The Real Reason Your Back Hurts

If you have low back pain, you already know how much it can mess with your swing, especially when using your driver.

One of the reasons your back hurts could be because of muscle imbalances.

A muscle imbalance is a combination of tight and weak muscles that can change your posture and how you move – increasing your risk for injury.

If you have low back pain, then it’s very likely that you have muscle imbalances in your body.

Fortunately, there are scientifically proven posture assessments and movement assessments that can be used to find if you have any muscle imbalances. And if you do, a corrective exercise routine can be designed specifically for you to correct your set muscle imbalances, reduce your low back pain, and improve your performance.

Static Posture Assessment

Your posture is the foundation from which you move. So, if you have bad posture you’re not going to move the way your body was made to move (this includes during your swing) and that could be one of the reasons why you have low back pain.

There are 3 common postural distortion syndromes (bad postures) that people have and all of them can lead to poor swing mechanics and low back pain.

  1. Upper Crossed Syndrome
  2. Lower Crossed Syndrome
  3. Pronation Distortion Syndrome

Upper Crossed Syndrome

People who have upper crossed syndrome (UCS) will have their head poking forward, shoulders rounded, and a hunched upper back.

In some people this will be very obvious and in other people not so much.

This posture is usually a result of sitting at a desk all day. What happens is the muscles through the chest and upper back/shoulders become too tight and the neck flexors and muscles through the mid back become too weak.

UCS will pull your thoracic spine into flexion (hunched upper back) and reduce its ability to extend and rotate.

If you can’t extend or rotate your thoracic spine properly, your lumbar spine (low back) will have to pick up the slack and extend/rotate more and your lumbar spine isn’t made for this, meaning you’re going to end up with low back pain.

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If you have UCS you’ll notice that it’s difficult to get full rotation during your backswing. So, your backswing will be short, which means you’ll have reduced club head speed, and reduced distance.

You’ll also find it difficult to get your club into the right plane, you’ll probably end up swinging over the top resulting in a pull or a slice.

Lower Crossed Syndrome

People who have lower crossed syndrome (LCS) will have a swayback, which is too much curve in their low back (lumbar curve).

Again, sometimes this is very obvious and sometimes it’s not obvious at all and will take a trained professional to see it.

This posture is usually from sitting a lot. Sitting causes the muscles in the front of the hips to shorten, which weakens the gluteal (buttock) and abdominal muscles, while creating tightness, tension, and pain in the low back.

Golfers with LCS will have what we call the S-posture (too much arch in low back) during their set-up.

S-posture is one of the main causes of low back pain in golfers.

If you have LCS your abdominal and core muscles will be weak and you’ll have a loss of posture or a reverse spine angle during your downswing.

Your upper body will end up dominating the downswing and you’ll find it hard to keep your club in the right plane and you’ll have inconsistent ball striking.

Another problem with LCS is that your shortened hip flexors will reciprocally inhibit (turn off) your gluteal muscles and they’re the king of the golf swing..

If you have weak gluteal muscles you won’t be able to generate enough power during your downswing, meaning you won’t get enough club head speed, and you won’t get as much distance as you could.

Pronation Distortion Syndrome

People who have pronation distortion syndrome (PDS) will have flat feet and knock knees.

This posture is a result of bad ankle and hip mobility combined with weak core and gluteal muscles. It puts a lot of stress on the lumbar spine and and can cause low back pain.

If you have PDS it’ll be hard for you to internally rotate your lead hip. If you don’t have enough internal rotation in your lead hip, your lumbar spine will have to pick up the slack and rotate more. Because the lumbar spine isn’t made for rotation, this leads to low back pain.

PDS can make it very difficult to have good swing mechanics because it messes with your feet, which are the foundation for your swing – everything moves up from your feet. This combined with having weak gluteal muscles means you won’t be able to generate enough power during your downswing. You’ll have reduced club head speed, and reduced distance.

Not only that, but this posture will also cause early extension and hanging back .

Early extension is when you straighten up too early in your downswing and usually results in a block or a hook.

Hanging back means you’re not transferring your body weight properly during your downswing. You end up keeping too much weight on your back leg, and you open up too soon. This can result in inconsistent ball striking often with a high trajectory with a slice or a fade.

Movement Assessment

The overhead squat assessment (OHSA) is one of the best movement assessments for finding muscle imbalances and coming up with a plan of action to reduce or eliminate low back pain.

What makes the OHSA such a great tool is that it’s done while you’re moving. Moving around is obviously part of your life, so having an assessment that involves you moving is very valuable.

