Today I met Carl Watts for the first time and what a treat that was! Carl is a friendly, enthusiastic man who is truly motivated to achieve his goal on getting that tour card back.
We started with a full bio-mechanical assessment. I try to assess each client as if I didn’t know what sport they played as not every golfer fits the stereotype. It’s important to look at each person with fresh eyes rather than jump to the ‘things’ you would expect to find.
Top to Bottom Summary of Findings in Session 1
On initial view of Carl in a resting standing posture there is a clear imbalance between right and left. His right shoulder drops down and this follows through the rest of his body resulting in a rotation towards the left. Another point of interest is that Carl’s breathing seems very shallow and is very much so an upper body breath with little use of the diaphragm and abdominals.
Carl has a posture summarised by Janda as Upper Cross Syndrome, see illustration below from www.erikdalton.com, resulting in restricted range of motion (ROM) in his neck.
What is more unusual is that this is more pronounced on this right side but is still present on the left to a lesser degree. This also translates to the lack of scapular control Carl exhibits on his right hand side compared with the left.
- Another deviation from the Janda model is that Carl’s head is less forward but points upwards as if trying to correct itself in some way but leading to even more tension on the back of his neck which is common complaint on discussion with Carl.
- Shoulder ROM restricted range of motion.
- Full Range of motion in wrists.
- Carl has another condition summarised by Janda – Lower Cross Syndrome. This is quite commonly seen alongside upper cross syndrome resulting in an ‘S’ posture.
- Again this is more pronounced on the right side and Carl complains of pain in his right knee when doing hip flexor strengthening. This also correlates to the rotation we see through Carl’s torso, although the left hip is not in a posterior tilt, it is dropped back compared with the right.
- On assessment Carl’s Rectus Femoris muscle is tighter than his Psoas so we will start here.
- Carl’s lower back is stiff and lacks movement. This lack of movement is evident through the lower and more so into the mid thoracic spine. On flexion of his trunk there is little to no movement in this region.
- Hip flexion is restricted and hamstrings are taut but not short, the anterior pelvis tilt is likely to be causing this apparent lack of flexibility.
- In addition Carl’s hips are both laterally rotated and his ankle range of movement is very restricted particularly in dorsi flexion.
On discussion with Andy Traynor, Carl’s coach, my findings match up nicely with what Andy is seeing in Carl’s swing. His lack of hip stability and flexibility is manifesting itself in a loss of power in Carl’s downswing as his body moves to compensate/re-balance in spite of his restricted movement.
The number one priority for Carl will be getting his core and hips stable, strong and flexible and his home care reflects this. I also feel that this restoration of balance in the hips may resolve some of the lower and upper body issues we are seeing.
Treatment Plan Session 1
The main focus of today’s treatment is to begin work on correcting Carl’s hip alignment. I used a variety of techniques to release the hip flexors and lower back. I also started work on engaging Carl’s diaphragm and abdominals to encourage a full and complete breathing pattern, this will be followed up by home care to start training Carl to use his core when breathing which will also help to start to correct some of the upper body issues we identified today.
- Hip flexor stretching, in particular Rectus Femoris
- Lower back stretching
- Introduce Yoga to training regime
- Breathing rehabilitation exercises
Remarks for Next Session
- Test Glute Strength/Firing Pattern
- Test Thoracic Rotation
- Retest Hip Alignment
- Continue treatment for hips and start upper body treatment
Check out Andy and Carl’s blog to find out how ‘The Experiment’ is going!