Understanding Rory's Injury

Most of you reading this have rolled your ankle at some point in your life. The ligament Rory McIlroy recently tore is the most commonly torn ligament in an ankle sprain. It connects the fibula (little bone on the outside of your leg) to the talus (a small bone in the top of your foot). This is why it is named the anterior talofibular ligament (ATFL). See photo below: 

                                             
                                                                 (credit: http://www.footdoc.ca/www.FootDoc.ca/Website%20Ankle%20Injuries%2025.htm)

When most people sprain their ankle it is an inversion sprain. This is when the sole of your foot rolls inward, and the top of your foot rolls outward. Rory happened to have a complete tear of the ligament we are talking about.

Let's talk golf with this injury. It is worse that Rory is right handed and he tore the ATFL in his left foot. We know Rory is a big hitter and that left ankle has to absorb a lot of stress every time he swings. Whenever he follows through and transitions his weight he is inverting the left ankle.

This is re-creating exactly how it was injured. Factor this in with a week of walking what isn't an easy course to walk. Considering it is unstable and painful for him to even bear weight, he would have to modify several things in order to be able to play golf soon.

He is taking the conservative approach and trying to take time for it to heal. This was the best chance he would have ever had to win another British Open and him not playing has a negative impact on the game of golf. Without physically seeing Rory, I can't make the call on what to do. 

I can tell you that with this type of injury we like to get our hands on it immediately and start working through the acute phase. It is very painful but effective. I would be shooting for him to play in The Open, but again every case is different and I'm not his treating doctor.  The reason I would shoot for him to play is because I know how athletes are and I know how important this one is to his legacy.

There are a few things he could do with his golf swing to be able to play next week.

Don't try to bomb it every time. This would help in putting as little stress as possible on the ankle.

Turn the left foot out a little more. Bio-mechanically this would help to minimize the amount of inversion of the left ankle required through impact and follow through. 

Take extra time to ensure stability of the feet and lower body before taking the club back.

Don't hold his finish. He would need to get out of the unstable position of inversion as quickly as possible. This would also get his body weight off of the ankle as quickly as possible.

These sound like big changes but remember we are talking about the No. 1 player in the world. If anyone can fight through a few changes, it's him.

Let's say Rory had been able to get the swelling and pain down enough to play. He would have been forced to have a significant amount of functional tape on the ankle and some serious bracing. It would probably balloon up each night and require continuous work.

This should make us all realize how special Tiger Woods' performance in 2008 was.  
                                                        

                                        (photo credit: http://www.nytimes.com/2008/06/19/sports/golf/19golf.html?_r=0)

Dr. Brian Mann, ART, BS, FDM, Nike NG360

Posture for Performance

It's no secret that golf is bad for your body. With all of the injuries occurring in golf today, that's pretty easy to see. No one has perfected the golf swing (feel free to argue for Ben Hogan), but we can definitely improve our setup. 

Not many people agree on the golf swing in general, but we can all agree it is bad for your spine. Players like Adam Scott with his textbook posture are able to remain relatively injury-free, and you should be able to as well.

Let's talk thoracic rotation for a bit. Not exactly the first body part you think of when you're thinking rotation. Dustin Johnson has the most thoracic mobility of all time which is why he's the longest hitter on tour. 

He doesn't stand as tall as Scott, but DJ still stands pretty tall at address. When we stand taller and try to maintain the God-given curves of our spine we are able to move bio-mechanically and fundamentally sound. 

When we keep the lordotic curve in our lumbar spine, fight gravity with our thoracic spine and keep our cervical spine's lordotic curvature, not only do we allow for more rotation, but we also get proper rotation throughout the entire spine. In short, the taller you stand the more thoracic rotation you have.

I'm obviously a huge fan of mobility in the right places. The area that everyone could all use some improvement with mobility on (not just golfers) is the oh-so-important thoracic spine (so I trust all of you are getting adjusted regularly and doing your mobility exercises).

We talked about fighting gravity earlier and I know most of you reading this are probably sitting which is putting a great deal of stress on your thoracic spine. Sitting also decreases your natural lordosis in your lumbar and cervical spine. 

If you're reading this while standing go ahead and raise your head up from that forward flexed position please. If you're reading this while laying on your back, just stop. If you are laying prone and reading this, good job practicing tummy time. 

Sitting is the new smoking. So if you have to sit at work, you would be wise to invest in a standing work station. If you are unable to get a standing work station, please get up and move around every 45 minutes to an hour. You are wrecking your spine by sitting too long and too often. 

Doing this all day Monday through Friday and then going to play golf all weekend is asking for pain and injury. This is why my junior golfers shouldn't sit on their iPads all day during free time. Movement is training. Be active.

Let's get back to golf in closing. When you're on the range, just keep your mental picture of Adam Scott's posture. The picture below should help in understading the curves of the spine (credit: http://www.drkarencann.com/2011/08/31/do-you-suffer-from-cervical-lordosis/). 

Below the picture is a checklist for next time you're on the range. 

1. Stand up straight before you begin to setup to the ball
2. Maintain lordosis of your lumbar spine
3. Have your thoracic spine and cervical spine as straight as you can
4. Stand as tall as possible with your knees flexed in an athletic position
5. Stretch to the ball while standing tall
6. Rotate your shoulders as far as possible on the way back (another Hogan reference)
7. Once you've reached the top of your swing, make sure your pelvis is initiating the downswing
8. As you fire your pelvis through make sure you're doing so aggressively (Hogan, again)
9. Allow your upper body to react to this motion naturally (your arms should feel like whips attached to your shoulders)
10. Finish with confidence

Use this checklist to gain distance, but most importantly use it to ensure a long and healthy career. Here is to hoping you are all capable of playing golf your entire life.

 Dr. Brian Mann, ART, FDM, Nike NG360