Podcast episode (~Evidence Based Chiropractor) by Dr. Jeff Langmaid reviewing a 2015 Journal of Physical Therapy Science paper titled "Impact of Post Manipulation Corrective Core Exercises on the Spinal Deformation and Lumbar Strength in Golfers." The host summarizes the study rationale (golf causes unilateral/postural distortions), key outcome measures (pelvic tilt, pelvic torsion, trunk length, lordotic angle), and reports substantial improvement in pelvic tilt over four weeks alongside twice-weekly Thompson drop adjustments combined with core exercises. The episode emphasizes clinical opportunities to treat golfers and use such research to engage community and grow practice.
Questions this video answers
Impact of Post Manipulation Corrective Core Exercises on the Spinal Deformation and Lumbar Strength in Golfers.
Journal of Physical Therapy Science, 2015.
Pelvic tilt, pelvic torsion, trunk length, and lordotic angle.
From about 5.5 mm pre-test to 1.0 mm at four weeks — a change of approximately 4.5 mm (reported as ~80% change).
Thompson drop technique adjustments twice a week during the four-week period.
Chapters
Foreign hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langme. This week we have a great piece of research that is sport specific. It focuses on chiropractic care and golf. So if you are somebody that is in the sports performance world, this is an episode for you. So the title of the paper that I am taking a look at is titled Impact of Post Manipulation Corrective Core exercises on the Spinal Deformation and Lumbar Strength in Golfers. This came out from the Journal of Physical Therapy Science just relatively recently 2015. So I'm gonna link that in the show notes and I'll also repeat that title. Impact of Post Manipulation Corrective Core Exercises on the Spinal Deformation Lumbar Strength in Golfers. So this research article highlights the effectiveness of core stability training after manipulation for golfers. We know golf, you know, there are tens of millions of people who enjoy golf each and every weekend there are probably tens of millions of more people that would like to play golf if their back or neck allowed them to. So this is very relevant for benefits with your patients, benefits for the people in your community. If you can show them that they can do more of what they love, I. E. Golf in this case, that's a huge win for your practice and that's something that's real world, stimulates people to pick up the phone and call your office. Additionally, if you find success with golfers, they're going to be talking to the people in their foursomes, they're going to be talking to the guys at the driving range. So it is a great opportunity to build your practice. And showcasing the research behind what you do is one huge way aside from just getting the results, you have to get that first person in showing the research can open some eyes probably with the golf clubs in your community. And when I say club, I mean, you know, not literally the club itself, but the membership area or the course and all of the people who belong. So the results of this study were measured as changes in pelvic tilt, pelvic torsion, trunk length and lordotic angle. Important characteristics. Right. Lordotic angle we looked at a few weeks ago regarding back pain prediction. Pelvic tilt back big issue. If their pelvic tilt is, you know, it's a drastically increased that places a lot of stress on the lower lumbar vertebra. All of these things go hand in hand. These measurements are key indicators of lumbar stabilization as well. Many popular sports such as baseball, golf and tennis as we know, tend to promote a distorted body posture. Through unilateral training, right? Everything's one sided. You throw left handed, throw left handed, bat in my case, right handed or right handed if you're the other way over. Training the musculoskeletal system without proper core stability can lead to an increased risk of injury. We see this time and time again. And this is where people, the conversations start around cross training and how do you go about that. And there's a lot of questions to be answered and I think there's a lot more to come on this. As papers like this dive deeper into these specific questions. We also know that chiropractic adjustments and spinal manipulation has been shown to facilitate healing by stimulating the central nervous system and decreasing intradiscal pressure and certainly the stretch response in muscle spindle. There's a variety of ways that we've explored on this podcast and you can find in the research showcasing how a spinal manipulation or how a chiropractic adjustment impacts our body and how the benefits essentially are transmitted. What are the mechanisms of action? So establishing proper segmental biomechanics through spinal manipulation will likely improve the outcome of corrective core exercises. And with that, let's take a look at a few quotes from this study specifically and what the researchers found. They found, quote, the causes of injuries experienced during golf include weakened muscles, lack of flexibility, excessive exercise, insufficient warmup, and an incorrect swing form. So when I look at that again, let's break that down a little bit. They're saying, hey, a lot of injuries causing golf are weakened muscles. Number one, number two, lack of flexibility. Number three, excessive exercise, insufficient warm up is number four. And incorrect swing form. Now, when I look at that list, here's the interesting thing. As a chiropractor and personally, not really as a golfer, I'm probably not a, a good one to talk about incorrect swing form or correct swing form. That's probably better left for the golf pro at their local club. But pretty much every single other one of those activities or causes of injury can be addressed with