Strategic Alliances



By Brian R. Hoke, PT, DPT

The sun creeps over a rugged mountain in the distance accompanied by the smell of freshly cut fairways. The golfer leans over to put his ball on a tee as his three golfing buddies watch to see how the day will begin. He makes a few low-speed practice swings and then sets himself up for his first shot of the day. His backswing is slow and deliberate, and his body coils until there is a brief pause and the club stops momentarily. As the downswing begins, there is a rapid release of energy as the club travels down to the ball with a crisp impact. The ball accelerates and rises over the morning mist, arcing upward then descending back to earth to a spot in the middle of the soft green grass hundreds of yards away.

With a few variations to the scenery and the players, this scene is repeated thousands of times a day all over the country. It is estimated that there are over 29 million golfers in the United States. Golfers enjoy the competitive yet friendly nature of the game, and for many in their retirement years, golf has a central role in the individual’s socialization and circle of friends. For a physical therapist in private practice who has an understanding and background in golf, this also represents a potential source of clients for screening, wellness, injury prevention, game improvement, and injury rehabilitation. Strategic alliances with golf professionals and golfing groups can be the mechanism to tap into this motivated and very appreciative client base.

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It is mission critical that the physical therapy practitioner who desires to delve into a golf-centric niche be well versed in the biomechanics of the golf swing and the physiological demands it places on the golfer’s body. There are excellent continuing education courses taught by physical therapists who have extensive experience in golf fitness and rehabilitation at all levels from novice to professional. Two major golf equipment manufacturers, Titleist and Nike, have also developed educational platforms to educate health care professionals on systems to screen, train, and rehabilitate golfers with a sport-specific functional approach. Physical therapists were integral collaborators with these programs. The Titleist program was created with the assistance of Gray Cook, and the Nike platform was created with the assistance of Gary Gray. Both of these programs include certification by their respective sponsors.

Marketing the program involves reaching out to the teaching Professional Golfers Association (PGA) professionals at local golf courses. It is very important for the physical therapist to emphasize the collaborative nature of the alliance. The golf professional is an expert in evaluating the golfer’s swing and working to make it more fundamentally sound. It is typical that the golfer is not getting into the correct positions during the swing, leading to inconsistency and loss of swing speed. Unfortunately for both the golfer and instructor, attaining the correct positions often requires more than desire and sincere effort.

The golfer’s body may not have adequate range of motion in the trunk, shoulders, or hips to move to the desired position (a common issue for men over 35). The golfer may lack the core control to separate the lumbopelvic rotation from the thoracic rotation creating control and power (a common problem for junior golfers under 18). The upper body strength, particularly in the wrists and forearms, may be inadequate for the timing necessary to release the energy of the club on the downswing for maximum club head speed at impact (common to women golfers). Physical therapists have all of the evaluative skills necessary to screen the golfer and identify these faults. They are then able to assist the golfer and the teaching golf professional in how to reduce the factors that might be impairing the golfer’s ability to produce a fundamentally sound swing.

Golf Quote 002

It is wise to move in the same direction as the general physical therapy profession and market the golf-specific program directly to the consumer. Many clubs have leagues and associations with regular meetings. These are excellent opportunities to briefly introduce potential golfing clients to golf-specific screening, fitness, and rehabilitation. This is also an opportunity for the physical therapist and the teaching PGA professional to be seen as a team dedicated to the same purpose. Particularly effective is a brief demonstration of some of the screening tests, instruction in a couple of golf-specific exercises, and discussion of a few of the most common injuries seen in avid golfers. These typical problems include rotator cuff pathology, lower back pain, elbow tendinitis/tendinosis, and plantar fasciitis.

Direct access is now becoming a more consistent source of clients entering the office of private practice physical therapists, and it is important to educate both the teaching PGA professional and the golfers that this is allowed. In the case of injury evaluation treatment, there may be insurance coverage for the services as well, though some payers such as Medicare still require a physician’s referral and certification of the physical therapist’s plan of care. Rather than viewing this as a hurdle, this can be seen as another opportunity for collaboration, particularly if physicians can be identified who are themselves avid golfers.

Brian R. Hoke, PT, DPT, is the owner of Atlantic Physical Therapy, PC, in Virginia Beach, Virginia. Brian is also a Titleist Performance Institute Certified Level 2 Golf Fitness Instructor. He can be reached at

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