KINKS FROM THE LINKS: Massage for Golfers
By: Janet Groene

Golfers are learning they don't need to be Tiger Woods to benefit from massage therapy. At destination spas and golf resorts around the world, massage sessions designed to target the specific needs of recreational golfers are gaining in popularity.

"Golf and spa are a great combination for today's travelers," says International Spa Association President Lynne Walker McNees. "People are looking for a one-stop shop for relaxation and stress relief, and that's one of the reasons why golf is such a popular offering at resort/hotel and destination spas."

From the "Golf Performance Treatment" offered at Willow Stream, the spa at The Fairmont Scottsdale Princess in Scottsdale, Arizona, to "The 19th Hole-Golf Massage" featured at The Manele Bay Hotel's Spa at Manele, in Lana'i, Hawaii, massage for golfers is becoming increasingly specialized. The PGA WEST golf resort, in La Quinta, California, has even created a branded treatment, PGA WEST Golf Massage, now offered at many resort and destination spas throughout North America.

Learning about golfers' special needs can benefit therapists in private practice, too. According to the National Golf Association, about 26.2 million Americans ages 18 and older play one or more rounds of golf each year—so massage therapists increasingly have opportunities to reach this group of affluent, motivated clients. Even more specialized are therapists who offer targeted massages for the 45 percent of golfers who are in the 11-39 age group; the 22 percent who are women; and the 33 percent of all golfers who are age 50-plus and who are likely to have additional age-related problems, such as arthritis.

How do you get golfers on your table before they injure themselves? Once they are in your hands, how do you prepare them for play, put tired muscles into repose after a day on the course, and ready their bodies for powerful, pain-free golf games in the future?

For answers we went to three Florida therapists who work in very different settings, all of them year-round golf destinations: a posh spa in a family resort that has a highly rated golf course; a swank athletic club at a AAA 4-Diamond hotel; and an upscale spa at a new luxury resort that has a strong golf focus.

Weekend warriors

Iris Casteen is lead massage therapist at Stillwater Spa in the Hyatt Regency Coconut Point at Bonita Springs in Southwest Florida. The resort’s 18-hole championship golf course, The Raptor, hosts a who's-who of corporate CEOs, as well as leisure guests who are avid golfers. Because the spa is one of the resort's leading assets, Casteen is likely to work with all adults in the family, golfers and non-golfers alike.

Golf’s Top 10 Stress Points
The areas most prone to injury in golfers are:

  1. Lower back
  2. Wrist
  3. Elbow
  4. Shoulder
  5. Knee
  6. Neck
  7. Hip
  8. Ribs
  9. Ankle
  10. Foot

—Source: John R. McCarroll, M.D., orthopedic surgeon and member of the American College of Sports Medicine.

"Golfers tend to gravitate to us once they've had a bad game," says Casteen. She says her challenge is to get golfers into massage therapy before their first play, educate them about their bodies, and then keep them pain-free. Because most of her clients are on vacation, they may not have played golf for some time, or may not have done proper warm-up and stretching before the game. By the time they come to Casteen they are already in pain, often attributing their stiffness to the long plane flight or a new bed.

"I prefer to start golfers with a relaxation massage, perhaps with assisted yoga, after the flight and before their first round," Casteen says.

"Communication is so important," she adds. "Not just in learning how the client feels physically, but about their expectations from a therapist. As I work, we talk. Often a client doesn't know that, for example, a tingling in the sciatic area has been caused by a golf posture."

Casteen believes in giving clients total attention, not just as weekend warriors, nor as golfers—but as people who come to her as part of the total resort experience. On their first visit to Stillwater Spa, she explains the ritual of spa and the importance of steam, sauna and the Swiss shower, followed by a massage to balance their energy system. She blends Swedish massage with tuina (Chinese push-pull massage) and Thai massage (assisted stretching).

With golfers, Casteen says, she usually has to deal with low-back issues, and she often finds shoulders "screaming for relaxation." She uses therapeutic massage, a blend of Eastern and Western techniques, and heat and cold, with the accent on cold (refrigerated stones or compresses). It's helpful, she finds, to use shiatsu, with a focus on the gluteus area, and she also uses trigger-point release. She finds neuromuscular release good for the lower back. While a 50-minute session is helpful, she prefers 80 minutes, especially for first-time massage clients.

When asked how she would work differently with older golfers, Casteen mentions needing to address problems such as arthritis or bursitis. She also sees younger golfers, who can choose from Stillwater Spa's teen massage menu. Casteen finds fewer golf injuries in younger players because their bodies are more resilient; however, they are also less cognizant of physical vulnerabilities, and are less likely to realize the connection between their golf game and their bodies. With teen-age clients she uses a more comforting, gentler touch.

"Lastly, it all begins and ends with the feet, so I recommend reflexology for everyone, including golfers," Casteen says. "The best thing about therapeutic massage is that it allows the therapist to tailor the session to the client's needs, to be creative, intuitive, innovative."

