NEW scientific research has shown that golfers who treat their sleep apnea, a major cause of snoring, can lower their handicap by as much as three strokes.

The US research has shown sleep disorder treatment has it greatest effect on older, better golfers.

Researchers were also somewhat surprised to discover golfers were much more likely to stick with sleep apnea treatment if they believed it could improve their golf, rather than just being given overall health benefit messages.

The study, entirely on the level, was presented this week at CHEST 2009, the 75th annual international scientific assembly of the American College of Chest Physicians (ACCP).

It found that golfers with obstructive sleep apnea (OSA) who received nasal positive airway pressure (NPAP) device treatment for their disorder improved their daytime sleepiness scores and lowered their golf handicaps.

“More so than many sports, golf has a strong intellectual component, with on-course strategizing, focus, and endurance being integral components to achieving good play,” said researcher Marc L. Benton.

“OSAS can lead to daytime sleepiness, fatigue, and cognitive impairment, all side effects which can negatively impact a person’s ability to golf to the best of one’s ability.”

“As any golfer knows, when your ability to think clearly or make good decisions is compromised, the likelihood of playing your best is greatly diminished,” said Dr. Benton. “Through treatment with NPAP, we can improve many cognitive metrics, such as attention span, memory, decision-making abilities, and frustration management, which may, in turn, positively affect a person’s golf game.”

Results of the study showed that the best golfers, (defined as those with US handicap indexes less than 12) had the biggest improvements in their game. Within this group, the average handicap dropped from 9.2 to 6.3.

“The biggest handicap improvements occurred in the lower handicap, often older golfers. This group typically would be expected to trend in the opposite direction due to age-related deterioration in strength and endurance,” another researcher said.

“The drop in handicap among the better golfers probably reflected that the major limiting factor was not golf skill but cognitive compromise that improved when the sleep apnea was treated.”

Dr. Benton estimated that there are 1 to 3 million regular golfers in the US (regular defined as 10 or more rounds per year) who have OSA, and most are undiagnosed or untreated.

However, even when proper treatment is offered, it is only effective if it is used regularly. In men, studies have reported compliance rates as low as 40 percent. Patients cite many reasons for noncompliance with NPAP, including discomfort, inconvenience, cost, noise, or embarrassment.

In the current study, nearly all patients in the treatment group had a compliance rate of above 90 percent.

In other words, the conference is being told, tell them it is good for their golf games and they’ll do it.

“In the case of this study, the possibility of improving one’s ability to play golf appears to have been a significant motivation to improve treatment compliance.” Dr Benton said.

The study apparently didn’t comment if the lack of rib and leg bruising caused by being elbowed and kicked by non compliant partners was also a factor in the better golfing scores.

By Trent Malcolm

HAVE you ever noticed how often golf coaches talk about the importance of good posture in a golf swing?

Good posture is also very important in reducing the likelihood of injury, particularly to your back and neck.

Unfortunately for many people, their general lifestyle and/or line of work lend themselves toward poor posture, with too many hours spent sitting down, either watching television, working on a computer or driving a car.

Whilst some postural deterioration is expected with age, there are a number of exercises and stretches that can help rectify poor posture, which will improve your body for golf (and life).

Increased curvature of your low and middle back and rounded shoulders are all common postures that may contribute negatively to your swing mechanics (and increase potential for injury) and if unaddressed, over time can become very difficult to improve.

1. Increased forward tilt of your pelvis

This increases the curve of your lower back placing added stress on your spine and surrounding tissues.  This added stress can create tightness and some restriction of pelvic movement, which is essential for good swing mechanics.

You can test this yourself by standing with your heels, buttocks, back and head against a wall.

Place your hand in the space between the wall and your lower back; you should be able to get your fingers and about half of your hand into the space. Any more than this and your pelvis is probably tilted too far forward.

[A side note…if you are carrying excess body fat around your stomach this will likely add to the stress on your lower back and compound the problem].

