When Shoulder Pain Starts Affecting Your Golf Game

If you’re dealing with shoulder pain when you play golf, the worst thing you can do is ignore it and hope it goes away.

Shoulder impingement and rotator cuff injuries are common causes of shoulder pain in golf. To understand shoulder impingement, you have to understand some anatomy. At the top of the arm bone (the humerus) is a bony structure called the greater tubercle, also known as the greater tuberosity. Above it sits a piece of your scapula (shoulder blade) called the acromion. There is between these two bones lies a small but important space called the subacromial space. It is usually about 6 mm in length. Inside this space is one of your rotator cuff tendons called the supraspinatus and a small cushioning structure called the subacromial bursa.

During certain shoulder movements—especially internal rotation (rolling your thumb down and adduction (bringing the arm across the body)—the greater tuberosity moves closer to the acromion. When this happens, the subacromial space becomes smaller.

If that space narrows too much, the rotator cuff tendons and bursa can become compressed or “pinched” between the bones. This is what we refer to as subacromial or shoulder impingement.

Over time, repeated compression can irritate the tendons, create inflammation, and eventually lead to rotator cuff injuries.

In golf, certain swing mechanics can cause the shoulder to go into this vulnerable position.

Swing Mechanics That Can Contribute to Shoulder Impingement

Poor Rotation Leading to Sway or Slide

When a golfer lacks proper rotation in the hips or thoracic spine, the body often compensates by swaying during the backswing or sliding during the downswing.

This movement changes how the shoulder moves during the swing. Instead of moving primarily through flexion, the shoulder is forced more into adduction.

Notice how just after impact the players trail arm moves across his body (adduction). This is in part because this player slid over his L foot rather than rotating around the L hip such that his hips would be pointing more towards his target.

Adduction is a much more stressful position for the shoulder joint because it brings the greater tuberosity closer to the acromion. Repeated swings from this position increase the likelihood of subacromial impingement.

Excessive Pronation During the Backswing

Excessive pronation of the lead forearm, or having a strong grip during the backswing often places the shoulder into excessive internal rotation and adduction as well.

As discussed earlier, these positions decrease the space between the greater tuberosity and the acromion. Over time, repeated swings from this position can compress the rotator cuff tendons.

Golfers who excessively pronate the lead forearm tend to open the clubface in the backswing. For these players, weakening the grip and focusing on keeping the clubface more square during the takeaway and backswing can help keep the shoulder in a safer position.

Casting and Rapid Deceleration

Casting—releasing the club too early in the downswing—creates rapid acceleration of the clubhead early in the swing.

If you imagine the player standing in a pool of water that comes up to the waist, you want to see the hands enter the pool of water otherwise they have released the angle of the club prematurely (casting).

Because the club speeds up too early, the shoulder and rotator cuff must work much harder to slow the club down later in the swing without the lower body being able to help.

This rapid deceleration places large forces on the rotator cuff.

Fat divots can create a similar problem. When the club strikes the ground before the ball, the shoulder must respond to this abrupt change in speed.

Repeated deceleration forces are a common contributor to rotator cuff irritation. 

Golfers who typically take a fat divot often have a shallow shoulder plane at the top of the back swing. For these golfers, steeping the shoulder plane in the backswing can help reduce the tendency to leave a fat divot. 

Trail Forearm Vertical Without Enough Shoulder Mobility

Some golf instruction encourages golfers to position the trail forearm vertically during the backswing.

However, this position requires sufficient external rotation of the trail shoulder.

If a golfer lacks this mobility and still tries to force the position, the shoulder can move into compensatory patterns that create pain and problems.

In these situations, it may be better to allow the shoulder to move within its natural range—even if that results in a slight “flying elbow.”

What We Look For at The Movement Clinic

At The Movement Clinic in Spokane, we take a different approach to golf injuries.

Instead of just treating the painful shoulder, our chiropractors evaluate how your body moves so we can understand how it is impacting your golf game.

During an assessment we typically look at:

• Painful parts of the body

• Dysfunctional movement patterns

• Total body mobility and stability

• Strength and power

• Swing mechanics and efficiency

By identifying the movement limitations and swing characteristics contributing to the problem, we can build a plan that helps golfers:

• Reduce shoulder irritation

• Restore mobility

• Improve swing efficiency

• Prevent the injury from returning

Most importantly, the goal is to help you keep playing the game you love.

One Lifestyle Habit That Surprises Many Golfers

One factor many golfers overlook is sleep position.

If you sleep on your side, the pressure placed on the shoulder can reduce circulation to the tissues. This creates tissue ischemia, which can lead to tightening of the muscles around the shoulder and make impingement symptoms worse.

For many patients, simply learning how to transition from side sleeping to back sleeping can significantly reduce shoulder irritation.

Because this is such a common problem, I’ve actually created a step-by-step course that teaches golfers how to successfully switch from side sleeping to back sleeping without destroying their sleep quality.

Get Back to Playing Golf Without Shoulder Pain

Golf should be something you look forward to—not something that leaves your shoulder throbbing afterward.

If shoulder pain is affecting your swing, your distance, or your enjoyment of the game, the best thing you can do is address it early before it progresses into a more serious rotator cuff injury.

If you’re in the Spokane area and you are in need of a chiropractor who won't just adjust you, but listen and evaluate you to find out what’s causing your shoulder pain, we’d be happy to help.

After evaluation our golfers benefit from our wide-ranging treatment skills which include chiropractic adjustments, soft-tissue (muscle) work and therapeutic exercise. We are also able to offer unique perspectives on golf as you go through the evaluation and treatment process.

Schedule a time to get assessed at The Movement Clinic and let’s get you back to swinging freely again.