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Why Hip Mobility Matters for Golfers With Low Back Pain

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

Your back may hurt because your hips are not doing enough

When golfers think about low back pain, they naturally focus on the spine. That makes sense. The pain is in the back. But the cause of the problem may not be isolated to the back.

One of the strongest themes in the source synthesis is the relationship between hip mobility and golf-related low back pain. In particular, limited lead hip internal rotation has been associated with low back pain in golfers.^[1, 2]

For a right-handed golfer, the lead hip is the left hip. For a left-handed golfer, the lead hip is the right hip. During the downswing and follow-through, the lead hip must accept rotation and help the pelvis clear. When that hip is stiff, the body still has to finish the swing. The motion may then shift into the pelvis and lumbar spine.

Why lead hip internal rotation matters

A golf swing is a rotational movement. Ideally, rotation is distributed through multiple regions: ankles, hips, pelvis, thoracic spine, shoulders, and trunk. The lumbar spine contributes, but it is not designed to be the sole rotational engine of the swing.

If the lead hip lacks internal rotation, the golfer may compensate by increasing lumbar flexion, lumbar rotation, lateral bending, or pelvic tilt.^[3] That compensation may allow the golfer to hit the ball, but it may also concentrate stress in the low back.

This is one reason a golfer can stretch the low back repeatedly and still have pain. The back may not be the primary mobility problem. The back may be compensating for a hip that does not rotate well.

Signs hip mobility may be contributing

Hip-related back pain patterns vary, but several clues can raise suspicion:

Back pain is worse during follow-through.
The golfer feels blocked or stuck rotating through the lead side.
The finish position feels forced or uncomfortable.
The golfer has known hip stiffness or arthritis.
The golfer has asymmetrical hip rotation.
Back pain returns despite repeated low back stretching.
Swing changes aimed only at the back do not solve the problem.

These clues do not prove the hip is the cause. But they suggest the hips should be evaluated as part of the back pain workup.

The hip-spine connection

The source synthesis notes strong coupling between lumbar spine and hip rotational movement during the golf swing.^[4] That means the hip and spine do not act independently. A change in one region can influence the other.

This is clinically important because treatment should not focus only on the painful tissue. A golfer with low back pain may need lumbar stabilization, but may also need hip mobility work, hip strengthening, gluteal strengthening, and swing retraining.

A purely spine-centered approach may miss the reason the lumbar spine is being overloaded.

What can golfers do?

A golf-specific program often includes a combination of mobility and control. Mobility alone is not enough. A golfer needs usable range of motion that can be controlled during the swing.

Common components may include:

Lead hip internal rotation mobility work.
Dynamic stretching before play.
Gluteal strengthening.
Hip abductor and rotator strengthening.
Trunk stabilization.
Pelvic control drills.
Swing coaching to improve rotation through the hips rather than the lumbar spine.

Foam rolling and dynamic stretching of the lead hip have been studied as ways to increase hip range of motion.^[5, 6] Case reports also describe golfers improving after treatment focused on hip range of motion and lumbar stabilization.^[7, 8] These are encouraging findings, but golfers should avoid assuming one stretch is a universal cure.

Do not force rotation through pain

A common mistake is to discover hip stiffness and then aggressively force the hip into rotation. That can irritate the hip, groin, or back. Mobility work should be progressive and controlled. Painful pinching in the front of the hip, sharp groin pain, or worsening back symptoms should prompt evaluation.

Golfers with arthritis, prior hip surgery, labral pathology, or significant stiffness may need a more individualized approach.

Bottom line

The low back and hips are linked during the golf swing. When the lead hip does not rotate well, the lumbar spine may be asked to do more than it should. For golfers with recurrent low back pain, hip mobility is not a side issue. It may be central.

A good golf back pain plan should evaluate both the spine and hips. The goal is not simply to become more flexible. The goal is to restore enough hip motion, strength, and control so the golfer can rotate through the swing without dumping excessive stress into the low back.

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.

Vad VB, Bhat AL, Basrai D, et al. Low back pain in professional golfers: the role of associated hip and low back range-of-motion deficits. Am J Sports Med. 2004;32(2):494-7.
Murray E, Birley E, Twycross-Lewis R, et al. The relationship between hip rotation range of movement and low back pain prevalence in amateur golfers: an observational study. Phys Ther Sport. 2009;10(4):131-5.
Kim SB, You JS, Kwon OY, et al. Lumbopelvic kinematic characteristics of golfers with limited hip rotation. Am J Sports Med. 2015;43(1):113-20.
Mun F, Suh SW, Park HJ, et al. Kinematic relationship between rotation of lumbar spine and hip joints during golf swing in professional golfers. Biomed Eng Online. 2015;14:41.
Hamada Y, Akasaka K, Otsudo T, et al. Golfers’ Performance Is Improved More by Combining Foam Rolling and Dynamic Stretch to the Lead Hip Than Practice Golf Swinging. J Strength Cond Res. 2024;38(7):e391-e397.
Hamada Y, Akasaka K, Otsudo T, et al. Immediate Effects of Foam Roller and Stretching to the Lead Hip on Golfers Swing: A Randomized Crossover Trial. Healthcare (Basel). 2023;11(14).
Lejkowski PM, Poulsen E. Elimination of intermittent chronic low back pain in a recreational golfer following improvement of hip range of motion impairments. J Bodyw Mov Ther. 2013;17(4):448-52.
Reinhardt G. The Role of Decreased Hip IR as a Cause of Low Back Pain in a Golfer: a Case Report. HSS J. 2013;9(3):278-83.