Due to its beautiful year-round climate, rich golfing history and high-quality courses, it’s no wonder locals and visitors alike enjoy golfing in Sarasota. And while popularity in the sport continues to rise, so does the risk of shoulder, elbow and wrist injuries, as well as unique wear and tear issues.
That’s where Dr. Otte and the Titleist Performance Institute- (TPI) certified physical therapists at Coastal Orthopedics, a full-service provider of comprehensive orthopedic surgery, sports medicine, spine care, diagnostic imaging and physical therapy service, come in.
Dr. Otte, a fellowship-trained orthopedic surgeon who specializes in shoulder and elbow, has worked as the head physician for the PGA Tour at the WGC Championship at The Concession, as well as the 2022-2024 ATP Sarasota Open professional tennis tournament. A golfer himself, he understands that the golf course is a sanctuary. That is, until pain throws off your swing.
In addition to orthopedic surgeons, Coastal Orthopedics also has TPI-certified physical therapists among its team, offering patients the opportunity to be assessed for how a golfer’s body moves during a swing, identify physical limitations and create customized treatment plans to improve biomechanics, reduce injury risk and enhance performance.
Below, Dr. Otte and Maria Scafario, TPI-certified physical therapist at Coastal Orthopedics, answer some questions about common injuries, early warning signs, the TPI rehab model and more.
Dr. Otte Q-and-A
Q: How common are shoulder and elbow injuries among golfers and what are some of the most frequent conditions you treat?
Dr. Otte: These injuries are some of the more common things I see in my office. Specific to the shoulder, the shoulder joint has the greatest range of motion of any joint in our body. Due to this, it is vulnerable when getting into positions that can strain the soft tissues surrounding the shoulder. The most common issue I see is rotator cuff injuries from minor strains and impingement symptoms to full thickness tears.
Q: What are some of the most common mobility or strength deficiencies you see in golfers that lead to shoulder or elbow injuries?
Dr. Otte: What I see most is the failure of a proper warm-up routine and maintaining flexibility. As we age, we lose elasticity in our soft tissues. As we lose range of motion, it can lead to an increase in pain. As it relates to golf, someone who has lost range of motion and is then faced with a challenging shot or tries to swing extra hard, can risk injuring their shoulder due to a sudden increase in range of motion, or an attempt at such.
Q: How important is it to assess hips, spine, shoulders, etc. when evaluating a golfer’s injury?
Dr. Otte: Like we learned as kids, the body is all connected, and nowhere is that more evident than in the golf swing. Oftentimes, there are alignment, balance or stability issues in the lower extremities that can subject patients to injury in the upper extremity as it tries to compensate. As part of a physical therapy evaluation, the entire kinetic chain would be evaluated to demonstrate how a deficiency in one joint or body part can lead to other downstream effect.
Q: What should golfers watch out for in terms of early warning signs of injury in the shoulder or elbow?
Dr. Otte: Generally, the earliest warning sign is pain or loss of motion. Instead of waiting for a warning sign, I recommend anyone that is golfing multiple times per week to have a dedicated warm-up and stretching routine. Many golfers walk right to the range or the first tee box and start swinging for the fences. This places an enormous amount of stress on the soft tissues and risks injury and inflammation. Even if it’s for only 5 minutes, there are a lot of simple shoulder and elbow exercises that can help warm up your body to get ready to play.
Q: What advice would you give to a golfer looking to stay injury-free and perform at their best year-round?
Dr. Otte: Prevention is key. In a lot of scenarios, if you start having constant pain in the joint it is often too late, and you risk needing to “sit out” or take extended time off to allow the body to heal. My advice is always to spend a small amount of time each day or at least before playing, stretching and warming up properly. It sounds elementary, but it can make all the difference in keeping you out on the course.
Q: Anything else you’d like golfers to know about the connection between orthopedic care and golf performance?
Dr. Otte: The great news is that a vast majority of the injuries I see from golf are non-surgical. However, if ignored or not managed appropriately, patients can risk needing to take extended time off to allow the body to fully heal and recover. Our goal as orthopedic specialists is to allow patients to do the things in life that they love to do, regardless if it is non-surgical (hopefully) or surgical. My strategy is to form a team between myself and Amanda, my physician assistant, as orthopedic specialists, our physical therapy team, and you to formulate a strategy to keep you healthy and playing your best.
Q: Billy Horschel, an American professional golfer who currently plays on the PGA Tour, recently took a proactive approach to his health by undergoing hip surgery in Colorado. What are your thoughts on proactive rehab?
Dr. Otte: While I do not know the extent of his specific scenario, there are instances in which unfortunately a surgery would be necessary, either to prevent further or ongoing injury, or because attempts at conservative care(medication, injections, PT) have failed to provide the sustained relief/functional improvement the patient desires. Professional golfers are so in-tune with their body and the mechanics of the swing, that when one joint is causing problems, it can risk injuring other joints.
Maria Scafario, TPI-certified physical therapist, Q-and-A
Q: For those unfamiliar, what exactly is TPI (Titleist Performance Institute) rehab, and how does it differ from traditional physical therapy?
Maria: TPI is the world’s leading educational organization dedicated to the study of how the human body functions in relation to the golf swing.
Q: Does TPI rehab take a more holistic or performance-based approach to treating and preventing golf-related injuries?
Maria: The TPI approach takes a look at the whole body’s functional range of motion as it specifically applies to the golf swing.
Q: When did Coastal Orthopedics start offering TPI rehab and why? Was there a demand for it in this area?
Maria: I became TPI certified in 2015 and my colleague Steve, the other TPI-certified physical therapist here, became certified in Medical Level 2 in 2022. There has always been a huge golfing community in this area. There are over 90 golf courses in Manatee and Sarasota Counties!
Q: How does the TPI model help golfers not only recover, but also gain more power, range of motion or consistency in their swing?
Maria: You don’t have to be injured or recovering from an injury to benefit from a TPI assessment. It helps to evaluate deficits in ranges of motion, strength and neuromuscular control.
Remember, you don’t have to play through your pain. With specialists like Dr. Otte and a physical therapist team trained in golf specific biomechanics, Coastal Orthopedics is helping golfers of all levels recover smarter in order to golf longer. Whether you’re dealing with an ongoing issue or looking to prevent one, contact our team today for a consultation!