To perform this test, I have my clients take a video of themselves from the front, back, and each side doing the following movement:

  • They start by standing with their feet shoulder width apart and toes pointing forward.
  • Next, they grasp a golf club approximately shoulder width apart and extend their arms directly overhead, keeping the shaft in-line with their head and over their
  • Next, I have them squat down as far as they can go, while keeping the club as high above their head as

If they feel any pain they stop the test.

This test challenges the mobility of their ankles, knees, hips, upper back and shoulders.

So what am I looking for?

I want to see how low they can squat. Can they get their thighs parallel to the ground? Do their feet turn out or heels come off the ground? Do their knees move in or out? Does their upper body lean forward too much? Does their back arch or round? Is it hard for them to keep their arms straight above their head?

There are 4 main areas I’m looking at:

  1. Feet and Ankles
  2. Knees
  3. Hips and Pelvis (lumbopelvic hip complex)
  4. Shoulders

Let’s go through a case study of a golfer who came to me with low back pain.

Feet and Ankles

Feet flattened and turned out. Ankles dropped in (eversion).


Moved in

Hips and Pelvis

Low back arched.


Arms fell forward.

So, with these observations I can make a list of probable overactive (tight) and underactive (weak) muscles. These are his muscle imbalances.

Probable Overactive Muscles

  • Soleus
  • Lateral gastrocnemius Peroneal complex
  • Biceps femoris (short head) Tensor fascia latte Adductor complex Hip flexor complex
  • Erector spinae Latissiumus dorsi
  • Pectoralis major/minor Coracobrachialis Teres major

Probable Underactive Muscles

  • Tibialis anterior
  • Tibialis posterior Medial gastrocnemius Popliteus Sartorius
  • Vastus medialis oblique Gluteus medius Gluteus maximus Intrinsic core stabilizers
  • Mid/lower trapezius Rhomboids
  • Posterior deltoid Rotator cuff

This list told me a lot about why this golfer’s low back hurt and also told me a lot about his swing.

By looking at this list I could predict that his lumbar spine and SI joints were unstable and this was probably a big reason why he had low back pain.

Let’s make some predictions about his swing.

First of all, the golfer wasn’t able to squat very deeply with his heels on the ground, which told me that it was almost impossible for him to maintain posture during his downswing. This was because he had tight calves and  weak core stabilizers. This golfer would end up thrusting his lower body towards the golf ball and raising his upper body during the downswing (early extension). The result will be a block, hook, or the dreaded shank.

Secondly, because his gluteal muscles were weak he couldn’t generate enough club head speed to hit the ball with any real distance.

Thirdly, his arms fell forward during the squat which told me he had poor thoracic mobility and shoulder range of motion. Because of this he would probably stand up out of his posture during his backswing (loss of posture/ flat shoulder plane). This would result in a inconsistent ball strike.

How Do We Fix All This?

To fix this golfer’s low back and his swing, we had to first fix his muscle imbalances.

The very first thing we did was create a corrective exercise routine that he did 3-5 days a week. He did this routine at home in the morning and it would take him 15-20 minutes.

This routine had very carefully selected movements that inhibited and lengthened his overactive muscles (see list) while activating his underactive muscles.

After two weeks he started doing integrated movements that focused on stabilizing his low back further while improving his coordination and movement patterns. At three weeks he was almost pain free and we were working on perfecting his swing.

To fix the root causes of your low back pain you must identify and target the muscle imbalances in your body.

I’m a Kinesiologist, Golf Fitness Specialist, Corrective Exercise Specialist, and Nutritionist. As a member of the American College of Sports Medicine and National Academy of Sports Medicine I have been helping people with low back pain for 20 years, including many Olympic and professional athletes.

The focus of my career is helping golfers like you.

If you’d like to get help identifying the root causes of your low back pain, the first step is to book a Free 30-Minute “Low Back Pain Troubleshooting Session For Golfers” where I’ll take you through a step- by-step posture and movement assessment and discover which of the 5 root causes are keeping you stuck in pain.

This is the first step I take with all of my low back pain patients and it’s the most critical, because once we know which of the root causes we need to attack, you’ll have a plan to heal your low back.

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Hi, I'm Thomas...

I understand what it is like to live with low back pain because I have three bulging discs and osteoarthritis in my low back. I learned how to not only manage my low back pain, but eliminate it almost entirely and without prescription drugs. I can teach you how to do the same.

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