During the past several years, the game of golf has grown dramatically. Of the 50 million golfers worldwide, at least half reside in the United States. According to the business section of a popular web site (www.golf.com), detailed statistics related to the golf industry are calculated as follows. The top ten states ranked by total number of avid golfers include California, Florida, New York, Texas, Ohio, Pennsylvania, Illinois, Michigan, North Carolina and New Jersey. Billions of dollars are spent on equipment, apparel and shoes. In addition, golfers generally tend to be a fairly affluent group. Numerous golfers are willing to pay $500 for a driver. The top golf schools are routinely booked, and they charge anywhere from $2,000 – $4,000.
Who do golfers visit for back problems?
We might like to think that chiropractors are the golfers’ doctors of choice. Unfortunately, this is not the case. As of 1994, the available data indicates that less than 2% of golfers choose to visit a chiropractor.1 This statistic is somewhat shocking considering that back pain is the most common problem among golfers. Meanwhile, physical therapists see a whopping 39% of golfers.
The reason that golf pros choose physical therapists is obviousa Centinela Hospital Fitness Trailer is present at all professional tour events. Perhaps amateurs think, “Well, if physical therapy is good for the pros, it must be good for me.” Whatever the reason, chiropractic’s golf market share is dismal at the present time. This situation is somewhat paradoxical when compared to the choices made by the rest of our population.
In a recent physical therapy text devoted to low back pain, Robin McKenzie wrote, “Chiropractors in the United States already see more patients with mechanical low back pain than the combined total of patients seen by all other health providers.”2 I believe all of MacKenzie’s comments are worth reading in the full text because he is concerned that physical therapists have lost the “back pain” market to chiropractors and discusses possible methods to remedy that situation. However, as mentioned above, back pain within the golf market is not presently an issue; the physical therapists already own this market.
To help illustrate why chiropractic care might not enter a golfer’s mind, simply visit Golf magazine’s web site (golfonline.com). Access the fitness link and you will eventually come to a list of numerous fitness experts recommended by Golf magazine (or you can go directly to golfonline.com/fitness).
Visitors to the site will discover the phone numbers for numerous physical therapists and trainers. Three organizations are particularly noticeable: Back to Golf has 140 centers, Body Balance for Performance has more than 50 licensed centers and HealthSouth Sports for Golf has 250 physical therapists nationwide. Chiropractic has no representation on this list of recommended fitness experts.
How are chiropractors viewed by golfers?
I have found that chiropractic is not a topic of interest to the various golf publications. This is not to say that golfers do not visit chiropractors. In fact, many chiropractors regularly treat golfers; however, this is not the norm and I do not know why. Perhaps it has to do with the mixed message our profession sends to the general public about who we are and what we think we do. Quite frankly, golfers could care less about innate intelligence, chiropractic principles, studies by the Rand Corporation or the accreditation of chiropractic colleges by various agencies. These are things that chiropractors tend to be preoccupied with because we think they are important.
Golfers, on the other hand, want to play golf without pain and musculoskeletal dysfunction. Golfers want to be flexible and strong so they can hit a golf ball far down the fairway and they want to shoot lower scores. For these outcomes, they are willing to pay a lot of money. At the present time, to achieve these goals golfers visit physical therapists and spend lots of money on new clubs.
If chiropractors want to engage the golf market, we have to make sure that our services will help golfers achieve what they want. If we can do this, perhaps the golfing industry will begin to appreciate what chiropractic has to offer.
What can you do to improve your golf market share?
Obviously, it will be impossible to improve our market share if we wait in our offices for golfers to walk in on their own. This means that we must go out and talk to golfers and write for local publications. However, before doing this I recommend learning about the golf swing. Golf pros also need to be educated about how the golf swing affects the spine. Each golf club has a head golf pro and usually a couple of assistants. So, go to your local club and offer to do an hour-long class on golf and back pain. You can then offer to do a similar program for the club’s members. Repeat this scenario at all the clubs in your area. Indeed, you should try to develop a relationship with as many local golf pros as possible.
One way to facilitate your entry to the golf market is to speak at a local continuing education meeting. I was recently invited to do a class on back pain for about 40 local pros at their annual education meeting. This could easily lead to frequent talks at the many golf clubs in my area.
Topics to discuss with golfers.
Professional and amateur golfers are equally uneducated when it comes to golf swing mechanics and methods to protect the spine from injury. A common notion is that a proper golf swing should involve minimal pelvic rotation and maximum spinal rotation so the shoulder position at the top of the backswing is rotated some 90 degrees or more from the address position. Such a swing creates significant injury-promoting torsional forces.
Believe it or not, I have seen golf videos by physical therapists and chiropractors in which exercises are recommended to increase the rotational capacity during the backswing. In other words, both DCs and PTs have urged golfers to assume injury-promoting positions in the golf swing.
Many golfers incorrectly believe that maximum spinal rotation is required to crush a golf ball miles down the fairway. This notion is patently incorrect. A couple of years ago, research demonstrated that club head speed and hitting distance did not suffer if golfers used a short backswing with minimal spinal rotation. In other words, they achieved the same distance with better accuracy and less spinal torsion.
Even if you are a non-golfer, you can recommend that golfers reduce spinal torsion; that is, shorten their backswings to help protect their spines. This recommendation is founded on basic known facts about biomechanics and spinal injury. You can also explain that many pros have short backswings and their games do not suffer. For example, Jeff Maggert has a short backswing and recently beat Tiger Woods in match play during a world golf tour event.
In addition to recommending swing modifications, you can teach golfers to do lumbar spinal stabilization exercises to help protect their spines during the golf swing. You could even do a class at a golf course and demonstrate the various exercises. Research has recently shown that such stabilization exercises can reduce pain and disability in patients with spinal instability caused by spondylolysis and spondylolisthesis.3 In addition, McGill has recently discussed the stabilizing exercises that impart the least amount of stress on the lumbar spine, including the cat stretch, curl-ups, isometric horizontal side support and the quadruped track of exercises.4 You can easily teach these simple exercises to a group of golfers and simultaneously stop them from doing sit-ups and dangerous back-bending and twisting exercises.
This article provides some basic ideas about how to gain access to the golf market. Naturally, there are many more topics and issues to be discussed in greater detail.
As we know, when it comes to marketing, new ideas are needed to draw attention. I have discussed how shortening the backswing to reduce spinal torque and doing specific lumbar stabilization exercises are new concepts for most golfers, including professionals. Take this exciting information to your local golf clubs and speak to the pros and members. I have found it helpful to use the internet and other sources to provide golfers with information about the spine, mechanics of the golf swing, back pain, treatment considerations and much more.
1. McCarroll JR, Mallon WJ. Epidemiology of golf injuries. In: Stover CN et al. eds. Feeling up to par: Medicine from tee to green. Philadelphia: FA Davis.
2. McKenzie RA. Mechanical diagnosis and therapy disorders of the low back. In: Twomey LT, Taylor JR. eds. Physical therapy of the low back. 2nd ed. New York: Churchill Livingstone; 1994: p.171-196.
3. O’Sullivan PB et al. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic evidence of spondylolysis or spondylolisthesis. Spine 1997; 22:23959-67.
4. McGill SM. Low back exercises: evidence for improving exercise regimens. Phys Ther 199; 78:754-65.