title: The Role of Decreased Hip IR as a Cause of Low Back Pain in a Golfer: a Case Report.
abstract: BACKGROUND
  Among golf injuries, low back pain (LBP) is the most common compliant for both professional and amateur golfers. Hip rotational range of motion (ROM) might be related to LBP in those who repeatedly place specific activity rotational demands on the hip in one direction. Coordination of timing of movement (neural control) between the hip and lumbopelvic region during trunk movements is critical for normal mechanics. Altered timing can contribute to areas of high tissue loading and can lead to LBP symptoms seen during active lower limb movement tests. Patient was a 42-year-old male recreational golfer who presented with low back pain and decreased hip internal rotation ROM.
  
  
  METHODS
  With the use of manual physical therapy to increase hip ROM and lumbar stabilization therapeutic exercises, the patient was able to return to pain-free golf and to better his handicap by three strokes.
  
  
  RESULTS
  Significant improvement was seen in his Oswestry outcome score, and a (-) prone instability test was noted.
  
  
  CONCLUSIONS
  It is recommended to address hip ROM limitations in those experiencing low back pain while golfing. Rapid spinal rotation may produce large spinal loads, but this is likely not the major contributor to low back pain in golfers. Mechanical factors may play a larger role.
authors.affiliation: Sports Rehabilitation and Performance Center, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021 USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Reinhardt
keywords: LBP; golfer; hip ROM; prone instability test; stabilization