Author of this article: Drs. Horst Dekkers
September 2007 –golf has become a trendy sport. Today more than 370,000 golfers are active in Germany. The green sport is very popular especially among the elder sportsmen. Every second golfer is older than 50 years of age. But very often the greatest problem is not the own handicap but the aching back. According to the latest studies about 80 percent of all golfers are suffering from back pains. Drs. Horst Dekkers, head physician and managing director of the Alphaklinik at Munich – head of the spine disease department –knows the best methods of prevention and treatment.
Playing golf belongs to the healthiest ways of staying fit. Exercises in the fresh air strengthen resistance. Furthermore, in the course of a 18-holes round 330 calories are burnt in addition to the basic consumption. Moreover, playing golf fights the decrease of flexibility and coordination capability caused by old age – however, more and more players are experiencing a painful handicap: back pains.
Dr. Horst Dekkers explains: "The crucial point is the region of the third to the fifth lumbar vertebra." The world-renowned spine specialist was the first to perform some of the latest surgical treatments and has significantly influenced the development in his field. The typical motion of this sport in the three dimensional area of walking, bending and stroking is straining especially beginners, hobby players and golfers with an insufficient stroke technique. Wrong motion often exposes the spinal column to problematic strokes.
Another strain for intervertebral disc and spinal column is often the exposure for hours to physical stress itself. Frequently already existing back trouble is the real cause for medical problems when playing golf.
"We consider underdeveloped muscles along the spine a risk. Big, attractive muscle plates at the upper part of the body and at the buttocks don't guarantee a stable, strong spinal column. However, the important support for this kind of sport is rather given by often weak muscle groups in the lower part of the lumber spine. Eight out of ten persons require training of these parts.
The reason for this is: by insufficient physical exercises and one-side labour there is already a pre-existing damage of the spinal disc due to ischemia. On the golf course a disc with a tear in the outer ring is additionally stressed by the increased mechanical pressure. As a result the tear will grow, parts of the buffering disc will be pushed out of their position and they will press on the nerve tracts. This problem can show up in the neck region as well as in the more robust lumbar region. The person affected will notice already on the golf course a strangely dull feeling in the back. However, it can take hours or even days until this becomes a sharp pain, which radiates as far as into the buttocks or even into the legs. Modern examinations methods, as for example magnetic resonance tomography, often show the typical result: spinal disc herniation.
However, golfers don't like living without their beloved sport. Help can be provided by a new treatment by means of the a minimally-invasive endoscopy – performed in the Munich Alpha Clinic of Dr. Horst Dekkers. This special surgical treatment is convincing: the core of the problem at the spine measures only a few millimeters. The head of the department for diseases of the spinal column reaches this point by implementing sensitive technology. "With surgical mini instruments we operate under a mild anaesthesia through a small tube with a diameter of only a few millimeters." this is how Dr. Horst Dekkers explains the procedure of the operation "A mini endoscope transmits the operation to a screen."
There is no faster way back to the golf course. Different as with the open surgery of the back which is still the most common method of treatment for patients with disc diseases and which holds a risk potential of up to 40 percent, most of the patients are released from pain or symptoms of paralysis already during the operation with minimally-invasive endoscopy. Very soon they recover considerably. During only one night's rest the patient's back is supported by a special corset and already one day after the operation, after a post-operative examination, the patient will be given detailed instructions for reasonable, back-conserving behaviour. As the endoscopic disc surgery is very careful for muscles, nerves, and bones the patient will completely recover very soon. Now the former disc patient can again perform his beloved sport.
Microscopic Surgery also against Stenosis
A very different problem occurs with older golfers having signs of wearing away. Walking becomes a torture, pains radiate into both thighs. However, as soon as the person affected sits or lies down, he will be immediately free from trouble. When playing golf, however, the walking distances get continuously longer and the next hole seems to be out of reach. The reason is a pathological narrowing of the spinal canal. The individual vertebrar segments have joints at the back which tend to slowly grow in case of wear or due to other damages in the course of years. These enlarged joints execute pressure on the marrow in the spinal cord – which is the main supply cord of the body. The physician will diagnose stenosis, a narrowing of the spinal canal. The Alpha Clinic in Munich can also help with a special treatment to eliminate this handicap of golfers racked with pain.
