miércoles, 21 de abril de 2021

Golf and Back pain. Hypopressives

 The improvement in golf swing speed and back pain reduction with the Hypopressive Method. Pilot study

Pallarés, C. 2021

 

César Pallarés, Bachelor of Sports Sciences. Hypopresssive Expert Trainer

Sandra Martín, professional golf player
















             



 

 

Introduction:

Golf is a sport in which lumbar injuries are common, so a specific training of the central area of ​​our body, the so-called core, will be decisive both for swing speed and to prevent back problems.

Core training, understood as the muscles of the abominal girdle and erectors of the spine, is used by many coaches to improve sports performance using different techniques, exercises and material.

The Hypopressive Method is defined as a systemic body posture technique that involves an activation of different skeletal muscle groups that are antagonists of the diaphragm from the postural point of view. (Caufriez, Fernández, Fanzel, Snoeck, 2006). It is also defined as a global method, since it uses the coordination of the diaphragm, the abdominal girdle and the pelvic floor muscles (Valacogne, 2012).

This article has been developed from the pilot study carried out with a professional golf player who was trained with the Hypopressive Method and obtained improvements in her sports performance.

 

Musculature involved in the golf swing:

During the execution of the golf swing the shoulder-hip structure can reach a rotation of more than 45 degree (Gluck, 2008). The amount of rotation is closely related to the speed of the ball (Myers, 2008).

The muscles involved during the swing are the abdominal muscles, the gluteus maximus to stabilize the hip, and the erector spine muscles to counter gravity (McHardy, 2005; Watkins, 1996).

Involved musculature in the swing:
 abdominal, gluteal and spinal erectorss


The importance of the core in sports performance:

The core is defined as the stabilizing muscles of the shoulders, trunk, and upper leg muscles (Lehman, 2006). An important function of this central musculature is to provide rigidity during the dynamics of the central joints and the spine (McGill, 1998), for this the trunk muscles must participate in a coordinated way (McGill, 2003), resulting in patterns of coactivation inadequate muscular tissues negatively affect the control of the mechanical stability of the spine (Granata, 2006).

The set of core muscles is the center of the functional kinetic chain and the origin of any movement (Akuthota y Nadler, 2004), and these would form a kind of closed box as follows:

- Through the abdominal muscles from the front.

- By the paraspinal and gluteal muscles in the back.

- By the diaphragm in the ceiling.

- By the muscles of the pelvic floor on the floor.

These structures, especially the lumbo-dorsal spine, that is, the lower and middle part of the back, and also the pelvis and hips, act together to stabilize the trunk during the sporting gesture of running, throwing or hitting, transferring forces from the central part of the body to the extremities. This transmission of forces, which allows to optimize performance in athletes during most of their actions, is generated both from the lower to the upper limbs, and vice versa (Kibler, 2006).

 

 
 In the golf swing, force is transmitted from
 the legs to the arms through the core.

Improving core stability will depend not only on strength development, but also on proprioceptive control, power, and endurance of the core muscles (Sharrok, 2011).  Some authors (Richardson, 1995; Jull, 2000) are more in favor of the development of the deeper muscles of the trunk such as the transverse abdomen and multifidus, and not so much the rectus abdominis for core stability training.

The importance of the abdominal and trunk muscles in sporting gestures is demonstrated by electromyographic studies, which show a reflex activity of this central musculature prior to the activation of the muscles that mobilize the extremities (Hodges, 1997).

 

Golf swing and back pain improvement training:

Simple workouts of abdominal exercises, abductors, adductors, hip flexors and spinal extensors have already shown improvements in golfers (Lephart, 2007), as well as swing-specific execution exercises (Lederman, 2010). However, it is advisable to reduce the specific swing exercises in the training programs, and to increase the isolated exercises of the core, in order to avoid the typical injuries of the golfer in the lumbar area due to the accumulated load (Lephart, 2007).

A study using traditional basic isometric abdominal exercises such as "the plank" among others, have obtained positive results in this hit, suggesting that the improvements could be associated with factors such as the reduction of contractions, strength and neural pathways (Weston, 2013).

Another study on two golfers with chronic back pain used corrective manipulation and core ball exercises aimed at correcting spinal deformation and lumbar strength, hip rotations, trunk flexion, sit-ups, and trunk extension. This study concludes that core strengthening and spinal correction play a fundamental role in correcting spinal deformation (Chul-ho, Minjeong & Gi Duck, 2015).

 

The Hypopressive Method

The etymological origin of the word comes from the French pressif - violent pressure, and from the Greek hypo - below, so its meaning is without pressure and its purpose is to eliminate or reduce pressure in the abdominal area and pelvic floor to avoid pathologies and improve health.

