Lower back pain is very commonly discussed. Less often discussed, but still very prevalent, are upper and middle back pain. Upper back pain is very common in golfers particularly among people who work at a desk for many hours a day or who hunch over their phones or other electronic devices. We see this issue increasing in all age groups, with adults working long hours at a desk and with juniors spending lots of time on their phones and in desks at school.
For some background to understand what we’ll be talking about, let’s discuss the structure and musculature of the back. The spine itself is broken up into individual vertebrae. The lower 5 of these are considered the lumbar spine. The next twelve up are what’s called the thoracic spine, followed by the seven cervical vertebrae.
When we talk about upper and middle back pain, we’re mostly talking about the thoracic spine, as opposed to the lumbar spine which is where we would look for the more achy lower back pain. Specifically, we’ll often see pain originate from the thoracic-lumbar junction, which is where the thoracic and lumbar spine areas meet. We’ll typically see pain in this area not on the spine itself but just to either side, on the large erector muscles of the back shown below.
So why do we see these issues so much in people who work at a desk or hunch over their phones? Well, this posture promotes a lot of flexion (forward bend) in the thoracic spine. The more your thoracic spine is in flexion, the more you lose the ability to extend it backwards and to rotate. Because of the way the vertebrae are shaped, in order to rotate, they have to extend somewhat, so if your ability to extend is limited, so is your ability to rotate, which can interfere with the golf swing in a huge number of ways.
The first way to help fix or improve your mobility or pain in your thoracic spine is very simple. Take two lacrosse balls and place them on the ground just touching each other. Lay on top of them, with the balls on either side of your spine, directly below the bottom of your ribcage. Cross your arms and put each hand on the opposite shoulder. Roll the balls up along your back until you find a sore spot. Once you do, relax your head and shoulders back, then curl your back and neck up and down a few times, keeping the point of contact with the balls. Continue rolling the ball until you get to around your shoulder blades.
If that doesn’t fix the problem by itself, or if you just want to improve more, you’ll want to get a foam roller. For this example, we’ll be referencing the exercise as if you’re laying on your right side, but it can be mirrored and done on the left side. Lay on your right side with your left knee bent and propped up on the foam roller. Extend your right arm above your head and your left arm out in front of you. Sweep your left arm around your head, keeping it extended and keeping your hand on the ground as much as possible, until your arm is as far back as you can get it. Do this several times, then repeat the arm sweeps in reverse. If your shoulders are particularly flexible, try to be aware of that and let as little extension as possible come from your shoulders.
Another helpful exercise starts with getting down onto all fours. Again, this can be done with either the left or the right side; just mirror the instructions. Once you’re on your hands and knees, take your right hand and put it behind you head with your elbow straight out to the side. Rotate so that right elbow touches your left elbow, then rotate back out the other way so that your right elbow points straight upwards. Repeat several times. As with the last exercise, a lot of motion can come from other places, so try to make sure you’re bringing as much motion as possible from your back.
One final exercise uses a resistance band with handles. Tie the band to a stationary object, then go down on all fours. Tension the band and take it in the hand furthest from where it was tied. Let the band pull your torso down and under to the end range of your mobility, then, keeping your elbow straight, pull back so that your back is flat. Repeat several times.
Hopefully this helps to give you some ideas about how you can help yourself improve your body for your golf game to help you continue to playing for many years to come, hitting it farther and avoiding future injury!