Educating athletes

Ariel Quinones is a massage therapist at The Spa at the Omni Orlando Resort at ChampionsGate, Florida. It's the only luxury resort in the Orlando area that has two 18-hole, championship golf courses. Because the resort is world headquarters of the David Leadbetter Golf Academy, it’s a frequent host to some of the top names in professional golf, and is popular for golf-oriented business conferences. Quinones' clients are likely to be expert and frequent players. Many also have a support system that includes instructors, coaches and personal trainers.

The most common causes of injuries in amateur golfers are:

  1. Too much play or practice
  2. Poor swing mechanics
  3. Hitting the ground
  4. Over-swinging
  5. Too little warming up
  6. Twisting during the swing
  7. Grip or swing change
  8. Falling
  9. Bending over the putt
  10. Cart-caused injury

—Source: John R. McCarroll, M.D., orthopedic surgeon and member of the American College of Sports Medicine.

Quinones' experience reveals that the most common injury sites in professional golfers are the wrist, back, hand, shoulder and knee.

"It's essential that we see the golfer before inflammation occurs. At that point, our hands are tied," he says. "There's little we can do except to work groups of muscles in areas other than the inflamed site.

"The human body was created to heal itself in many ways, so we try to educate athletes to help us by listening to their bodies," Quinones continues. "They can come to me for maintenance, but they must be responsible for preparation."

With proper warm-up and stretching, followed by massage to prepare muscles, tendons and ligaments, Quinones says he can bring a golfer up to 100-percent performance from a pre-massage potential of only 60-70 percent.

Quinones' massage for golfing clients differs from his general sports- massage sessions, in that he goes directly to the deltoids; the four rotator-cuff muscles, the supraspinatus, infraspinatus, teres minor and subscapularis; the calf muscles, the soleus and gastrocnemius; gluteus medius and maximus; and the latissimus dorsi.

When Quinones works with older golfers, he finds that range of motion may be limited by aging factors, such as arthritis or an old injury. In younger players—and he does see serious golfers as young as age 16—he says the chance of injury is higher because they don't know yet how to read what their bodies are trying to tell them. During the massage session, he tries to educate his clients about their anatomy and physiology, specifically in regard to how it all ties in with their golf game.

To keep his clients pain-free, he advises them in the use of proper warm-up and stretching, followed by a massage and adequate hydration before and during the game. Then he advises rehydration, sauna use and massage after the game to bring the muscles back into balance.

Listening with ears and hands

Both Casteen and Quinones work at spas in golf resorts. By contrast, massage therapist Jane Frances is with the athletic club at The Peabody Orlando. A convention hotel and also a popular venue for guests who want to visit nearby Walt Disney World, The Peabody Orlando does not have a golf course—yet it is as golf-savvy as any resort in Florida, thanks to an in-house golf service that provides guests with tee times and personalized transportation to a choice of the area's top 20 courses. As a result, the hotel's clientele includes avid amateurs, as well as top professionals who stay at The Peabody Orlando, the host hotel for the annual PGA Golf Expo. Frances also works with a core clientele of local golfers who belong to the Peabody Athletic Club.

The low back is often the area most in need of attention, she says.

"The lumbar region is the fulcrum of the coil that goes with the golf swing," Frances explains. She urges golfers to come to her first for a massage that prepares the low back, shoulders, hips, legs and elbows for the motions and stresses of the game.

"I use warmth and cold, deep-tissue massage, [neuromuscular therapy], and I like stone [therapy] to sink heat deep into the muscles," she says.

She also focuses on improving circulation in knees and hamstrings. She finds positional release is especially good for elbows. While she works, she talks to clients about the importance of thorough warm-up and stretching. "Younger players are sometimes too eager to get on the course, and they may overdo the golf while under-doing the warm-up," Frances says. "I tell them to be faithful to whatever stretch routine was recommended by their own personal trainer."

A lot depends on how often a golfer plays, Frances has learned. The player who is on the course three times a week is, obviously, more in tune with his or her body than the monthly player. In any case, she starts with a sports massage to loosen up restricted muscles, and she urges golfers to follow up the next day with another massage. Many of her clients are recommended to her by their chiropractors and osteopaths.

Frances is also a reiki master and facial specialist. She recommends that golfers have a one-hour aloe facial mask for deep hydration to counteract the strong Florida sun, and she incorporates reflexology into her work on golfers. "We are like chefs," she says. "We throw everything into the pot that will address the client's concerns. We listen with our ears and our hands."

Janet Groene is a journalist whose work as a travel writer takes her to dozens of resort spas each year. Her newest books include Caribbean Guide (Open Road Publishing) and Fantastic Discounts & Deals for Anyone Over 50 (Cold Spring Press). Her Jamaica Guide will be published in fall 2005. Groene is a member of the American Society of Journalists & Authors and the Society of American Travel Writers.