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Orthotics and Golf: Less Pain, More Game

All elite golfers exhibit good footwork. It is not at all controversial that the function of the foot in golf is different from almost any other activity. Weight is placed lightly on the balls of the feet, while being balanced between the leading and rear feet.

How important are feet to a good golf swing? Jack Nicklaus, widely regarded as the greatest professional golfer of all time, tells us:

“All timing, distance and direction comes out of the lower body with the feet leading the way.”

According to Jack, feet are integral to the golf swing. But how can we turn this insight into practical, actionable information to enhance golf performance?

First, it’s important to be proactive about looking after your feet. Stretching and self-massage using a foam roller or spiky ball should be used to address tightness in the plantar fascia, pretibial muscles and calf.

Next, you might consider the use of orthotics help with stability, injury prevention and support. As we’ll discuss below, there’s some compelling evidence that orthotics can lead to tangible improvements in golf performance. The use of orthotics, for example, was associated with a 3-5 mph increase in clubhead velocity among experienced golfers [2].

Specialized Footwear for Golf

A couple of decades ago, golf shoes were basic wing-tip oxfords with spikes. Advancements in golf shoe design have led to the development of specialized footwear based on golf biomechanics. Canonical research conducted by Williams and Cavanagh identified shear and vertical force as the most important elements influencing resistance to slippage, force generation and stability [3].

Although the aesthetics of golf shoes over recent years has changed, Paul Worsfold [4] makes the argument that the spike configuration and sole shape remains unchanged from golf shoes designed nearly a century ago. The asymmetrical use of the front and back foot during the swing has posed an irksome design problem for shoe manufacturers. Even worse, the hilly topography of golf courses exacerbates this front/back foot asymmetry.

Worsfold also makes the case that there is no current evidence to suggest that any particular golf shoe design enhances shot distance, accuracy or any other golf performance metric [4].

This view is controversial, but we believe practical considerations like comfort during strenuous use and support should be prioritized. You might be interested in the following commonsense suggestions about choosing the right golf shoes:

  • It’s best to shop late in the later afternoon when feet are slightly swollen
  • Don’t forget to try shoes with the thickest socks you might wear while golfing
  • Never buy shoes you wouldn’t be comfortable walking in for an extended period of time

Designing footwear has been particularly challenging because golf requires using the feet in extremely divergent ways.

On the one hand, shoes need to provide stability, support, and traction during the golf swing. The golf swing is technically intricate, involving specific patterns of weight shifting and a high degree of coordination. On the other hand, golf shoes must be suitable for ambulation around an 18 hole golf course. The challenge is meeting both of these demands in a singular shoe design.

The wrong golf shoes can cause foot injuries, e.g., neuromas or blisters. (A neuroma is a benign growth of nerve tissue that can cause pain, numbness, tingling or burning between the ball of the foot and the toes). Often in golf, subtle adjustments can result in a competitive edge that results in victory.

Orthotic Interventions

Orthotics can markedly improve footwork in golf. Orthotics not only support your efforts to cultivate excellent footwork, but also are an important preventive measure against ankle injury. If the foot is functioning abnormally due to biomechanical conditions like rolling in (pronation) or rolling out (supination), the use of orthotics will be particularly beneficial.

Reviewing the Biomedical Literature

McRitchie [1] conducted a three-month, randomized control trial to evaluate the effectiveness of orthotics for pain relief in 32 amateur golfers. The results of the trial indicated that golf orthoses significantly alleviate pain while improving foot posture by managing pronatory movements.

An earlier study by Stude [2] investigated the effects of orthotics on clubhead velocity in a cohort of experienced golfers. Specifically, clubhead velocity was measured using an electronic device during golf swings both before and after 9 holes of simulated golf. Next, the participants were retested using the same parameters after wearing custom-made, flexible orthotics daily for 6 weeks.

The results? Clubhead velocity increased by 3 to 5 mph (or 7%) after orthotic intervention. Note that a 5 mph improvement in clubhead velocity corresponds to an increase in golf ball travel distance of about 15 yards. The authors concluded that the use of custom-fit, flexible orthotics positively affected clubhead velocity in professional golfers, while concomitantly reducing fatigue and leading to more consistent golf performance.

Custom vs Prefabricated Orthotics For Golf

If you already wear orthoses for everyday activities, it makes economical sense to use them in your golf shoes. However, if you’re a professional golfer or play regularly, there are some compelling reasons to invest in a pair of specialized orthotics that are specifically designed with the biomechanics of golf in mind. An advantage of custom orthotics Is that they will help equalize the weight distribution on the lower extremities, decreasing the risk of injuries. Biomechanical imbalances in footwork can cause the torque generated during the golf swing to strain the musculoskeletal system.

Are custom foot orthoses more effective, both for golfing and managing foot pain? Foot orthoses are typically prescribed by podiatrists, and custom orthoses are substantially more expensive than prefabricated ones. In one study by Hawke [5], the authors identified 11 randomized controlled trials comparing custom orthoses to controls. An important limitation of these studies is that it was not possible for the study participants to be blinded to the various conditions.

However, Hawke [5] reported that there was evidence for the benefit of custom orthoses in painful hallux valgus, rheumatoid arthritis, and foot pain in the context of juvenile idiopathic arthritis. These results hint that custom orthoses may superior to prefabricated ones.

 

[1] McRitchie M, Curran M. A randomized control trial for evaluating over-the-counter golf orthoses in alleviating pain in amateur golfers. J Foot 2006
[2] Stude DE, Gullickson J. Effects of orthotic intervention and nine holes of simulated golf on club-head velocity in experienced golfers. J Manipulative Physiol Ther. 2000;23(3):168-74.
[3] Williams KR, Cavanagh PR. The mechanics of foot action during the golf swing and implications for shoe design. Med Sci Sports Exerc 15: 247–255, 1983.
[4] Paul R. Worsfold. Golf footwear: the past, the present and the future. Footwear Science. Vol. 3, Iss. 3, 2011.
[5] Hawke F, Burns J, Radford JA, du Toit V. Custom-made foot orthoses for the treatment of foot pain. Cochrane Database Syst Rev. 2008;(3):CD006801.[/vc_column_text][/vc_column][/vc_row]

SPORTS PODIATRY SERVICES
Sports injury assessment, diagnosis and treatment for the lower limb
Sports injury prevention and performance enhancement
Footwear advice for sports
Video Gait Analysis
Stretching and strengthening programmes
Orthotic therapy
Low-dye taping

Sports Podiatry is the assessment, diagnosis and treatment of foot, ankle and lower limb disorders for all levels of sports. A sports Podiatrist can evaluate, through gait analyses and specific testing any biomechanical discrepancies that has led to your injury or recurrent injuries or possibly improve function.

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