In our office, we see our share of golfers who come in with neck pain after golf. It often presents with pain inside the shoulder blade that runs up into the base of the skull after playing.
The neck usually isn’t a big source of pain in golf. The low back, shoulder, elbow and wrist tend to get most of the attention. But when golfers do come in with neck pain, it’s rarely just a neck problem, and it tends to follow the same pattern.
That pattern happens because your mid back rotates, but the neck itself stays still to keep your eyes on the ball. Your hips turn, your shoulders turn, your spine rotates, and through all of that, your head is supposed to stay quiet. That’s a lot to ask of a handful of small joints and muscles, especially when they’re doing it dozens of times a round, week after week.
Several things can cause it, and they often show up together. Limited rotation through the mid back or hips means the neck has to rotate further than it should to compensate, since the body is going to find the motion somewhere. A head that sways or slides during the swing, rather than staying centered, puts extra strain on the muscles trying to stabilize it. And simply not having enough cervical rotation to begin with means you’re already starting the swing close to your end range, before you’ve even taken the club back.
Your shoulder blades are the piece that gets missed most often. When the scapulas sit elevated, up closer to your ears, the muscles that connect them to the neck, like the upper traps and levator scapulae, are stuck in a shortened, overworked position. That tends to restrict cervical spine range of motion, so the neck can’t rotate as far as it needs to. It’s also no coincidence that the pain people describe runs along the inside edge of the shoulder blade and up to the base of the skull. Elevated scapulas are common in people who sit at a desk all day or carry their stress in their shoulders. Add a golf swing that asks the head and neck to turn while the arms and shoulders are moving, and the neck runs out of room early.
Your shoulder blades also have to keep moving through the swing. In general, the trail shoulder blade retracts on the way back while the lead one protracts, and on the way through they trade roles. If they’re stuck, either elevated or rounded forward, they can’t glide like that, and the neck tends to get pulled into the work to keep up with the turn.
Preventing it starts with the same idea that shows up throughout the rest of the swing: the neck shouldn’t have to work overtime to make up for a lack of rotation somewhere else in the body. Improving thoracic and hip rotation takes the pressure off the neck, which lets the eyes and head stay quiet through the swing. From there, we build cervical rotation and strength so the neck can stay stable. That pain running from your shoulder blade to the base of your skull isn’t really a neck problem. It’s simply your neck telling you that you have an issue with rotation.
