Hip Pain From Golf: Lead Hip, Trail Hip and How to Keep Playing

Why is the golf swing hard on the hips?

The power in a golf swing comes from the ground up. Your hips turn away from the target on the backswing, then rotate forcefully toward the target on the downswing, while your weight shifts from the trail leg to the lead leg.

AAOS OrthoInfo notes that golf can cause injuries to the hip, spine and other joints, and that most golf injuries come from overuse, repeating the same motion again and again. Amateurs who play more than 3 or 4 rounds a week have a higher injury risk than those who play less.

Research on professional golfers describes how repeated hip rotation can bruise or detach the labrum, the ring of cartilage around the socket, especially in hips with femoroacetabular impingement (FAI).

Why does my lead hip hurt?

For a right-handed golfer, the lead hip is the left. Through impact and into the finish, that hip has to rotate inward while bearing most of your weight. This is the exact motion that pinches the front of the hip in people with FAI.

Lead hip pain from the joint often feels like a deep ache or sharp pinch in the groin or front of the hip, sometimes with clicking. It may be worse on full drives than on short irons and chips.

Arthritis can produce similar pain, along with morning stiffness and trouble putting on socks or shoes. Both FAI and arthritis reduce inward rotation, so the swing feels blocked.

Outside hip pain on the lead side is a different problem. It usually comes from the gluteal tendons, which work hard to stabilize the pelvis as you post up on that leg. This type of pain is often tender to the touch and worse lying on that side at night.

Why do the trail hip and lower back hurt?

When the lead hip cannot rotate fully, the body finds the motion somewhere else. The trail hip may be pushed to rotate more on the backswing, and the lower back often twists more than it should.

OrthoInfo reports that low back injuries are the most common complaint among golfers and links them to poor swing mechanics, rotational stress and limited flexibility and strength.

This is why a hip specialist should look at both hips and the spine together. Back pain can also travel into the buttock and hip, so the true source is not always where it hurts most.

Trail hip pain can also come from the same joint problems as the lead side. Some golfers have FAI or arthritis in both hips, with one simply louder than the other.

What swing and warm-up changes help?

OrthoInfo recommends always warming up before a round. A few minutes of brisk walking, gentle hip circles and progressive practice swings starting with short clubs prepare the hips for full rotation.

Small swing changes can unload a painful lead hip. A golf professional can help you find a version of your swing that feels better.

Between rounds, short daily mobility work keeps the hips ready. Gentle hip rotation drills done slowly and within comfort tend to help more than one long stretching session before the first tee.

• Turn the lead foot out slightly at address to ease inward rotation
• Allow a shorter backswing and a less forced finish
• Let the trail heel come up on the backswing
• Use a cart or push cart on days the hip is sore
• Limit range sessions with a large bucket of full drivers

Which exercises help, and which should I avoid?

Strong glutes and a stable core let the hips share the load of the swing. Bridges, side planks, step-ups and controlled rotation drills are common starting points. OrthoInfo also notes that yoga and Pilates can build trunk strength and flexibility for golfers.

If FAI or a labral tear is suspected, avoid forcing deep hip flexion combined with inward rotation, such as aggressive pigeon stretches or very deep squats. With outside hip pain, avoid long holds of crossed-leg stretches that compress the tendons.

A physical therapist can test your hip rotation on each side and build a plan that matches what your swing needs.

Can I play golf after hip arthroscopy or replacement?

Usually, yes. In a study of professional golfers who had arthroscopic hip surgery, mostly for FAI and labral problems, all returned to play at an average of 4.7 months.

For golfers with advanced arthritis, hip replacement is common and golf is generally encouraged afterward. A large survey of amateur golfers found that 94 percent of hip replacement patients maintained or increased how much golf they played, with handicaps rising only slightly on average. OrthoInfo lists golf among the lower-impact activities preferred after a new hip.

Your surgeon will guide when you can chip, putt and then make full swings, and recovery varies from person to person.

When should a golfer see a hip specialist?

See a specialist if hip pain lasts more than a couple of weeks despite rest, keeps returning after rounds, wakes you at night or causes a limp. Groin pain with clicking or catching also deserves a closer look.

Bring your swing questions, too. Knowing whether you play once a week or five times, walk or ride, and practice on mats or grass helps shape realistic advice. If you have had hip X-rays or an MRI, bring the images to your visit.

Our exams include hip rotation testing on both sides, a gait check, X-rays and a look at the lower back. The goal is a plan that keeps you on the course, starting with non-surgical care whenever it makes sense.

Questions patients ask