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Effects of Orthotic Intervention and Nine Holes of Simulated Golf On 168 Journal of Manipulative and Physiological Therapeutics Volume 23 • Number 3 • March/April 2000 0161-4754/2000/$12.00+00161-4754/2000/$12.00 + 0 76/1/105116 e©2000 JMPT Effects ofof OrthoticOrthotic Intervention andand NineNine HolesHoles ofof SimulatedSimulated GolfGolf on Club-HeadClub-Head Velocity in Experienced Golfers David E. stude,Stude,DC,a DC,a and Jeff Gullickson,DCb DCb ABSTRACT PHYSIO flexibleflexible orthotics for 6 weeks and before and af- Objective: This study was an initial investi- ter completing 9 holes of simulated golf. gation evaluating the effects of orthotic inter- Results: There was an approximate increase in vention on club-head velocity (CHV) among CHV of between 3 and 5 mph, or a relative in- a group of experienced golfers before and crease in CHV by up to 7%, after subjects had o after 9 holes of simulated golf. worn custom-made, weight-bearing, flexible flexible orthotics daily for 6 weeks. A 5-mph increase Setting: Northwestern College ofChiroprac-of Chiroprac- orthotics daily for 6 weeks. A 5-mph increase in CHV is equivalent to an approximate in- tic, Bloomington, Minnesota. O in CHV is equivalent to an approximate in- crease in golf ball travel distance of 1515 yards, a Participants: Twelve experienced golfers were Participants: Twelve experienced golfers were 1978 significantsignificant increase for the tour player for whom included in the study. included in the study. small increases in performance can reflectreflect large posi- Method: CHV was measured with a device used by tion changes on the roster board. In addition, the use of many Professional Golf Association and Ladies Professional these custom orthoses eliminated the effects of fatigue associated Golf Association teaching professionals before and after wear- with playing 9 holes of golf (relative to CHV) and therefore may ing orthotics and before and after completing 9 holes of simu- Improveimprove the likelihood forfor more consistent golf performance. lated golf. Subjects wore custom-made,flexible flexible orthotics daily Conclusion: The use of the custom-fit,custom-fit, flexible flexible orthotics in this for 6 weeks and then were retested with the same objective mea- study had a positive influence on CHV in experienced golfers. surement parameters. (J Manipulative Physiol Ther 2000;232000;23:168-74):168-74) Outcome Measure: CHV (swing speed in miles per hour) was Key Indexing Terms: Biomechanics; Orthotic Devices; Golf; measured in all subjects before and after wearing custom-fit,custom-fit, Sports INTRODUCTIONINTRODUCTION Wiren7Wiren7 identifiedidentified 5 factors that influenceinfluence golf ball flight:flight: The lower extremity and the spine represent a closed club head speed, club angle of approach,club face position, kinetic chain in the upright posture. Furthermore,the func- centerness of contact, and golf fundamentals (eg, stance,grip, tion of one region can influence the function of another swing position, and posture). The golf industry has made region. 1-3 The foot and ankle,as part of this kinetic chain, many innovations in golf club design to address these factors, have considerable potential for influencing the function of including but not limited to oversized club heads and larger the rest of the kinetic chain. Stude and Brink4Brink4 found that in "sweet“sweet spots"spots”to improve the point of contact. In addition, subjects who wore custom-made,flexible flexible orthotics, proprio- changes have been made in club shaft design and materials ception improved, and the effects of fatigue were reduced in (steel vs graphite shafts),which have influencedinfluenced changes in a population of experienced golfers. Evidence suggests that shaft flexibilityflexibility and torque. All these club changes have shoe selection affects balance performance,performance,55 indicating that caused some changes in golf performance,S'9performance,8,9 although aver- foot function can influenceinfluence whole-person activity. In golfers, age overall scores do not seem to have improved during this the pedal foundation, or sole,has a greater effect on lower time of technologic advances in equipment. extremity biomechanics and thus overall performance than Exercise programs have been designed and developed to the upper construction of the shoe.shoe.55 Subsequently, golf shoe improve golf swing and to reduce the likelihood for in- design modifications and the use of custom orthotics to juries.juries.10-12 It has been assumed that by strengthening the address individual differences have been recommended by muscles used during the golf swing, more power will be gen- Williams and Cavanagh.6 erated and club-head velocity (CHV) will subsequently in- crease. However,research has not been conducted to address this assumption. One premise in this study is that improved pedogenic aWoIfe-HarrisaWolfe-Harris Center for Clinical Studies,Northwestern College One premise in this study is that improved pedogenic of Chiropractic, Bloomington, Minn. function improves balance, which may influence the func- bPrivatebPrivate practice of chiropractic, Edina,Minn. tion of the rest of the closed kinetic chain during the golf Submit reprint requests to: David E. Stude,DC, Wolfe-Harris swing and subsequently increase CHV. Center for Clinical Studies, Northwestern College of Chiropractic, Evidence supports a relation between changes in physical 2501 W 84th St, Bloomington, MN 55431; [email protected]. 