Sports Medicine
Dr. Greene discusses “Surfers Shoulder”
ShoreOrtho Sports Performance
& Injury Prevention Tips
A monthly series presented by: 
Damon A. Greene, MD
Board Certified Orthopaedic Surgeon
Shore Orthopaedic University Associates
November 2019
“Surfers Shoulder” also known as Shoulder Impingement is a common overuse injury of the shoulder.
When we paddle we use the front of our shoulder the pectoralis major, pectoralis minor and anterior aspect of our deltoid. We also strengthen shoulder elevators the trapezuim and levator scapula among others. This causes a net upward and anterior directed force across our shoulder. This then leads to impingement of the rotator cuff on the acromion (the roof of the shoulder). Intern the tissue around the rotator cuff becomes inflamed which then will lead to bursitis.
If left unaddressed scar tissue can form in the capsule causing a loss of a range of motion and chronic shoulder pain and ultimately rotator cuff tears. In order to prevent this proper paddling technique is crucial. Secondly learning to activate the posterior and inferior aspects of our shoulders while preforming activities will help keep us paddling stronger and out of pain.
While there are many different exercises that can achieve this, one of my favorites is an exercise called Wall Angels.
To begin, plant yourself against a nice, roomy wall space. Elbows start at a 90 degree bend, with the elbows parallel to the ground. Hips, spine, shoulder blades…all against the wall! To get to the stretch-and-strengthen part – although you might already feel some tension while holding the arms at 90 degrees – begin to straighten the arms directly overhead, trying to at least keep the elbows sliding up against the wall. As you get stronger and looser, maybe the forearms and back of the hands will be able to stay in contact with the wall, as well.
Dr. Greene is a Sports Medicine Fellowship-Trained, Board Certified Orthopaedic Surgeon.
He specializes in; acute and chronic ligament, tendon, or cartilage injuries to all major joints; primarily shoulders, elbows, knees and hips. He treats fractures surgically when necessary, but performs casting, bracing, and other non-operative treatments such as specialized injection therapies.
Dr. Dalzell Explains Treatment and Prevention of the “Most Common Golf Injuries”
MOST COMMON GOLF INJURIES
Frederick G. Dalzell, MD
Board Certified Orthopaedic Surgeon
Fractured ribs, herniated discs, injured wrist and knees, we’re not talking the Eagles injury report, but rather some of the injuries suffered on the PGA tour! Hard to believe that what’s been described as “a good walk spoiled” and debated by others as not even being a sport could result in this litany of injuries.
So what are the most common problems suffered by the weekend golfer and how can you treat and prevent them?
BACK PAIN
It’s been estimated that 80% of Americans will experience back pain at some time in their life. That number becomes even higher when you enjoy golf as an activity. With the average golfer generating torque and swing speeds of 80 to 90 miles an hour and pros well over 110 it is not surprising that the raid generation and sudden stop put significant stress on the lumbar spine. Pre and in-season stretching and core strengthening can be good preventatives. Rest, anti-inflammatories (like Motrin or Aleve) stretching, deep tissue massage and bracing all may be helpful early on. If not responding after a week you may need to see your health care professional.
ELBOW PAIN
Tennis elbow (outside of the elbow) and golfer’s elbow (medial elbow) are also the bane of the duffer and pro golfer alike. Over use, hitting off mats, too stiff a shaft and improper grip size can lead to these problems. Stretching, tennis elbow straps, ice, anti inflammatories and injections all have a place in treatment. Sometimes a switch to graphite or a more flexible shaft may be beneficial and could be a reason to consult a golf professional.
WRIST PAIN
Most wrist pain related to golf comes from tendonitis and over use. Taking time off (sorry fellow golfers), ice and anti-inflammatories will cure most cases. If the pain follows striking a root or another object, results in joint swelling or lasts more than a week after treatment than a more serious injury (fracture or ligament tear) is a possibility and a trip to the doctor is more advisable.
KNEE PAIN
The stiff lead leg is exposed to high stress during weight shift, and while not as common as some of these other problems these injuries often involve ligaments or meniscus and may need medical attention earlier. Those with arthritis also may see flares during golf season. Bracing and an evaluation of your swing by your golf pro may help. Continue reading
Golf Injuries to the Wrist and Hand
Mark Walsh PT, DPT, MS, CHT
Titleist Performance Institute Certified
Shore Orthopaedic Physical Therapy
Did you know that of all the sports the most injuries to the hand and wrist occur in golf?
Hand injuries occur in about 10% of professional and 20% in the amateur golfers. The incidence may be explained by the anatomic and mechanical complexity of the wrist and hand. Most of the injuries occur in the lead wrist and hand associated with overuse, golf swing faults and mechanics and trauma.
Overuse injuries are primarily tendonitis or tenosynovitis such as deQuervains tenosynovitis (inflammation of tendons on the thumb side of the wrist). Overuse injuries often occur in the amateur at the beginning of the golf season, when the golfer is not appropriately physically prepared to strike the golf ball. For example, as the golf season approaches it’s off to the driving range hitting a large bucket of balls one after another without appropriate warm up and rest between swings. Watch a professional warm up hitting golf balls notice, that between each swing, they stop, analyze the ball flight, divot etc. and discuss it with their caddy or coach. The take home message is that the amateur hits too many golf balls to quickly and too often. Overuse also occurs due to a lack of physical conditioning for their entire body, not just the upper extremity. The power and the ability to strike the golf ball correctly comes from the use of the powerful core and lower extremity muscles. If the lower body does not initiate the swing sequence correctly this can cause changes in the upper body swing mechanics placing the wrist and hand at risk. Swing faults of “Casting, Scooping, Chicken Winging and Over the Top” can contribute to wrist and hand injuries.
BETTER GOLF THROUGH FITNESS
Ocean City Sure Guide
JUNE 19 – JUNE 25, 2019
Pg. 54
Periodization effective way to prepare for golf season
By: GRADY BROZYNA MSPT, OCS, COMT
Residency & Fellowship Trained in OMT
Shore Orthopaedic Physical Therapy
Summer is here and I am sure you prepared your golf bag. But how are your rotator cuffs, hip joints and spinal discs?
If you have not been preparing for the past four weeks, then they are not ready for that first tee giant swing to impress the foursome. You are also at prime potential for injury and poor performance. But don’t fret: it’s never too late to ready the body.
Strength and conditioning coaches use what is called periodization to prepare athletes. This breaks down the year into three main categories: Offseason, preseason and in season.
Periodization is designed so the athlete has time to work on recovery and weak areas of performance in the offseason, ramp up to peak form and power during preseason and maximize performance during the season. Golfers are power athletes with swings taking as little as 2 seconds. So golfers should be training for power, which involves strength and speed. And they should be reaching their maximal potential in the heart of summer. That means preseason is spring and offseason winter.
Offseason is when the golfer must take some time and let the repetitive motions stop so the body can heal.
Have a spa day or two to work out the byproducts that build inside the muscles and connective tissue during the season. Sample a yoga class or stretch class to lengthen the muscles that tightened up playing all summer and fall. After a few weeks of rest, the remainder of the offseason should be spent working on the skills for which you are weakest. If you want more distance on your drives, then build strength in your legs and core. Use exercises such as squats and step-ups, pull-ups and push-ups to build basic strength.
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