the information that you provide or I provide in the practice or the services we deliver. Include weakened muscles. Well, you can guide on, you know, strengthening muscles, right? That's something you do every single day. Lack of flexibility, showcasing how what are the best stretches for them? With their body habitus, with their form, you could do that all day long. Excessive exercise. So making them or letting them know that more is not always better. So showcasing balance, I think ultimately right, Balancing things out, insufficient warmup. This is just a killer, but it is something that we as chiropractors can absolutely coach the people in our practice and in our community on regarding the importance of proper warm up. So that is one of the things that this research paper focuses. I think it's so relevant to what we do because out of the five causes of injuries, four of them you can address in your practice. That is absolutely huge. The researchers also found athletes develop an asymmetrical body posture due to long term training of particular movements. This deformation makes maintenance of the normal curve of the spine difficult and causes reduced range of motion in weakened abdominal muscles as well as back pain. I mean, that pretty much tells it all right. There's no question that as we develop, develop unilateral movement patterns, as I'll call them, it creates body distortions and asymmetrical body postures. And anytime that there's a lack of balance in the human body that is outside of what I'd call or pulling away from homeostasis. So when there's a lack of balance, of course it goes to reason that there's going to be an increased likelihood of injury. Now what they touched on also in that is they touched on the fact that that deformation is, can really impact spinal curves. And I'm not the biggest spinal. I don't believe a spinal curve needs to be perfect for a person to function at a very, very high level. But Certainly I would 100% agree and stand behind the fact that alterations of the curve place undue stress upon the musculoskeletal neuromusculoskeletal system of a body. And if you are looking for performance, not just bare bones, being able to get around those incremental changes matter. So that's a great quote from this research paper. And finally, the researchers also found, quote. In golfers, core muscles are critical as they are closely related to spinal deformation. Core strengthening and spinal correction play a pivotal role in the correction of spinal deformation. So they're talking about segmental motion, right? Making sure that you can have good segmental range of motion is important for the overall regional movement and full spine movement. That makes complete sense. That's where we can make a huge impact, literally with our adjustments. They also talk about the core strengthening. So making sure that individuals have good core strength. I always think about it as the balance of strength and flexibility. You want to be flexible, you want to be supple. That's a great way to avoid injury. But you also want to make sure that there is strength where you're not pushing so hard to failure, where that's where injuries are going to happen. So this article I think is a great touchstone. We released this a couple years ago for members of the evidence based chiropractor to get out there to other healthcare providers in their community. Because you probably have also seen there's doctors in your town right now that are sport specific medical doctors or orthopedic guys or gals for that matter. So using papers like this to get out there and bridge the gap is sort of a different take on it because now you're focusing on a specific population of people in your community, in this case golfers. So what they found was pretty drastic changes in pelvic tilt. I'll give you know, some very, some broad based data here, but you can take a look at it again by hitting this paper in the show notes. They found pelvic tilt changed by 4.5 millimeters. So pre test it was about 5.5 week one of care went down to four, two weeks of care, 2.5, three weeks of care two, four weeks one. So that's a pretty substantial change. 80% change. If you want to break down starting at 5.5 ending at one point in terms of pelvic tilt, that's an 80% change over the course of four weeks. And during those four weeks they were getting adjusted Thompson drop technique twice a week just to put that in framework. And they're also of course doing some core stability and strengthening exercises. So hopefully that's some good information for you to be able to kind of take home and then get out there to the golfers in your community. Talk about it online, run a Facebook live video, hit me up. If you want papers just like this to get out to the other practicing docs in your community or healthcare providers, definitely let me know. Become a member at the evidence based chiropractor. This is what we do all of the time. But great information. Five causes of injuries with golfers, four of them. And if you're a golfer, maybe you can even help on swing form that fight that fifth criteria. But four of these you can definitively start addressing in your practice today. And that is powerful for benefits of people getting quality of life. People retire, they want to play golf. They're unable to because at that point their body's in failure mode because they haven't taken care of it for the last 40 years. We see it all day, every day in our practice. I know this is a great paper to get out there, showcase the benefits of what you do, help people enjoy their life at a higher level and certainly make sure that you are doing the best you can for the people in your community. So I hope you have a great week in practice and I will talk to you soon.
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