An effective strength exercise for this posture is shown in Figure 1.

Starting with your knees bent at 90 degrees and your thighs pointing skyward, pull your knees in toward your chest to lift your buttocks 5 to 10 cm off the ground (Figure 1). Pause for a second then slowly lower your legs back to the starting position.

Commonly, with this type of posture, golfers have tight hip flexors (muscles around the top of the thighs).  We need to stretch these out and Figure 2 demonstrates this effectively.  Use your buttocks to push your pelvis forward and try and straighten your trailing leg by pushing your heel back.  Maintain a tall upper body position and hold onto a chair for balance if you are a little shaky.  

Hold this stretch position for about 20 seconds.

2. Increased curvature of the middle back (kyphosis)

Increased rounding of the middle back places strain on the muscles and connective tissue around this area and can significantly limit your ability to rotate in the golf swing.

If you found it difficult to touch your head against the wall in the previous test, without lifting your chin up, there is a good chance you are too rounded through your thoracic spine.

Essentially we need to reverse this curve by stretching your spine in the opposite direction and increasing the strength of your back muscles surrounding this spinal segment.

To address this, lie on your stomach with your palms turned down.  Softly draw your stomach in and raise your chest off the mat, keeping your chin tucked in throughout the movement.

Roll your shoulders back and down at the end position (Figure 3).

Now lie on your stomach and slowly push off with your arms to bend your spine backwards.  Ensure your lower back muscles are relaxed, your chin is tucked in and your shoulders are down throughout the movement (Figure 4).

Caution: avoid over extending the lower back, as per Figure 4.

3.  Rounded shoulders

If you found it difficult to get your shoulders back against the wall in the previous test it is likely your shoulders are too rounded.

This goes hand in glove with increased curvature of the middle back (kyphosis), and is typified by tight chest and shoulder muscles and/or weak back muscles. 

Rounded shoulders can be linked to poor shoulder rotation and an arm-dominated swing. Figure 3 also demonstrates one way to increase the strength around your shoulder blades.

Stretching your chest and shoulders will also help. 

In the position shown in Figure 5, ensure your hand is well behind your body and feel as though you are rotating your shoulders away from your hand i.e. your left hand is in a doorway, and your shoulders are turning to the right to increase the stretch.

Despite your age and level of postural deterioration, a commitment to the stretches and exercises just outlined could be enough to improve your swing mechanics (and your health and well being).  This is the “THE POWER OF POSTURE!”

Trent Malcolm is an Accredited Exercise Physiologist, specialising in golf-specific strength and conditioning.

Visit Active One Golf for more information on the importance of golf-specific exercise 

Before commencing any conditioning program it is recommended you consult a Medical or Allied Health Professional

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Are Your Fit For Golf? - By Trent Malcolm

Dehydration can be a major issue for Australian golfers in summer. Blow out scores on the back nine can be just one of the very much unwanted symptoms of failing to keep up adequate fluid intake.

This article will give you information and simple tips on avoiding a drop in fluid levels that can seriously affect your concentration and performance.

Merely waiting to drink till you feel thirsty is not the answer. By the time you are feeling thirsty on the course you are already experiencing the first symptoms of dehydration.

Some early symptoms are:

• General fatigue
• Headache
• Muscle ache and fatigue
• Light headedness
• Heat intolerance
  
  

Sally Girvan, a Dietician associated with the Melbourne Golf Injury Clinic, says our bodies are made up of 60 percent water and when this level decreases even by a small amount it can greatly effect our bodily functions.

Girvan says dehydration of only one to two percent can effect your concentration, decision-making skills and impair your performance by as much as five percent and this can make a huge difference to your scorecard.

When you exercise your muscles generate heat that must be dissipated. We sweat to cool our bodies down by evaporation. If this fluid is not replaced dehydration occurs and if this continues heat stroke  is the ultimate outcome.

