Golfing with Hip Arthritis and After Total Hip Replacement

The metro NY City area is among the best golfing regions in the country, including Westchester, Nassau and Suffolk counties, populated with droves of passionate golfers. New York State is ranked in the top three states with greater than 830 public and private courses including the famed courses of Shinnecock, National, Winged Foot, and Bethpage Black. Matching this impressive roster of courses to play is an equally enthusiastic population of golfers of all ages.

Unfortunately, hip arthritis and the worsening physical effects can dampen one’s enjoyment of the game and cause more than just a worsening physical handicap but, even worse, an increase in one’s golf “handicap.”

Understanding the Hip Joint

The hip joint is a “ball and socket” joint with the ball, known as the femoral head, and the socket, known as the acetabulum. The femoral head and the acetabulum are coated with a soft, smooth “lubricatable” surface called articular cartilage that allows the ball and socket to both smoothly glide against one another and provide cushioning.

Osteoarthritis (OA), also known as degenerative arthritis or “wear and tear” arthritis is the process whereby the cartilage or cushion degenerates and becomes thin, roughened and frayed. The loss of cartilage can ultimately lead to a complete wearing out or “bone on bone” interaction with increased friction between the two sides of the joint causing pain, inflammation, osteophyte or “bone spur” formation, joint stiffening and loss of motion.

Osteoarthritis effects approximately 28 million people in the United States and roughly 9.2% of adults older than 45 years of age. OA affects men more commonly for populations younger than 50 years of age, and women more commonly for people greater than 50 years of age. The most common symptoms of hip arthritis are disabling pain with both activity and rest periods including night-time, stiffness or loss of motion, locking or catching sensations, and increase flare ups or pain with activity. The pain is most commonly located in the groin and thigh and radiates into the buttock and/or knee. Once a patient loses their hip motion as OA advances, hip rotation is often diminished and lost irreversibly.

How Does Hip Arthritis Effects my Golf Game?

Hip rotation, both internal and external, are frequently lost with the worsening effects of hip OA. As the OA advances, rotation is diminished, particularly internal rotation, which results in compensational alterations of golfer’s backswing and follow-through.

Hip rotation is extremely important to allow for adequate back swing and follow-through. If either internal and/or external rotation is limited, any number of compensations can be noted including less ideal weight shift patterns, which can decrease swing velocity and force and therefore ability to drive the ball. More specifically a loss of internal rotation in the rear leg can have a large impact on limiting the backswing, and a loss of internal rotation of the lead leg can affect the follow-through according to Doctor of Physical therapy Catherine O’Mahoney of NISMAT (Nicholas Institute of Sports Medicine and Athletic Trauma). Additionally, strain can result from compensation in other body parts including the lower back and arms.

What Happens to my Golf Swing after Total Hip Replacement?

Total hip replacement surgery reliably improves pain and range of motion particularly in the transverse plane where hip rotation, both internal and external, take place. Therefore, what was once taken away pre-surgically is typically restored allowing for backswing and follow through to return to near normal states. In turn, patients are able to again have better ball striking and driving potential post-hip replacement. This in addition to unburdening areas affected by compensational changes including the lower back and arms.

When Can I Return to Golf after a Hip Replacement?

We advise golfing patients to return to chipping and putting at about 4 weeks and begin swinging/driving 4-8 weeks, and finally resume rounds of golf between 8-12 weeks. Most importantly, patients are able to return to the game they love at the level of play they are accustomed to.

Dr. Eric Grossman is a joint replacement surgeon at Rothman Orthopaedic New York and currently sees patients in Murray Hill, Gramercy and Madison Avenue (September 2020).