The Hypopressive Method was created by the Doctor of Motor Sciences Marcel Caufriez in the 80s, in order to improve the abdominal girdle and the pelvic floor, but he soon realized, through research, that it was a global gymnastics, since it was improving several parameters of our system: respiratory improvements, increased flexibility, stimulation of erythropoietin, increased red blood cells, rectification of vertebral curvatures and reduction of waist circumference, among others. That is why physical activity coaches and professionals have seen this technique as a very useful tool to improve sports performance or quality of life. It is also proposed as a way to prevent the harmful effects that physical exercise can sometimes cause, such as hernias, urinary incontinence and other pathologies related to the pelvic floor. There are already many professionals in physiotherapy specialized in uro-gynecology who present this method as an alternative to traditional abdominal exercise.

César Pallarés, Hypopressive Master Trainer

The Hypopressive Method and its benefits:

Some of the health-related benefits obtained through the Hypopressive Method have been confirmed by different published scientific studies:

- Increased pelvic floor tone and lower back pain, greater hamstring extensibility and a high degree of satisfaction and well-being (Soriano, 2013).

- Increase in extensibility of upper limbs (Rial, Negreira, Álvarez-Sáez, García-Soidán, 2013).

- Greater flexibility in the lower limbs and improvement of the flexibility of the lumbar spine and pelvic limbs (Galindo and Espinoza, 2009).

- Improvements in prolapses, vaginal hernias (Resende, Stüpp, Bernardes, Oliveira, Castro, Girão and Sartori, 2012).

- Increased isometric strength of the trunk extensor muscles and better mobility of the pelvis (Caufriez, 2006).

- Stabilization and improvement of the rotation of the vertebrae (Caufriez, Fernández, Brynhildsvoll, 2011)

- Reductions in the curvatures of the spine, 7% in the lumbar, and 8% in the cervical and dorsal (Caufriez et al., 2006). It emerged that these improvements in dorso-lumbar statics could have occurred for three reasons: an increase in the flexion capacity of the trunk (related to the extensibility of the hamstring, quadratus lumbar muscles and hip), an improvement in the self-elongation of the spine, and greater strength in the superficial paravertebral muscles.

- Increased thoracic amplitude (Rial, 2014).

- Reduction of urinary incontinence in women and of the waist circumference (Rial, 2014; Soriano, 2013).

 

Hypopressive exercises to improve the golf swing:

The present pilot study was carried out in a 24-year-old professional golf player that consisted of a training with 5 exercises of the original Hypopressive Fitness Method for 8 weeks, 2 weekly sessions of 25 minutes, with a total of 15 sessions.

 Hypopressive exercises are combined with the specific breathing technique, inhaling in 2 seconds and exhaling in 4, three complete breaths, followed by an apnea of ​​12 seconds and repeating this cycle. The following exercises have been used:

 

                                                                            1. Sitting


      


 

 


   2. Atlas




      3. Horse

                                                 

      


         4. Sitting Cross Leg

                                                                                                                     


 

     5. Lying Cross Leg

                                


 

Results

Swing speed test:

The golf club head speed test is considered an appropriate test to assess the golfer's swing performance (Weston, 2013)

Using a speed radar brand PureContact, model Zelocity expressed in miles per hour (mph), 5 tests were carried out.

                 
                                                                              

Test nº

Pretest

Postest

1

81 mph

87 mph

2

81 mph

89 mph

3

87 mph

84 mph

4

83 mph

97 mph

5

83 mph

93 mph

 



Graph 1: Golf swing speed test results expressed in mph (miles per hour)



 

Toe Touch flexibility test:

Using a millimeter ruler, and after performing a maximum forward flexion of the trunk and with both hands at the same height, the remaining distance to touch the ground is calculated.


Pretest

Postest

 10´5 cm to the floor

6 cm to the floor




Spirometry test:

Using the portable spirometer brand nSpire, model Piko-1, measurements of 3 insufflations were taken from the sitting position.

Test nº

Pretest

Postest

 

FEV1

PEF

FEV1

PEF

1

3,01

2,58

2,61

3,03

2

3,01

2,44

3,21

3,27

3

2,61

2,58

3,16

3,17

 FEV1: amount of air expired in one second, expressed in liters

 PEF: maximum speed with which this air leaves

 

Diaphragmatic tension test:

By means of a palpation test using the thumbs to sink them below the last rib, contact with the diaphragm is reached to determine the degree of tension while it is relaxed, evaluating from 0 to 3, where "0" is no tone and "3" represents the maximum voltage.