F1uid requirements are increased if you are physical1y fit, if the playing conditions are hot, humid and windy, and if you are nervous. They all make you sweat more. People, exercising in the same conditions, sweat at different rates. On average people lose 500 to 1000ml of sweat per hour. This fluid needs to be replaced if you want to play to the best of your ability.

Girvan provides the following advice:

Are you getting enough fluids?

Your intake of fluids is adequate when you are playing if:

• You do not feel thirsty
• You weigh the same before and after the game (see below)
• Your urine remains a pale straw colour during and after the game
• Try to estimate your fluid requirements under
  different weather conditions during training.

How to estimate your fluid loss:

• Weigh yourself before and after you play
• Weigh yourself in minimal clothing
• Towel yourself dry
• Any weight change is due to loss a of fluid, not fat
• For every kilogram of weight lost a deficit of one litre of fluid has occurred
  (i.e. a litre more of fluid has been lost via sweat than replaced by fluids consumed)
• 1kg = 1 litre of fluid
• To replace one litre of fluid you need to drink 1.5 litres of fluid

Drinks, how much?

• Establish and maintain a habit that best suits you.
• Estimate during training your fluid requirements and a regime for drinking that supplies these requirements.
• Ensure you are well hydrated before you exercise.
• Make sure you drink plenty of fluids the day before, and that you have re-hydrated after exercise.
• Have a drink 10-15 minutes before you start exercising of about 250mls
• The stomach empties 1000 m1s per hour so this is probably the maximum you can drink and still feel comfortable. Try to train yourself to drink between 150 to 250mls every 15 to 20 minutes.
• What suits others may not suit you, some golfers drink a small amount at the end of every hole or second hole while others feel more comfortable with a larger volume every 3rd or 4th.
• Concentrate on hydrating adequately in the two hours post exercise. For every kilogram you have lost in weight you need 1.5litres to correct the fluid balance.

What you should drink?

• WATER is fine, and is usually freely available. If water is your main fluid you will need to consume some solids to provide you with energy.
• SRORTS DRINKS are good because they also provide you with a good source of carbohydrates for energy; it should contain between 4 to 8 Gms of carbohydrate per l00mIs of fluid to maximise the rate of absorption from the stomach.
• FRUIT JU1CE, SOFT DRINKS AND CORDIAL are too high in sugar for the fluid to be readily absorbed. They need to be diluted 50/50 with water or alternate drinks with water

DON’T RELY on adequate drinks being provided;
always take your own drink bottle!

• HALF FILL your bottle with your preferred drink and freeze. When required top up the rest of the bottle. This will keep your drink cool all day.
• AVOID Tea, coffee, Cola Soft Drinks and Alcohol before during and immediately after a game, because they act as Diuretics i.e. they make you urinate more frequently.
• ALCOHOL should be avoided also because it impairs your concentration, co-ordination and reflexes Alcohol interferes with hydration and recovery.

Melbourne Golf Injury Clinic

Loss of flexibility, strength and conditioning can be a real problem for older golfers. Here, Trent Malcolm, an Accredited Exercise Physiologist, provides a tailored improvement program especially for older golfers.

Could your body be limiting your golfing potential?

By Trent Malcolm

Are you trying to change your golf swing and finding it difficult to get into the positions your coach is asking for?  If this is the case then maybe your physical make up is slowing your progress.  Perhaps you are too stiff around your back or shoulders, maybe the co-ordination/timing of your body movements is a little off or maybe you are swaying and sliding in your swing?  A conditioning program specific to your body and your swing priorities can fast track your golf improvement and reduce the likelihood of injury.

Figure 1

 
In a standing position with your arms across your chest, rotate your shoulders around as far as you can without moving your head laterally (Figure 2).  Pause for a second and rotate to the opposite side.  Gradually increase the range of this dynamic stretch as you complete 20 repetitions.

Figure 2

Does the timing and co-ordination of your swing feel a little out?