The conventional stenosis operation as carried out in conventional medicine is literally a procedure done with hammer, chisel, saw or drill: under general anesthetic a large area of the patient's back is opened. Mostly disturbing and constricting bone formations at several vertebrar segments are removed by rough methods and replaced by implants. This surgery is rapidly done in about half an hour. However, this drastic operation involves high risks. Even renowned university hospitals report many patients with headaches, infections, symptoms of paralysis.
The mild alternative of the practice of Drs. Dekker in the Alpha Clinic in Munich is called microscopic stenosis operation. This is also a minimally invasive procedure, carried out through a cannulas with a diameter of only a few millimeters. Another significant difference to the hammer and chisel treatment of a larger region of the back is the concentration on specially defined points, because the actual problem affects only a few, tiny spots – they have just to be located and reached. Under the microscope, with 20x to 40x magnification, Drs. Dekkers cautiously removes with small diamand drills the layers which are to thick. The procedure affects only a few millimeters, however, it takes at least two hours of patient and precise work. This way the supporting structure of the vertebrar bones is conserved – contrary to a conventional operation. The patient gets only a mild anesthetic and remains responsive during the complete procedure. Immediately after the operation he can feel that the narrowing of the spinal canal has been removed.
The relief of patients that have been healed from spinal stenosis can hardly be exceeded. Many of them heard from other doctors before more than once: "Your back is worn, there isn't anything do about it, you have to live with that condition." Many of the patients were taken all hope by pointing out a very great risk. It does not seldom happen that people had to face the thread that they would end up in a wheel chair with a probability of 50%. Dr. Horst Dekkers, head physician of the department of spinal diseases assures: "If proceeded as cautiously as we do, the risk is zero percent."
In order to prevent these troubles right from the beginning, golfers should stick to the following rules. They help to prevent damages caused by strain as well as injuries of the back, the shoulder, and even of the wrists.
Export Advise of Dr. Horst Dekkers for back conserving golf playing:
Build up your muscles by regular strength training, e.g. in a fitness center. A simple exercise for your back to practice every morning in the bathroom: put a towel behind your neck; hold both ends of the towel and press the head against it. Hold for five seconds, relax, and repeat fifteen times.
Already before making the first stroke golfers should warm up for more than ten minutes, for example by jogging. Furthermore you should continue with stretching of the forearms, shoulders, the lower back, chest, trunk as well as the groin. This warm-up makes sense: scientific studies show that golfers that had spent more than ten minutes for a warm-up not only achieved a better handicap but they also had significantly fewer injuries.
This advantage can be increased by taking a rest once in a while during the game and by not playing too often. It turned out that golf players who play four or more rounds a week during the golf season and at least 200 balls per week run a higher risk of damages by strain. One more very important point: even if it looks less sporty, don't carry the heavy golf bag, but draw it behind in a cart or use an electric car. The reason: Merely lifting the golf bag which usually weighs about eight kilograms, causes an axial pressure in the spine of 20 bar. This corresponds to ten times the pressure of a tire. Adequately high is the risk of injury for back and shoulders.
Drs. Horst Dekkers …
is spine specialist, head physician and managing director of the Alpha-Klinik in Munich which specializes on the treatment of spinal diseases and and knee and shoulder surgery. The Alpha-Klinik stands for development and perfection of minimally-invasive techniques as well as for high surgical performance, prevention and conveniences for patients from more than 60 countries. The Alpha-Klinik team speaks more than 20 languages.
Contact: Drs. Horst Dekkers Alpha-KlinikGmbH
Mrs. Barbara Kohl
Effnerstraße 38
D-81925 München
Telefon: +49-89-204000-402
E-mail: kohl@alphaklinik.de