 

Pretest

Postest

Left dome

Right dome

Left dome

Right dome

2

3

1

2

 

 

Postural test:


Pretest

Postest



Analysis of the results

Golf swing speed test:

In the swing speed test, an improvement of 87 mph was obtained before training (prestest), to 97 mph after training (posttest), which represents a significant increase in hitting power of 11.50% (graph one).

                                      Speed radar                                     

 



 The values ​​obtained in the Tou Touch flexibility test show a significant improvement in rear end flexibility by 42.8%.

In the spirometry test, an improvement from 2.58 l/s to 3.27 l/s is obtained in the speed with which the air is expelled, which represents a significant increase of 26.7% in this capacity.

The diaphragm tension was reduced from an initial level 2, to a level 1 for the left dome, and from a tension level 3 to a level 2 for the right dome.

Postural analysis shows a general forward movement of the whole body that is reduced after training from 3.3º to 2.5º incline, thus approaching the vertical line that marks the ideal alignment. The area where it is best appreciated is in the shoulder area, where there is a displacement that ranges from 7.60 cm to 6.03 cm with respect to the vertical.

Detail of rectification in shoulder anteversion
 before and after training

Conclusions:

Analyzing the changes in the test results after training, significant improvements can be seen in several parameters, which may have caused an increase in the speed of the hit. The existence of a relationship between the abdominal and erector spinae muscles and the swing speed provided by Lephart (2007), supports the hypothesis that also relates them in this study. In our case, the change in the abdominal musculature is interpreted by the increase in the power of the air in the spirometer test, since the expiratory muscles are the rectus abdominis, the pyramidal of the abdomen, the transverse abdominis, the internal and external oblique of the abdomen, the levator ani and the internal intercostals. In the same way, the diaphragm, which has an important postural function, has reduced its tension, thus improving its effectiveness in contributing to the stability of the trunk.

The improvement of the flexibility of the posterior muscular chain shows a relaxation in this musculature, which could be alleviating contractures, as expressed verbally by the athlete. Thus, Weston (2013) suggests that the positive results in this beating could also be associated with the reduction of contractures.

A better aligned posture is a reflection of a healthier spine, which relieves the stress that causes a constant asymmetry on the ligaments, intervertebral discs, muscles and spinal nerves, also translated in the reduction of contractures and back pain and joints .

All these improvements together could be generating an adequate intermuscular coordination of the trunk muscles, which, as McGill (2003) points out, is necessary for a correct stability of the core during the dynamics of the central joints and the spine.

Finally, the subjective sensations expressed by the athlete were a reduction in stress during the competition, greater proprioception of the abdominal area, elimination of a contracture in the upper part of the back, which caused a kind of "tic" prior to the exercise. execution of the blows, and the disappearance of pain in the wrist joint.

As a conclusion, the hypothesis could be established that the Hypopressive Method could contribute by improving performance in other hitting and throwing sports such as tennis, shot put, volleyball or paddle tennis, both for the improvement of power and for the prevention of damage in the back caused by the accumulation of load in the workouts.

 

Important: this pilot study has been developed following the exercises of the original Hypopressive Fitness Method, so the author is not responsible for the results obtained by practicing other similar methods that try to emulate the authentic one. In the same way, it is recommended that the training of these exercises be tutored by a professional qualified in original method, since the exercises present a peculiar complexity.

 


 

       

 The author of this article, César Pallarés, is

Bachelor of Science in Physical Activity and Sports,

Diploma in Physical Education Teaching,

Instructor Trainer of the Hypopressive Method,

member of Dr. Caufriez's team, and personal trainer.

 Tel. +34 655 03 26 30. Mail: cesarpallares@hotmail.es

Instagram: cesar_pallares_g

Facebook: https://www.facebook.com/cesar.pallaresg



References:

