By Mike Touzeau
Green Valley News
October 2004

Golf is probably the most popular sport in Green Valley, mirroring its tremendous growth across the country in the last few years. It's estimated there are nearly 40 million golfers, and a fourth of those are 65 or older.

So, it's no wonder with Father Time and new equipment that can generate club head speeds around 100 miles an hour that senior golfers are experiencing an increase in shoulder injuries, according to Tucson orthopedic surgeon Bill Prickett, a golfer himself.

"Ninety percent of shoulder problems in golfers involve the lead shoulder," said Prickett, former U of A football standout in the early 90s, and now an M.D. who specializes in sports injuries and sees a lot of aging tennis players and golfers in his practice at Tucson Orthopedic Institute Northwest.

Rotator cuff
"Rotator cuff problems are the most common among senior golfers," he says, which is surprising given the fact that golfers generally don't have very much movement above their heads like tennis players and baseball players, who are often thought to be more susceptible.

"Tennis players often are more likely to come in with elbow problems," Prickett said.

The rotator cuff is a collective term, according to the Kerlan-Jobe Clinic, pioneers in sports medicine, which refers to a group of four muscles and their associated tendons that join together within the shoulder.

Prickett points to overuse from repetitive swings along with overcompensation among older golfers as major causes.
He claims overcompensation comes as a result of poor swing mechanics that are being corrected improperly, thus placing excess stresses on the shoulder girdle, which is why he recommends seniors make sure they see a pro to get the swing into proper alignment.

"Pros and elite amateurs may swing around 2000 times a week," Prickett said, "but they're consistently activating the same muscles with each swing."

Muscle control
"Recreational golfers tend to have inadequate muscle control and have difficulty duplicating swings, which leads to poor mechanics, to the point that repeated practice swinging can be harmful and may lead to premature injury."

The patient, he says, can help pinpoint the specific area of concern by paying attention to pain that might occur during one the five phases of the swing--the take away, backswing, downswing, acceleration, or the follow through.

Prickett, who once worked with the New York Giants, and is now team doctor for some of Tucson's high school teams, believes most joint problems for both golfers and tennis players can be prevented with a little self-evaluation.

"You need to find where your threshold of pain is and participate below that," he says, knowing full well that it sounds very simple, but that many senior athletes don't pay attention to it.

"The vast majority of problems will improve with nonoperative treatment and an initial period of rest," he said.

You can hit fewer balls at the range, practice putting, or play a par three course until the pain decreases, according to Prickett, while at the same time using ice and anti-inflammants and starting a regular program of daily flexibility and strengthening of the muscles around the joints, perhaps with a certified trainer or physical therapist.

"We always try to do everything possible to avoid surgery."

Warmups important
A lot of players go right to the first tee with no warm-up or preround stretching, which Prickett also cautions is asking for problems as we grow older.

If the pain, however, whether it's shoulder, knee, hip, or whatever, begins to interfere with daily activity, then it's time to come in, Prickett says.

If rotator cuff surgery is required, for example, 90 percent return to their sport, according to him, in an average of four to six months.

He finds that golfers can generally begin to chip and putt about six weeks after surgery, pitching in 10 to 12, then gradually short to mid irons, then their drivers.

He reports that often his patients develop smoother, more fluid swings and lower handicaps after surgery.

Dr. Prickett will put in something artificial in place of the cartilage, usually what he calls "resurfacing" with the shoulder, but materials are similar with knees or hips, too, usually a metal or plastic or both.

Prevention strategy
Tennis players should take the same simple advice with regard to prevention. If the pain signals a problem, then cut back for a while, treat the area, and try to make more effort to develop flexibility and strengthening routines to help avoid the kind of injury that can put you out of the game permanently.

Senior athletes can't do anything to change the fact that the joints lose cartilage. Some will suffer from arthritis. Some won't. But they can make the effort to practice wisely and learn the correct way to swing their favorite weapon.

And, if all the evidence points toward surgery, new technology and doctors like William Prickett are making it possible for older athletes to keep playing when their fathers were forced to quit.

mtouzeau@gvnews.com