Could knee joint mechanics during the golf swing be contributing to chronic knee injuries in professional golfers?

Abstract

Full three-dimensional movements and external moments in golfers' knees and the possible involvement in injuries have not been evaluated using motion capture at high sample frequencies. This study measured joint angles and external moments around the three anatomical axes in both knees of ten professional golfers performing golf drives whilst standing on two force plates in a motion capture laboratory. Significant differences were found in the knee joint moments between the lead and trail limbs for the peak values and throughout all stages during the swing phase. A significantly higher net abduction moment impulse was seen in the trail limb compared with the lead limb (−0.518 vs. −0.135 Nms.kg −1 ), indicating greater loading over the whole swing, which could contribute to knee lateral compartment or ACL injuries. A significant correlation (r=−0.85) between clubhead speed at ball contact and maximum joint moment was found, with the largest correlations being found for joint moments at the top of the backswing event and at the end of the follow through. Therefore, although knee moments can contribute to high clubhead speeds, the large moments and impulses suggest that they may also contribute to chronic knee injuries or exacerbate existing conditions.

Lower Limb Biomechanics during the Golf Downswing in Individuals with and without a History of Knee Joint Injury

“…Previous studies reported the golf knee load ranged from being similar to a stair descent, to tennis serving or jogging, and concluded that the peak load generated in the golf swing was not enough to cause immediate injury and that the risk of knee joint injury was caused by repeated swings over a prolonged period [38]. On the other hand, our studies showed the KIH− group had smaller values for the axial rotational moment than other research with PGA participants during the downswing (knee external rotation moment: −0.24 ± 0.26 vs. −0.32 ± 0.11 Nm/kg, respectively) [2]. It is suggested that the KIH− group should avoid prolonged swing training that can lead to overuse injuries.…”

“…The golf swing is a complex movement, requiring the coordination of all of the parts of the body in order for it to be executed skillfully [1]. Although people believe that golf is a non-strenuous sport, the skeletal muscles exert a great force during the swing possibly leading to the occurrence of chronic injuries [2][3][4]. Although injuries of the lower limbs are not as common as injuries of the upper limbs and back, some studies found that the former accounts for 18% of the injuries from playing golf [5].…”

Potential biomechanical risk factors on developing lead knee osteoarthritis in the golf swing

“…The Vicon Nexus software was used to calculate knee adduction and abduction moments using an inverse dynamics approach. The knee adduction and abduction moments were normalized to the participants’ body mass 8 , 9 , 21 and were calculated at the first peaks. There are generally two peaks for knee adduction during the golf swing, and the first peak was chosen in this study for consistent timing; an additional reason for this choice was that the timing of pain felt by golfers was reported to be around impact 21 , and the first peak occurs around impact while the second peak occurs near finish 8 .…”

“…The knee adduction and abduction moments were normalized to the participants’ body mass 8 , 9 , 21 and were calculated at the first peaks. There are generally two peaks for knee adduction during the golf swing, and the first peak was chosen in this study for consistent timing; an additional reason for this choice was that the timing of pain felt by golfers was reported to be around impact 21 , and the first peak occurs around impact while the second peak occurs near finish 8 . The first peak has also been consistently used in previous studies to examine modifications to reduce the peak knee adduction moment for golf swing 9 , 13 .…”

“…These studies, primarily conducted for walking, consisted of identifying biomechanical risk factors 5 as well as evaluating the effects of modifications on reduction of knee-joint loads 3 . Some golf swing modifications have been evaluated given that knee-joint loading is greater than gait and stair ascent 8 – 10 . Additionally, although efforts to develop preventive training that include personalized modifications 11 and vision technology 7 are currently available as treatment for gait, such advanced techniques are limited for golf.…”