  1. Caufriez, M., Fernández, J.C., Fanzel, R., Snoeck, T. (2006). Efectos de un programa de entrenamiento estructurado de Gimnasia Abdominal Hipopresiva sobre la estática vertebral cervical y dorsolumbar. Fisioterapia, 28(4), 205-16.
  2. Caufriez, M., Fernández, J.C., Brynhildsvoll, N. (2011).  Estudio preliminar sobre la acción de la gimnasia hipopresiva en el tratamiento de la escoliosis idiopáticaEnfermería Clínica, 21(6), 354-8.
  3. Chul-ho, S., Minjeong, K., y Gi Duck, P. (2015). Impact of post-manipulation corrective core exercises on the spinal deformation and lumbar strength in golfers: a case study. Journal of Physical Therapy Science, 27(9), 3027-3030.
  4. Galindo, G., Espinoza, A. (2009).  Programas de ejercicio en lumbalgia mecanopostural. Revista Mexicana de Medicina Física y Rehabilitación. 21, 11-19.
  5. Gluck, G., Bendo J., Spivak J. (2008). The lumbar spine and lower back pain in golf: A literature review of swing biomechanics and injury prevention. Spine J, 8(5), 778-88.
  6. Hodges, P., Richardson, C. (1997). Contraction of the abdominal muscles associated with movement of the lower limb. Phys Ther, 77(2), 132–42.
  7. Jull, G., Richardson, C. (2000). Motor control problems in patients with spinal pain: A new direction for therapeutic exercise. J Manipulative Physiol Ther, 23(2), 115–7.
  8. Kibler, W., Press, J., Sciascia, A. (2006). The role of core stability in athletic function. Sports Med, 36(3), 189–98.
  9. Lehman, G. (2006). Resistance training for performance and injury prevention in golf. J Can Chiropr Assoc, 50(1), 27-42.
  10. Lederman, E. (2010) The myth of core stability. J Bodyw Mov Ther, 14(1), 84-98.
  11. Lephart, S., Smoliga, J., Myers, J., Sell, T., Tsai, Y. (2007). An eight-week golf-specific exercise program improves physical characteristics swing mechanics and golf performance in recreational golfers. J Strength Cond Res, 21(3), 860-9.
  12. McGill, S. (1998). Low back exercises: Evidence for improving exercise regimens. Phys Ther, 78(7), 754-765.
  13. McGill, S., Grenier, S., Kavcic, N., Cholewicki, J. (2003). Coordination of muscle activity to assure stability of the lumbar spine. J Electromyogr Kinesiol, 13(4), 353–9.
  14. McHardy, A., Pollard, H. (2005). Muscle activity during the golf swing. B J Sports Med, 39(11), 799-804.
  15. Milagros, M. y Esteban, D. (2007). Mejoría de la estática vertebral con un programa de gimnasia abdominal hipopresiva. A propósito de un caso. Revista Fisioterapia UCAM, 6 (supl), 21-56.
  16. Myers, J., Lephart, S., Tsai, Y., Sell, T., Smoliga, J., Jolly, J. (2008). The Role of Upper Torso and Pelvis Rotation in Driving Performance During the Golf Swing. J Sports Sci, 26(2), 181-188.
  17. Resende, A., Stüpp, L., Bernardes, B., Oliveira, E., Castro, R., Girão, M., Sartori, M. (2012). Can hypopressive exercises provide additional benefits to pelvic floor muscle training in women with pelvic organ prolapse?. Neurourology and Urodynamics, 31(1), 121-5.
  18. Rial, T., Negreira, R., Álvarez-Sáez, M., García-Soidán, J. (2013). ¿Puede un programa de ejercicio hipopresivo influir en la extensibilidad isquiosural y movilidad lumbar de jugadoras de fútbol?. Revista de preparación física de fútbol, 8(3), 15-30.
  19. Rial, T. (2014). Efectos de la Gimnasia Hipopresiva en la Incontinencia Urinaria de la mujer AdultaTesis Doctoral Europea, Universidad de Vigo.
  20. Richardson, C., Jull, G. (1995). Muscle control-pain control. What exercises would you prescribe? Man Ther, 1(1), 2–10.
  21. Sharrock, C., Cropper, J., Mostad, J., Johnson,  M., Malone, T. (2011). A pilot study of core stability and athletic performance: Is there a relationship? IntJ Sports Phys Ther, 6(2), 63–74.
  22. Soriano, L. (2013). Efectos de un programa de ejercitación física basado en técnicas hipopresivas sobre diferentes parámetros antropométricos y fisiológicos relacionados con la salud de la mujer.  Tesis Doctoral Universidad Camilo José Cela.
  23. Valacogne, G. (2012). Rôle et efficacité de la rééducation périnéologique dans la prise en charge des prolapsus des organes pelviens. Réalités Gynécologie Obstétrique, 159(1), 1-6.
  24. Watkins, R., Uppal, G., Perry, J., Pink, M., Dinsay, J. (1996). Dynamic electromyographic analysis of trunk musculature in professional golfers. Am J Sports Med, 24(4), 535- 538.
  25. Weston, M., Coleman, N., Spears, I. (2013). The effect of isolated core training on selected measures of golf swing performance. Med Sci Sports Exerc, 45(12), 2292–7

Golf and Back pain. Hypopressives

  The improvement in golf swing speed and back pain reduction with the Hypopressive Method. Pilot study Pallarés, C. 2021   César Pallarés, ...