Kinesiology THURSDAY – The Right Big Toe, Left Low Back Pain and the Golf Swing (Why Did That Work?!)

“I have constant pain on the left side of my back,” she said, pointing to the area of the left quadratus lumborum. She was a woman in her late 60’s, an avid golfer and worked at a job that required sitting at a computer. “I play golf several times a week and I won’t stop,” she added.

Her evaluation revealed normal lumbar ROM in all planes, but the one thing that reproduced her left low back pain was a supine stretch of her right hip external rotators, like this:

This means a lack of right hip internal rotation due to muscular tightness was causing the rotational force to be transferred to her left lower back. This led me to a simple evaluation of her golf swing. Her left low back pain was reproduced during her backswing and I noticed her right foot rolled to the outside (supinated) at the top of this phase. I cued her to plant her big toe to the ground during her backswing and her low back pain was eliminated.

This weight shift to the right leg while maintaining pressure under the ball of her right foot became her home exercise. Two days later, she reported a significant reduction in her symptoms, including during sitting.

Why did that work?!

Subtalar joint eversion is the first movement in a chain reaction that ultimately loads the biggest muscle of your body, the gluteus maximus. And the safest and most powerful movers know how to load their butt muscles. If you rotate and don’t load your gluteus maximus, then small muscles in the biomechanical chain take a hit, in this case, the left quadratus lumborum. And the deep hip external rotators will become chronically tight, further limiting hip internal rotation.

During the right-handed golf backswing, the foot pressure remains on the right foot, including the big toe.

This causes the tibia to internally rotate, then the femur to internally rotate and that is what loads your butt. During the backswing, the left quadratus lumborum and erector spinae are also loaded as the trunk rotates to the right. Most of that force should go to the larger muscles of the right leg, but if the big toe comes up off the ground, it interrupts the biomechanical chain and the smaller muscles take the hit.

So the next time someone has low back pain while rotating, check to see if their big toe is planted on the ground. A solid big toe makes for a strong butt. Their low back will thank you.

Because nobody has time to be in pain.

Until next time…

Kind Regards,
MoveWell Academy
[email protected]

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