S-POSTURE AND BACK PAIN
S-POSTURE AND BACK PAIN
Bob Forman
Director, The Golf Fitness Academy
Certified Golf Fitness Instructor
There it is. In the center row in the fold out of the April issue of a prominent golf publication. A touring player in an S-posture or an “athletic” posture as it’s sometimes called.
It’s something you see quite often, especially in women and young men. It’s characterized by an arching of the lower back while standing over the ball at address. Of concern is the stress the S-posture places on the lower back. Not good for the long haul and will more than likely develop into chronic lower back pain if not addressed.
It can also disrupt the golf swing due to a concomitant relaxation of the abdominal muscles, resulting in swing faults like reverse spine (a leaning back of the spine toward the target at the top of the backswing).
One of the primary factors in the S-posture is a tightness of the hip flexor muscle group in the front part of the hip. Three of these, the tensor fascia latae (TFL), the rectus femoris, and the sartorius insert at the iliac crest and will flex the thigh up to hip level. The other two, the psoas and iliacus (more commonly known as iliopsoas), will flex the thigh beyond 90 degrees as the former originates in the lumbar spine and the latter on the back of the hip. Weakness, which can be easily assessed, in the iliopsoas can also contribute to back pain.
Having a sedentary lifestyle where you sit a good part of the day can produce and/or enhance this condition, as can wearing heels, being pregnant, or having a beer belly. The latter three shifts the center of gravity forward thereby causing the individual to arch their back a bit to prevent them from falling on their face. Over time, the body adapts to the posture.
As the hip flexors are in the front hip area they may rotate the hip forward, if tight, resulting in a swaying of the lower back. Short term affects are discomfort and pain, which often times are exacerbated by the explosive, one-sided nature of swinging a golf club.
Much more serious is the potential long-term damage the excessive curvature of the spine may have on the discs in the lower spine, as an increase in the lordotic curve will pinch the discs, increasing wear and tear and disc degeneration. This often leads to the slipped or ruptured disc and sciatica.
If you have a swayed back, naturally or while getting ready to hit a golf ball, it’s a good bet your hip flexors are tight. You’ll need to get into a consistent stretching program to loosen them up and bring balance back into the system.
One good stretch is called the knee hug. Lie on your back on the floor with legs flat. Bring one knee up toward your chest, grab behind the knee, and hug your knee into your chest till a gentle stretch is felt. Hold for 30 seconds, switch the legs, and repeat. Remember to breathe normally. As part of the golf physical assessment, if the thigh of the extended leg comes off the floor while hugging the opposite knee, you’re hip flexor to that side is tight. 
A progression to the knee hug is to perform the stretch while lying on a flat surface such as a bench or solid coffee table (photo right). Sit on the edge, lie back and let one leg hang down toward the floor while you hug the opposite knee. This will provide more of a stretch to the front hip of the extended leg as that leg is now below you vs. level with you like when doing the stretch on the floor.
Another good stretch is a half-kneel hip flexor stretch (video left). Kneeling on one knee with other foot flat on the floor and extended out in front, slowly lean into the front leg, making sure your knee doesn’t go past the toe and your trunk stays upright. Feel the gentle stretch in the front hip of the extended back leg. Hold 30 seconds and repeat with other leg. Remember to breathe throughout.
A hip flexor stretch you can do without getting on the ground (photos right) is good to do as a warm-up before golf using the side of a cart, for example. Place your left foot up on the fender of a cart with arms raised parallel to the ground. Make sure you have good firm footing. Bend the left knee forward as you rotate your arms around to the left. Keep your trunk upright and the right heel flat on the ground. You should feel this in the front of the right hip. Switch leg position and repeat to the right side. With a little bit of patience a regular stretching routine can anatomically help the back discomfort associated with tight hip flexors and the often related S-posture. Practicing your posture in the mirror will also help. Strive for a nice straight spine when addressing the ball with no arching of the lower back. A quick fix is to pull your belly button into your spine as that will rotate the hip bone back and flatten out the lower back. The long-term solution, however, is stretching out those tight hip flexors.
