Over 45 million Americans participate in amateur golf. A full round of golf affords the opportunity for a close to 5 mile workout that can reduce stress and improve your cardiac health. Good foot action is the mark of an accomplished golfer and has been compared to intricate dance steps. Why is it then that a golfer's feet get no respect? Everyone talks about golf-induced pain, but foot injuries are hardly ever discussed. Most people just try to limp around the course, ride a cart or just throw their swing off and increase their stress when their feet hurt! Addressing your foot biomechanics can add yards to your game and make your golf outing much more enjoyable.

During the golf swing the body acts as a whip, power production starts with the feet pushing against the ground. The foot pivots and provides intrinsic lateral movement to enable the hip to fully rotate around a fixed leg position. Each foot moves differently during a golf swing, the back foot must allow for more pronation (rolling in to collapse the arch) during the follow through of the golf swing than the front foot.

The anatomy of a biomechanically sound swing goes like this: During set-up, your weight should be evenly distributed on both feet with slightly more weight on the forefoot as you lean over, and slightly more weight on the insides of both feet. Maintenance of proper foot alignment on the back swing is critical for control of the downswing and contact position. During the back swing, weight should be shifted to the back foot; it should be evenly distributed on the back foot or maintained slightly on the inside.

As the back foot remains in a solid position on the back swing without any rolling to the outside, the front foot is in turn rolling to the inside. The front heel occasionally comes off the ground to promote a full shoulder turn. Completion of the back swing places the weight on the back foot, evenly distributed between forefoot and rear foot, with the weight left on the front foot rolling to the inside.

The downswing involves a rapid shift of weight from back to front foot; momentum brings the heel of the front foot down, and follow-though naturally causes a rolling of the back foot to the inside and the front foot to the outside. Golf should always be played from the insides of the feet.

As you can imagine, healthy feet are critical to a successful golf game. Having biomechanically sound, stable feet will attain that goal!

What kinds of injuries are seen in golf that are caused directly or indirectly by foot function?

  • Lower Back Pain: This is the most common injury seen in golfers. Pain and stiffness in the back and neck are usually caused by the twisting motion of the golf swing as the shoulders rotate around the hips. This twisting of the torso in a coil fashion can put enormous pressure on the vertebrae, muscles and ligaments of the spine especially during the recovery phase. Indeed when one addresses the ball, the bent back puts the golfer in a most vulnerable position. A very common, yet insidious cause of lower back pain is over pronation in the feet. Even a slight postural misalignment caused by over pronation can lead to back pain.
  • Knee Problems: Inflammation or pain in the knees is caused by the twisting motion of the golf swing and sometimes by walking in ill fitting shoes. Rest, is again the best medicine. However, a re-evaluation of one's swing and foot orthotics to realign the knee can help prevent this condition from occurring.
  • Shin Splints: Pain in the muscles of the lower leg is usually caused by excessive walking after a period of inactivity. It can also be caused by over pronation in the feet, putting excessive pressure on the lower leg.
  • Heel/Arch Pain: Plantar fasciitis is very prevalent in all sports and commonly occurs due to excessive pronation in the feet. Golfers will often complain of pain when first rising in the morning and after periods of rest. Pain will be located in the center of the heel radiating along the arch.
  • Achilles Tendonitis: Inflammation of the Achilles tendon is caused by repetitive stress when pushing off or following through. Excessive stress on the tendon during your swing can really inflame this tendon.
  • Hallux Limitis: Jamming and deterioration of the big toe joint cartilage is caused by overextension during the follow through. This can eventually cause the joint to swell, stiffen and limit its motion. Hallux limitis can be so painful that it affects your walking and eventually hampers your swing.
  • Metatarsalgia: This term actually refers to any pain in the forefoot region. This can be caused by excessive twisting which causes painful blisters, calluses and sore joints.
  • Morton's Neuroma: Inflammation of the nerve in the ball of the foot in between the toes occurs from excessive twisting in your swing. This can be very painful for golfers who walk around the fairway and can often make their toes feel numb or have significant burning pain.

Custom Foot Orthotics and Golfing Injuries

Orthotics allow a golfer's body to establish a better point of contact with the ground when executing a golf swing. They will also stabilize your feet, evenly redistribute weight and correct your entire body posture during the golf swing. Researchers have shown that 71% of participants felt their balance was improved while using orthotics and playing golf. An impressive 50% felt that they were hitting the ball harder and 38% of participants reported a lower golf score while using orthotics. This research suggests that orthotics can help golfers improve balance, hit the ball harder and obtain a lower golf score. Why is everyone not taking this easy advantage to improve their swing?

Anyone who has a foot that is not able to function normally due to biomechanical conditions such as excessive pronation or supination can achieve a state of optimal biomechanics with custom foot orthotics from your podiatrist. Orthotics not only allow your feet to function better, but they also can prevent and treat a variety of painful injuries that can affect your concentration and ultimately your golfing handicap. Bringing painful knees, legs, feet or an aching lower back to the fairway can prevent you from playing to the best of your golfing potential.

And don't forget the shoes! Remember to make sure your golf shoes fit well before you leave the store. Shop in the afternoon when your feet are slightly swollen so the fit will be accurate. Wear the socks you play in to try on the new shoes. This also helps you get the right fit. Don't buy anything you wouldn't wear on a long walk, remember the close to 5 miles you will be walking on the course!

Bottom line: If you want to improve your swing, lower your handicap, and decrease your stress level while playing golf; address your foundation - your feet! Do not ignore foot pain; it affects your entire game!