Bishop also says “A physical issue or poor swing concept can produce timing and sequence problems in the swing. The upper body has furthest to rotate in the back swing so should lead the motion followed by the lower half. This is reversed in the downswing. Think of any throwing or hitting motion you have ever performed and you will better understand the correct sequence.”

The following movements work on increasing rotation into both left and right hips and are designed to give you the feeling of improved hip release (for better sequencing) from the top of the back swing.

In figures 3 and 4, imagine your pelvis and spine make up a steering wheel and the column it is attached to.  Turn the steering wheel (your pelvis) to the left and the right in isolation (no lateral movement) to improve the co-ordination and range of motion of your pelvis.  

The next exercise (Figure 5) is a lot more advanced, and the previous steering wheel analogy can also be used here.  In the position shown, turn the steering wheel (your pelvis) to the right, pause for 5 seconds then turn to the left.  Your upper body is working hard to stabilise your shoulders and the muscles through your trunk to your pelvis are creating this rotational movement.

Both these exercise are designed to help you dissociate your upper and lower body, important in good swing mechanics.

Does your body move too far laterally throughout your swing?

Lower body strength is imperative in golf.  Bishop says “The lower body is the foundation of the golf swing.  If you lack strength in your lower body you will not be able to provide the stability and balance necessary for your upper body to rotate, which can lead to unwanted lateral movement and inconsistent ball striking”.

Stand with a broomstick across your shoulders, your feet wider than shoulder width apart and your toes turned out 45 degrees.  Squat down and rotate your shoulders, ensuring your back is flat and head focused forward (Figure 6).  Alternate your shoulder turn after each repetition.  In this position your inner thighs (the adductors) are targeted, to help stabilise your lower body throughout the swing and the turn of the shoulders will also help improve the range of your back swing.

 
In the next exercise, lie on your back with your heels up on the ball and raise your buttocks off the ground to form a straight line from your ankles to shoulders (starting position).  Now raise your right leg (about 20 cm) and rotate your pelvis to take your leg over to the opposite side (Figure 7).  Hold this position for 5 to 10 seconds and return to the starting position; alternate legs.  This more advanced exercise will increase the strength of important muscles around the outside of your hip (like gluteus medius) that resist lateral movement in your swing.

There are two important questions you need to ask yourself: what am I trying to improve in my golf swing, and could this be related to my body’s physical limitations?  To maximise your golfing potential, a golf-specific exercise physiologist will design an exercise program which integrates information from your coach and golf-specific physiotherapist.  If most tour players are doing it to enhance their performance and reduce the likelihood of injury, why shouldn’t you?

Trent Malcolm is an Accredited Exercise Physiologist specialising in golf-specific strength and conditioning.  He consults to the Australian Institute of Sport Golf Program, Women’s Golf Victoria, the Melbourne Golf Injury Clinic and the Sandhurst Club (in association with the PGA of Australia), working with some of Australia’s finest young talent as well as numerous international touring professionals.  He is a regular contributor to Golf Australia magazine and designs golf-specific exercise programs for people online.

For your own personally designed golf-specific exercise regime you can contact Trent via email at tmalcolm@optusnet.com.au or call him on (03) 8707 0830. Visit his new website Active One Golf

Note: Before commencing any conditioning program it is recommended you consult a Medical or Allied Health Professional

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The Power of Posture!

 By Ramsay McMaster Golf Physiotherapist

1. RUSHING TO THE GOLF COURSE

Common technical breakdowns caused:

• Disruption of golf rhythm
• High anxiety levels, in turn leading to tension
• Poor control of breathing

Common injuries possible:

• Wrist - to tendons, cartilage or bones
• Neck - to joints, discs, ligaments or muscles
• Low back - muscle strains, disc injuries, joint problems

2. DRAGGING GOLF BAG AND CLUBS

Common technical breakdowns caused:

• Poor alignment in address position
• Poor posture at setup
• Excessive strain through particular muscles e.g. wrist & neck
• Increased gripping

