Hiding In Plain Sight

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Today, we’re back with Dr. James Caldwell, The Golf Physio.

Hiding In Plain Sight

Dr. James Caldwell, PT, DPT, CSCS, TPI Certified

     How many times have you heard about posture? If there is one thing I constantly preach to my patients, it is the concept of posture. And for good reason! If we slouch in our chairs or sit up too much that we arch our backs, our bodies will eventually get angry and let us know. Now, take a look at the photos at the top of this page. Any of those postures look familiar? At what time in the last month have checked your posture before swinging away?

     Posture might seem simple, but it is an overlooked skill that most golfers do not realize should be incorporated into training. If you cannot set up to hit the ball properly, how do you think the rest of your swing is going to look? Now, do not get me wrong, you will probably see professionals on the tour with postures like the “S” or the “C” and be fine. Always remember: they are professionals for a reason. Although they may not start out perfectly, they have learned to compensate in other ways to make up for their lack of premium posture to strike the ball perfectly with practically every swing. Going back to TPI’s philosophy, there is no one perfect way to hit a golf ball. There are a thousand different ways to hit a ball, but there is only one efficient way for each individual golfer to swing in order to maximize their potential. Now, let us review each posture and I’ll explain why they are not ideal for us, the average golfer.


     Typically seen in the older population, the “C-posture” looks like the golfer has a rounded or hunched back while addressing the ball. With this posture, thoracic spine mobility will be the most limited. If the golfer fails to keep his or her backswing short, then the body will most likely compensate by arching from the lumbar spine which can lead to low back pain.

     Sometimes, this posture can be easily corrected by showing the golfer on video what they are doing and putting them in the correct position. Unfortunately, most golfers assume this position due to a series of muscle imbalances and/or joint restrictions that have developed over the years. They are in this posture for a reason, so the key is to figure out why and address it appropriately.

     The most common reason for this posture is what is known as “Upper-Crossed Syndrome.”

Coined by Dr. Vladimir Janda, someone who demonstrates an upper-crossed syndrome posture will most likely demonstrate tight or shortened pectoralis major/minor, upper trapezius, levator scapula muscles, latissimus dorsi, and sternocleidomastoid muscles. They may also demonstrate weak or inhibited serratus anterior, deep neck flexors, and lower trapezius muscles.  If you demonstrate this posture, do not worry, there are many different exercises to correct this. The key, as I said earlier, is to figure out why this is going on in the first place. That is where the TPI screen comes into play.

***Another important thing to note is that these are all the possible impairments that one might have with this posture. It does not mean you have all or any of them for that matter.

     With this posture, the golfer will most likely have the most difficult time demonstrating sufficient thoracic extension (think backward bending over a chair). The problem is that the golfer will then have trouble rotating their thoracic spine, limiting their motion during their backswing one can perform without significantly compensating from somewhere else (most likely, your low back). This can result in a loss of power, loss of posture during the swing, early extension, and, most importantly, pain. Although this posture is not ideal, I consider the next one to be slightly worse.


      On the other end of the spectrum is what is termed an “S-posture.” The best description I can give you is that of a female gymnast at the Olympics. Think of how they finish their routine and they pose to the judges with their hands overhead. That is an exaggerated S-posture. Thankfully, almost no golfer will ever demonstrate that much lumbar extension when they set-up to swing the club.

     Being a physical therapist, I would consider this posture the more dangerous of the two if I had to pick. When you start in this position, you are telling your brain to use your low back muscles too much and are essentially shutting off your abdominals from working at all. With that lack of stability from your abdominals (our main lumbar stabilizers), you are bound to hurt your back at some point during the round.

     Just like the C-posture resulting from what is known as upper-crossed syndrome, an S-posture results from what is known as “lower-crossed syndrome.” With this condition, a person will most likely demonstrate tight or shortened hip flexors, erector spinae, tensor fascia latae (TFL), and quadratus lumborum (QL).

The person may also demonstrate weak abdominals and gluteus muscles (maximus and medius). This is the most common posture I see with not only golfers, but the general population as well. The most likely cause is due to the fact most of us sit throughout our day. This creates muscle imbalances and joint restrictions that can easily be prevented if we would sit less for our jobs and move more.

     Another side note to consider. Just like the C-posture and upper-crossed syndrome, you may have none, some, or all of what I listed in terms of what it means. I am just giving the full definition for convenience and general knowledge.

What To Do?

     It is not all doom and gloom if you do set-up in either one of these postures. In fact, TPI did a survey of 423 amateur golfers and found that 33.1% admitted to having a C-posture and 25.3% demonstrating an S-posture. Clearly, you are not alone. But, what to do now? I will post specifically about how to correct upper and lower-crossed syndromes at a later time, but here are some suggestions for you:

1. Get screened: Invest in a Golf Screen by a trained professional. I cannot stress this enough. If you have not been screened by anyone (TPI would be the best in my opinion), that should be your first step. Getting to know your own body and own limitations is a huge component in being able to address your weaknesses and become a better golfer.

2. Sit less: One of my biggest pet peeves is the amount of sitting we do on a day-to-day basis. If you work at a desk job, try to see if your employer will get you a standing desk. If not, I always tell my patients for every 35-45 minutes of sitting, stand up and walk around for 3-5 minutes. Not only does it return blood flow, it keeps you awake and helps you reassess your posture to make sure you are in proper alignment. Speaking of posture…

3. Be mindful of your posture: Whether you are sitting or standing, it is always good to be mindful of how your body is being stressed. Think about if you sprained your wrist and bending it one direction always caused it to hurt. Imagine if you were to walk around with your wrist in that same position that caused it pain for six hours without changing it. Don’t you think it might be a little angry with you at the end of the day? That is essentially what you are doing to your back and your back muscles when you are not actively changing how you sit or stand. Check out the images below for what good posture means.

4. Stay active: If you are active, make sure you are doing the correct exercises. The TPI website has plenty of exercises to help with your golf game that will keep you on the right track. Performing one thousand crunches is not the answer. In fact, crunches are the worst exercise you can do for your abdominals (more on that later). If you are not active, what is holding you back? Time? Do not know what to do? Feel free to message me if you need help, or contact your local TPI expert for assistance on ideas.


Although we all want to hit the massive drive and work on finishing our putts, we cannot forget the most basic part of the golf swing: the address. If we are not addressing the ball properly, we are already setting ourselves up to perform at a less than optimal level. Do not let that happen!

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