Golfer's Shoulder

Overview

Golfer's shoulder is shoulder pain that develops in golfers from the repeated rotational and reaching demands of the golf swing. While golf is lower impact than many sports, the swing puts both shoulders through a wide, forceful arc many times during practice and play, and the lead shoulder in particular crosses the body and can be pinched at the top of the backswing.

The most common causes are rotator cuff tendinitis and impingement, but the joint at the top of the shoulder (the AC joint) and underlying arthritis can also contribute, especially in older golfers. Most cases respond to rest, swing adjustments, and strengthening rather than surgery.

Golf is often taken up or continued later in life, so age-related joint changes frequently overlap with overuse. The lead shoulder, the left shoulder for a right-handed golfer, tends to take the most strain at the top of the backswing, where it is drawn across the body. Recognizing the source of pain and adjusting the swing and training load usually allows golfers to keep playing comfortably.

Symptoms

Golfers commonly notice:

• Shoulder pain during the backswing, top of swing, or follow-through
• Pain reaching overhead or across the body off the course
• Aching at night or when lying on the affected side
• Weakness or fatigue in the shoulder during a round
• A catching or pinching sensation when raising the arm
• Loss of swing power or range

Pain may appear at a specific point in the swing, which can give clues about the cause. Discomfort at the top of the backswing often points to impingement, while pain across the front of the shoulder may suggest tendon or joint involvement. Many golfers first notice the problem as a nagging ache after a round before it progresses to pain during play.

Causes

Golfer's shoulder usually results from repetitive stress and contributing factors:

• Repetitive swinging: Many swings during practice and play load the rotator cuff and pinch tendons.
• Swing technique flaws: An over-long or across-the-body backswing increases shoulder strain.
• Muscle imbalance and fatigue: Weak rotator cuff and shoulder-blade muscles allow impingement.
• Joint wear: Arthritis of the shoulder or AC joint contributes in older golfers.
• Inadequate warm-up and overplay: Cold muscles and sudden increases in play raise injury risk.

Risk Factors

• Frequent practice and play with many repeated swings
• Older age and existing joint wear
• Faulty swing mechanics
• Weak rotator cuff and shoulder-blade muscles
• Sudden increases in golfing volume
• Inadequate warm-up before play

Diagnosis

A clinician diagnoses golfer's shoulder from the golfing history and a physical examination that tests strength, motion, and impingement. Further studies may include:

• Swing and movement analysis: Identifying mechanics that overload the shoulder.
• X-rays: To look for arthritis or AC joint changes.
• Ultrasound or MRI: Used if a rotator cuff tear or labral injury is suspected.

Treatment

Most cases improve with conservative care:

• Relative rest: Reducing swings and practice volume to offload the shoulder.
• Physical therapy: Strengthening the rotator cuff and shoulder-blade muscles and improving flexibility.
• Technique changes: Adjusting the backswing and follow-through with a coach.
• Pain relief: Ice and anti-inflammatory medicine for flare-ups, and occasionally a corticosteroid injection.
• Gradual return: Slowly rebuilding play as pain settles.

Surgery is rarely needed and is reserved for a confirmed structural injury or advanced arthritis that does not respond to rehabilitation.

Returning to the course gradually is important. Rebuilding from short chips and putts to a full swing over a few weeks, while keeping up strengthening exercises, helps the shoulder adapt and reduces the chance of a flare-up. A lesson focused on a more efficient, shorter backswing can also take strain off the shoulder for the long term.

Prevention

• Warm up and stretch before playing
• Maintain rotator cuff and shoulder-blade strength
• Use sound swing mechanics
• Increase practice and play volume gradually
• Rest at the first sign of shoulder pain

When to See a Doctor

See a doctor or sports clinician if shoulder pain persists despite rest and swing adjustments, disturbs your sleep, or comes with arm weakness. Seek prompt care for sudden severe pain, a feeling that the shoulder slipped out of place, or numbness and tingling down the arm, which suggest an injury beyond simple overuse.

Related Topics

Frequently Asked Questions

References

1. American Academy of Orthopaedic Surgeons (OrthoInfo). Shoulder Impingement/Rotator Cuff Tendinitis.
2. Mayo Clinic. Rotator cuff injury — Symptoms and causes.
3. MedlinePlus, U.S. National Library of Medicine. Sports injuries.
4. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).