Common injuries possible:

• Neck - to joints, discs, ligaments or muscles
• Low back - muscle strains, disc injuries, joint problems
• Shoulder & rotator cuff - muscle strains, tendon injury/tears

3. BOUNCING IN FORWARD FLEXION

Common technical breakdowns caused:

• Bad flexion postures
• Reduced activity of flexor muscles
• Stiffens back, leading to poor sequencing of golf swing

Common injuries possible:

• Low back - muscle strains, disc injuries, joint problems
• Hamstring strainsww.golfmed.net

4. POOR ROTATION SEQUENCING

Common technical breakdowns caused:

• Compensatory sway in swing
• Poor weight transference
• Poor balance
• Poor shoulder position on backswing and follow through

Common injuries possible:

• Low back - muscle strains, disc injuries, joint problems
• Neck - to joints, discs, ligaments or muscles

5. WARMING UP WITH MULTIPLE CLUBS

Common technical breakdowns caused:

• Compensation movements in arms
• Altered proprioception
• Altered weight control
• Overswinging
• Reversed C positions & reversed pivot

Common injuries possible:

• Low back - muscle strains, disc injuries, joint problems
• Left hip strains
• Shoulder & rotator cuff - muscle strains, tendon injury/tears

6. HITTING WOODS TO START WARM UP

Common technical breakdowns caused:

• Alters feel due to practicing power before feel
• Over swinging
• Incorrect sequencing
• Use of incorrect muscles

Common injuries possible:

• Low back - muscle strains, disc injuries, joint problems
• Shoulder & rotator cuff - muscle strains, tendon injury/tears

7. HITTING BALLS INTO NETS OFF HARD SURFACES

Common technical breakdowns caused:

• Jarring of body
• Altered co-ordination

Common injuries possible:

• Neck - to joints, discs, ligaments or muscles
• Shoulder & rotator cuff - muscle strains, tendon injury/tears
• Low back - muscle strains, disc injuries, joint problems

Ramsay McMaster is an industry leading golf specific physiotherapist who has worked with thousands of average golfers, with leading tour pros and coaches, with major golf organisations in Australia and around the world and is the founder of the Melbourne Golf Injury Clinic.

For further information, individual assessment or advice on programs email Ramsay at golfphysio@golfmed.net or visit golfmed.net

Ramsay McMaster and the Melbourne Golf Injury Clinic: Related Articles

Ramsay McMaster Golf Fitness

Your 5 Minute Golf Warm-up

By Ramsay McMaster Golf Physiotherapist

Sequencing Your Golf Warm Up to build up the correct `feel’ in your golf swing

1. The golf exercise drills will gradually build up the correct “feel” for golf performed in the correct sequence.

2. Maintain good breathing and tempo control throughout each golf exercise drill.

3. Maintain good upright posture throughout each exercise drill.

4. Use pistol grip on both hands with each exercise drill.

5. Repeat each exercise for between15-30 seconds 2-3 times depending on time and ability to maintain form.

• Stop if you experience sharp pain, dizziness or have an acute condition. Always consult your health professional.

### Ramsay explains all the moves in the new video attached below ### 

1.BUILDING UP YOUR `GOLF FEEL’ 

Using the Flexibility & Mobility Warm-up Drill

Combined Hip Trunk & Shoulder Stretch 

Get into the lunge position, feel stretch at right hip. Maintain an upright posture and tuck in your lower abdomen. Hold golf club above head with pistol grip. Bend trunk to left side, keeping head aligned on shoulders 

2. BUILDING UP YOUR `GOLF FEEL’

Using the Balance & Static Posture Warm-up drill

Standing upright in the `angel wings position’ against the wall, place a golf ball between the balls of your feet. Keep your nose and belly button in line with the ball. Tuck in your chin and look at the bottom of your lower eyelids. Keeping your arms by your side and forming a pistol grip in both hands, slowly lift the ball

up with your feet. Feel yourself getting taller as you pump up.

