When to Shut it Down?

Tue Feb 18, 2014 by Dr. Peter Mackay

When to shut it down

The medical and coaching personnel working with professional golfers are often called upon to make judgments with respect to a player being fit to play or to continue to play in a specific event.  For the handicap golfer the decision is usually straightforward; millions of dollars are not involved and the decision should always be safety first. With a tour pro on the verge of a career day the answer may be more complex.

Let’s look at a tour pro that develops back pain within a round. It is very difficult to discern the difference between a simple muscle strain and a more severe structural injury in the heat of battle. Many significant injuries take hours and even days to become debilitating and it is important to be aware of the early signs of what could turn into a big problem. 

Rules of engagement

  1. For an amateur player if there is any difficulty at all in assuming the set-up position he is shut down; the reasoning being that the amount of stress in just setting up will be much less than that required in the dynamics of a full swing; remember, better to be safe and play when clear than to risk permanent injury.
  2. If the player can assume a comfortable set up position we then use the pelvic tilt test as our second level screen; failure in either direction warrants further assessment; provoking of any referred pain, into the legs for example, means automatic shut down!

Back to an injured golfer on the course; if I see a player unable to comfortably place the tee in the ground or pick up his ball from the cup, I am concerned. This could indicate a structural injury beyond a simple muscle strain. It should be noted that even the most dangerous back and neck problems often disguise as muscular pain because there is almost always a muscular component to the problem! When in doubt, be smart; rest, seek professional advice and recover to play another day!

Learn more at

Dr. Peter Mackay, Chiropractor, Downtown San Diego

Dr. Peter Mackay
As a board-certified chiropractor in the State of California, a Qualified Medical Evaluator, and founding member of the Titleist Performance Institute (TPI) Advisory Board, Dr. Peter Mackay has an extensive career in sports injuries, industrial medicine, and physical rehabilitation.


  • Stefan Näslund

    I had herniated discs as well, 3 years ago. I am getting better, slowly, and sometimes with setbacks. What has helped me above all is a chiropractor and core strengthening. I have been to ten different chiropractors and fysio therapists, my current chiropractor corrected my hip in a way no one else could, that was a turning point. If what you are doing does not help you in six months, then try someone else. The other important thing is strengthening the core and being able to control the body, it is not about being strong or having big muscles, stay out of the gym. I do pilates, which is really boring, but have a tremendous effect! Yoga with a proper instructor can be good to, or what in Sweden is called "sjukgymnastik". The most important factor is to find a instructor who knows what he/she is doing. My experience is that there is no help to get from doctors. Pain killers can make a difference though, because they can make cramping muscles relax. Especially when in pain after exercising. Resting makes things worse, you need to exercise as much as you can, but without creating more pain, go easy and do exercise that takes tension away. I want to stay away from surgery, because it can make things much worse. I sometimes get setbacks and loose faith, but looking back I am in much better shape now than 3 years ago.

  • Anonymous User


  • Anonymous User

    The last time out I had no warning signs of injury, and I can never tell until after I’m done golfing. I had a herniated disc that first occurred in 2011, and went through PT for a long time. Then I waited a year until golfing again. The next time out I herniated the same disc again and the disc above it (L4 & L5). I have had problems with sciatic nerve pain as a result of these injuries. So I waited until 2014 to try golfing again. The first time out everything was fine, but the next time my nerve pain came back. I also played baseball for 15 years. Is it possible that the swinging motion will never be achievable for my disc to withstand without injury? I’m 32 years old. The only thing that seems to help while injured is rest. PT makes it worse. The spinal doctors haven’t really been any help. Injections in my back have helped. The only other option is surgery. Can anyone HELP?

  • Anonymous User

    If you are the one being shut down, you May bot beliau so quick to do that. I cantik have knowledge of what I am and coexist peacefully. I understand now that it was the not knowing that was causing a lot of the "crazy behavior". I would like a chance to be heard and not just judged. Thanks. Amy (?)

  • John Stevens

    Guys, this was hugely helpful. I am recovering from back surgery and needed a good review of how to proceed. Thank- you - JWS

  • Anonymous User

    Some great "Rules of engagement" guys! It is always important to stop play and seek medical advice from a professional immediately if you are experiencing severe LBP. Thanks for sharing.

  • Anonymous User

    Thank you for the valuable information gentlemen. It is very important to have guidleines to follow and know when to make an educated decision involving any level of pain or injury when playing golf. This is a great test to do in helping to decide whether to continue to play or not when experiencing lower back pain. Golden Rule: If it hurts a lot - STOP! Seek help.

  • Anonymous User

    20 years ago I fell from a roof resulting in a twisted right pelvis and lower leg length. My back gradually got worse, I've had 75% of the cartilage removed from both knees and my lower 2 vertebrae keep popping out. My shoulders hunch in and up and I'm in constant pain very single day even after ££££ of chiropractic appointments. I play golf every Saturday to unwind and loosen up even when I'm really bad. I carry my bag as it helps to open up and stretch back my shoulders. This may sound dangerous and not recommended to some but to me it's the best theropy I can get. Come Monday morning I'm fully stretched and in less pain and able to carry on the full week at work as a builder.

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