally Validated Sham Treatment

    2022, Journal of Chiropractic Medicine
    Citation Excerpt :

    It has been proposed that SMT may influence and improve aspects of sports performance. These aspects include increased full-swing for golfers,40 increased judoka grip strength,25 and increased ball kicking speed for soccer players41; however, there are few studies in this field about the influence of SMT on sports performance from laboratory studies, field tests, and real events.42 In soccer, athletic trainers and coaches use various field tests to assess the fitness and capacity of their players.43,44

  • Spinal Manipulative Therapy and Sports Performance Enhancement: A Systematic Review

    2017, Journal of Manipulative and Physiological Therapeutics
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    These contrasting results suggest that the SMT effect is transient, and this needs to be further demonstrated. CNS modulation through sensorimotor integration, combined with cortical motoneuron and spinal reflex excitability changes after SMT, should be the central mechanism associated with the increased full-swing in golfers,61 the increased kicking speed in soccer players,69 and the increased hip extension in runners.60 These mechanisms should be related to the improved muscle strength observed in judokas44 and in non-athletes.43,45

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No funding sources or conflicts of interest were reported for this study.

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