3. BUILDING UP YOUR `GOLF FEEL’

Using the Core Stability Golf Drill

Push

Slowly extend your arms and thrust the body in a slow pushing movement against an imaginary truck. Feel your shoulders, neck, abdominals, gluteals and legs all work together as if you are simulating an hydraulic pump.

4. BUILDING UP YOUR `GOLF FEEL’

Using Core Stability & Rotation

X-Factor Check

Keep yourself in an upright and stable posture. Place your elbows in by the side of our ribcage. Slowly rotate your trunk to the right maintaining your hips in a stable position to the front. Keep your elbows into your ribcage, feel the tension between your inside thigh and lower abdominals.

5. BUILDING UP YOUR `GOLF FEEL’

Using Core Stability, Rotation & Dynamic Posture

The Cross Over Golf Exercise Drill

Stand in an upright position and maintaining good spinal posture at all times, cross your right elbow to the top of your left knee. Then cross your left elbow on to your right knee. The movements should be smooth and the speed of the exercise gradually increased.

Ramsay McMaster is an industry leading golf specific physiotherapist who has worked with thousands of average golfers, with leading tour pros and coaches, with major golf organisations in Australia and around the world and is the founder of the Melbourne Golf Injury Clinic.

For further information, individual assessment or advice on programs email Ramsay at golfphysio@golfmed.net or visit golfmed.net

Ramsay McMaster and the Melbourne Golf Injury Clinic: Related Articles

Ramsay McMaster Golf Fitness

The 7 Deadly Sins of Warming-up

Australian Senior Golfer is teaming with Ramsay McMaster, one of the world’s leading authorities on golf and the body to publish a series of articles on golf fitness, particularly relating to older golfers.

Ramsay is a groundbreaking golf specific physiotherapist and has worked with thousands of average golfers, with leading tour pros and coaches, with major golf organisations in Australia and elsewhere and is the founder of the Melbourne Golf Injury Clinic.

Ramsay’s vast experience working not just with professional players on all world tours but with more than 5000 average weekend players of all ages makes his insights on the game and on golf and the body invaluable.

Ramsay has some simple advice and exercises that can not only help prevent injury and prolong golfing longevity but can also improve overall mobility, stability and posture and give you a better basis for a consistent golf swing and of continued game improvement.

Just by effectively warming up, staying ‘warm’ throughout your round and warming down correctly afterwards you stand a good chance of preventing injury and playing better, more consistent golf. 

For those who do have injuries or chronic conditions affecting their golf, there are also pointers to effective treatments, programs and individual assessments.

Just by effectively warming up, staying ‘warm’ throughout your round and warming down correctly afterwards you stand a good chance of preventing injury and playing better, more consistent golf

Ramsay, an A Grade golfer himself, was the first therapist to realise the need to develop a practice specifically to service and treat golfers.

He established the Melbourne Golf Injury Clinic in 1992 and has continued to build a talented multi-disciplinary team dedicated to the treatment and wellbeing of golfers of all ages and abilities.

The clinic provides a range of services including physiotherapists specifically trained to work with golfers, golf specific myotherapists, remedial massage therapists, orthotists “working with golf orthotics”, 3D swing analysis, golf specific exercise programs, Fitball classes for golfers, “Get fit for golf” lectures for golf teams and clubs, and a number of others.

There are also new and unique programs including the “Train like a Tour Player” program and “GUR: Golfers Under Repair”.

For individual advice and assessment visit http://www.golfmed.net/ or email Ramsey at golfphysio@golfmed.net

Ramsay consults to a number of organisations including The Australian Institute of Sport Golf Unit,  the PGA of Australia and the PGA ‘s of Britain, US, Ireland and New Zealand amongst others. 

Golf Fitness Articles: Ramsay McMaster and the Melbourne Golf Injury Clinic.

Your 5 Minute Golf Warm-Up 

The 7 Deadly Sins of Warming-up