Associations between flexibility, stretching habits, and spine injuries in professional golfers: a nationwide, cross-sectional study.

Background: Although pre-training stretching and the inherent flexibility of an athlete are generally regarded as beneficial for injury prevention, limited evidence exists on the association between flexibility, stretching habits, and spine injuries in professional golfers. This study aimed to evaluate the association between flexibility and spinal injuries among professional golfers in South Korea.

Methods: A nationwide cross-sectional study was conducted to assess spine injuries among professional active golfers in South Korea. Data on cervical (C)-spine and thoracolumbar/lumbar (T/L)-spine injury experiences, pre-injury golf-related habits, and flexibility measures containing the floor touch test, shoulder reach test, and thumb-to-forearm test were collected. Post-injury modifications in stretching, warming-up, and swing motion were also assessed. Multivariate logistic regression analysis was used to analyze the risks of golf-related spinal injuries.

Results: Of the 439 participants, 33.7% reported the experience of spinal injuries, with 15.5% experiencing C-spine injuries and 21.9% reporting T/L-spine injuries. For the flexibility measures, the shoulder reach test showed significant differentiation between injured and non-injured golfers (P = 0.010), with a "fair" grade being associated with a lower risk of T/L-spine injuries (OR, 0.29; 95% CI, 0.14-0.62). However, the floor touch test did not show a significant distinction (P = 0.274). Among golfers with the experience of T/L-spine injury, performance was significantly associated with modifications in warming-up (P = 0.002) and swing motion (P = 0.033).

Conclusion: This study found that a fair grade of flexibility in the shoulder reach test was associated with a significantly lower risk of T/L-spine injuries. Additionally, modifications in warming-up and swing motion after T/L-spine injuries were significantly associated with the performance of professional golfers.