A knee injury could be just one golf swing away

Does it surprise you to learn that a golf swing puts more force on the knee than jogging? Among all golf-related injuries, knee injuries are second only to back injuries.

“There's significant rotational stress put on the lead knee – so for a right-handed golfer, that would be the left knee – on the downswing,” said Andrew Markwith, MD, an orthopedic surgeon based at Total Orthopedic Care in Falmouth, located at the Falmouth Orthopedic Center. “That can put increased stress on the meniscus, and it can also cause exacerbation of arthritis symptoms.”

A 2017 study found that medial meniscus tears were the most commonly diagnosed knee injury for golfers, followed by joint pain due to osteoarthritis.

“Playing golf doesn't cause arthritis and it doesn't cause the arthritis to worsen, but it can cause your symptoms of the arthritis to worsen,” he said. “I try to reassure my patients that they aren't doing structural damage to the cartilage when they're playing golf. 

“Within reason, it's okay to play through some discomfort, but you don't want to get to the point of severe pain or having a setback.”

Remedies for knee pain related to arthritis include taking off a week, taking anti-inflammatory medications and physical therapy, he said.

If you hear a “pop or have swelling or ongoing pain, you should see your doctor,” he added.

Treatment for meniscus injuries range from rest to surgery, depending on the specific diagnosis, which typically requires an MRI. Often a cortisone shot, physical therapy or anti-inflammatory medications will minimize the pain from a meniscus tear and allow the patient to keep playing golf, Dr. Markwith said.

A confirmed meniscus tear may be treated with an arthroscopic surgical procedure called a partial meniscectomy, in which a portion of the meniscus is removed. Surgeons frequently recommend patients take a four-week break from golf after the surgery, he said.

“A lot of patients in the summer don't want to take off that long, so a good compromise is you can start practicing putting and chipping two weeks out from surgery,” he said. “I try to remind my patients that most of the scoring in golf comes from the short game, but it's frequently neglected.”

If the knee can tolerate that, surgery patients can get back on the driving range after about a month and then start to play, if they still feel good.

“I think a lot of it is being in tune with your knee, being on top of any worsening symptoms, and trying to figure out what you can and can't get away with and not overdoing it,” Dr. Markwith said.

Lowering the Risk

Stretching is a great way to cut the odds of a knee injury, he said. “Especially as we get older, tissue is not as pliable and is more prone to a knee strain.” With minor aches, it makes sense to use a cart or take more days off between rounds.

Walking, biking or swimming on non-golf days will increase your overall health and endurance.

“When you get tired, you can be prone to using worse mechanics with your golf swing,” he said. “If you can improve your endurance, that definitely can help.”

And no matter how long you’ve played or how low your golf handicap, lessons focused on improving the mechanics of your swing can help with injury prevention.

“I'm always in favor of taking lessons for whatever sport or activity it is, so I'm a big proponent of golf lessons,” said Dr. Markwith.