2501 W 84th St, Bloomington, MN 55431; [email protected]. status/ability and subsequent performance potential on the Paper submitted April 7, 1999. status/ability and subsequent performance potential on the doi:10.1067/mmt.2000.105116 golf course. Adlington13Adlington13 observed that a stable base of sup- Searchable PDF created by OCR.space (Free Version) Journal of Manipulative and Physiological Therapeutics 169169 Volume 23 • Number 3 • March/April 2000 Orthotic Intervention in Golf •• studeStude and Gullickson 90 Subject Subject Recruitment 85 Project 80 Orthotics Fit & Flow Final Data Baseline Data 70 Collection Chart Collection 75.3 82.69 1.31 .38 3.78 1.00 73.85 65 Nine Holes Nine Holes Testing Status * Simulated Golf Simulated Golf Fig 2. CHV values measured during all stages of testing. Super- scripted abbreviations reflect a recorded value based on the indi- cated number swing attempt only; unsuperscripted abbreviations Data Orthotics Provided reflect a recorded value based on the overall average CHV after Collection to Subjects Collection completing 3 trials. N, Before wearing orthotics; I, before complet- 'Itie Chronological steps summarizing the ing 9 holes of golf; J, after wearing orthotics for 6 weeks; P, after sequence of data collection eventas and the ing 9 holes of golf; J, after wearing orthotics for 6 weeks; P, after interventions for subjects in the study completing 9 holes of golf.golf. Fig 1.l. Project flow flow chart. port will allow a player to generate more acceleration during 5. History of stroke, heart attack,or angina the downswing,with a subsequent increase in CHV and 6.A handicap (subjectively reported) ≤10O greater flight distance. He has also noted that many players Of the 1212 subjects (11(I I men and 1I woman) tested on the with poor balance have less consistency in properly contact- first day, 9 returned for data collection 2 months later. One ing the ball, thus negatively affecting flightflight distance. subject did not return because of a golf tournament, one McTeigue et alall144showed that the majority of tour players because of an acute fracture, and the last because of a job initiate the downswing with hip rotation. In addition, conflict.conflict. RobinsonRobinson1515 found that the angular velocity of the hips posi- tively influences CHV. Therefore the main purpose of this Informed ConsentConsent study was to investigate if improved function of the pedal All subjects were required to sign a consent form before foundation and subsequent improvements in balance and the participating in data collection. Subjects were informed that rest of the closed kinetic chain promote greater efficiency the study would examine the biomechanics of golf perfor- during the golf swing (eg, lower extremity and pelvic func- mance. This study was approved by the Human Subjects tion) and in this way influenceinfluence subsequent CHV. Committee on the campus of NWCC. METHODSANDMATERIALS METHODS AND MATERIALS Instrumentation Subject Recruitment: Demographics andand AttritionAttrition Subjects were tested with a Bel-Tronics Swing Mate (Bel- Potential subjects were recruited for the study by adver- Tronics, Inc,Mississauga, Ontario), an electronic device that tising at an annual golf exposition held at the Metrodome in measures the speed of the club head as the golfer swings, the Minneapolis-St. Paul area, by word of mouth through which offers several options for the golfer, such as club se- students at Northwestern College of Chiropractic (NWCC), lection, distance,club head speed, and average speed for up and on the “Dr"Dr Golf'Golf” radio talk show on AM 15001500 in the to 10 swings. This device has an operating frequency of community. Only experienced golfers with a reported handi- 10.52510.525 GHz (X band) with a nominal measurement range cap ≤SIO10 were allowed to participate. Some of these golfers from 40 to 135 mph and is used by numerous Professional were teaching or touring professionals. This subject popula- Golf Association and Ladies Professional Golf Association tion was chosen to reduce the learning curve that is associat- teaching professionals. ed with golf performance—experienced golfers tend to have a more consistent golf swing. A standard telephone inter- Testing Protocols view script was prepared. Interested subjects were excluded Before beginning 9 holes of simulated golf, each subject if any of the following criteria were identified:identified: was instructed to hit 10 golf balls as a warm-up. The partici- 1.I. Use of any form of custom-fit orthotic within the past 2 pants were also instructed to warm up by stretching. The years participants were then instructed to take 2 practice shots at 2.Allopathic health care within the 6 months before the the tee and then a final shot.
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