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Core Timing, Muscle Activation, and Low Back Pain in Golfers

Written by Ifije Ohiorhenuan, MD, PhD — Board-Certified Spine Surgeon. Last updated 2026-06-20.

Core strength is not just about having strong abs

Golfers are often told to strengthen their core. That advice is not wrong, but it is incomplete. For golf-related low back pain, the issue is not just whether the abdominal muscles are strong. It is whether the trunk muscles activate at the right time, in the right amount, and with enough endurance to support repeated swings.

The golf swing is fast. The trunk muscles have to stabilize the spine while also allowing force to transfer from the legs and pelvis to the upper body and club. Too little activation may lead to poor control. Too much activation, or activation at the wrong time, may create stiffness, inefficient movement, or excessive load.

The back muscles may be working too early or too hard

The source synthesis describes studies where golfers with low back pain showed altered erector spinae activation.^[1, 2] The erector spinae are large muscles along the back of the spine. They are important, but they are not the only stabilizers of the spine.

Some golfers with pain appear to activate these superficial back muscles earlier than pain-free golfers.^[3] This may represent a guarding strategy. The body senses threat or instability and stiffens the back in anticipation of movement.

That strategy can help in the short term, but it may become a problem if the golfer repeatedly swings with excessive back muscle tension. The spine may become over-compressed, movement may become less efficient, and pain may persist.

The abdominal muscles matter too

The abdominal wall, including the obliques and transverse abdominis, helps control rotation and trunk stiffness during the swing.^[4] The source synthesis includes evidence that golfers with low back pain may show differences in abdominal muscle timing and activation.^[5, 6]

Again, the practical message is not that one muscle is “bad” and another muscle is “good.” The swing requires coordinated activity. The trunk must be stable enough to transfer force but mobile enough to rotate.

This is why generic sit-ups or crunches are often not the best answer for golf-related back pain. A golfer may need anti-rotation control, trunk endurance, pelvic control, breathing mechanics, and sport-specific progression.

Endurance may be more important than max strength

Golf is repetitive. A golfer may take dozens of full swings, partial swings, warm-up swings, and practice swings in a single session. The trunk muscles must support the spine repeatedly, not just once.

The source synthesis notes that golfers with low back pain demonstrated less trunk rotation endurance in the non-dominant direction, which corresponds to the follow-through direction.^[7] This is a useful concept clinically. A golfer may be strong enough for one swing but not conditioned enough for a full round, a long practice session, or back-to-back days of play.

If pain appears late in the round, after a range session, or during tournament weeks, trunk endurance and workload tolerance should be considered.

What good core training should include

For golfers, useful core training often emphasizes control rather than maximal strain. Examples of training categories include:

Anti-rotation exercises.
Side plank progressions.
Dead bug variations.
Bird dog variations.
Pallof press variations.
Loaded carries.
Hip and trunk dissociation drills.
Medicine ball progressions when appropriate.
Balance and lower-extremity control work.

The goal is to teach the trunk to resist unwanted motion while allowing appropriate motion through the hips and thoracic spine.

Biofeedback may help some golfers

The source synthesis includes a study where ultrasound biofeedback increased activation of the transverse abdominis and abdominal obliques in golfers with a history of low back pain.^[8] Biofeedback is not necessary for everyone, but it highlights an important point: many golfers do not automatically know how to activate the deep abdominal wall.

A physical therapist may use tactile cues, breathing drills, ultrasound, pressure biofeedback, or movement retraining to help a golfer learn better trunk control.

Bottom line

Golf-related low back pain is not always a simple strength problem. It may be a timing, endurance, coordination, and control problem. The trunk muscles must stabilize the spine, transfer force, and decelerate the body during the swing.

For golfers with recurrent back pain, the best core program is usually not just more crunches. It is a progressive plan that builds trunk endurance, improves hip-spine coordination, and teaches the body to control rotation without excessive lumbar strain.

References

This guide draws on the following studies and reviews. Much of this literature is observational or abstract-level, so findings are described here as associations rather than proof. The numbered markers in the text show which sources support each point.

Cole MH, Grimshaw PN. Electromyography of the trunk and abdominal muscles in golfers with and without low back pain. J Sci Med Sport. 2008;11(2):174-81.
Weishaupt P, Obermüller R, Hofmann A. [Spine stabilizing muscles in golfers]. Sportverletz Sportschaden. 2000;14(2):55-8.
Quinn SL, Olivier B, McKinon W, et al. Increased trunk muscle recruitment during the golf swing is linked to developing lower back pain: A prospective longitudinal cohort study. J Electromyogr Kinesiol. 2022;64:102663.
Wu S, Zhang H, Ren Z, et al. An examination of the correlation between antagonist coactivation of the abdomen and rotational kinematics in skilled golfers. Sports Biomech. 2026:1-15.
Cole MH, Grimshaw PN. Trunk muscle onset and cessation in golfers with and without low back pain. J Biomech. 2008;41(13):2829-33.
Horton JF, Lindsay DM, Macintosh BR. Abdominal muscle activation of elite male golfers with chronic low back pain. Med Sci Sports Exerc. 2001;33(10):1647-54.
Lindsay DM, Horton JF. Trunk rotation strength and endurance in healthy normals and elite male golfers with and without low back pain. N Am J Sports Phys Ther. 2006;1(2):80-9.
Skibski A, Stout JR, Ingersoll CD, et al. Ultrasound Biofeedback Increases Abdominal Muscle Activation in Golfers With a History of Low Back Pain. Clin J Sport Med. 2024;34(4):341-347.