A prospective study of injuries and illnesses among 910 amateur golfers during one season

Abstract

Objectives

Our aims were (a) to describe the prevalence and incidence of self-reported injuries and illnesses of amateur golfers over a 5-month period and (b) to investigate potential risk factors for injury.

Methods

We recruited 910 amateur golfers (733 males [81%] and 177 females [19%]) from golf clubs in the USA and Switzerland. The median age was 60 (IQR: 47–67) and the median golfing handicap was 12 (IQR: 6–18). Participants’ health was monitored weekly for 5 months using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Players also completed a baseline questionnaire on personal and golf-specific characteristics and their medical history.

Results

We distributed 19 406 questionnaires and received 11 180 responses (57.6%). The prevalence of injuries was 11.3% (95% CI: 9.8 to 12.8) and of illnesses was 2% (95% CI 1.7 to 2.2). The incidence of injuries and illnesses was 3.79 (95% CI 3.54 to 4.06) and 0.94 (95% CI 0.81 to 1.07) per golfer per year, respectively. The injury regions with the highest burden of injury (time-loss days per player per year) were lumbosacral spine (5.93), shoulder (3.47) and knee (2.08). Injury risk was higher with increased age, osteoarthritis and previous injury.

Conclusion

The prevalence and incidence of injury and illness in amateur golf were low compared with many other sports. To further reduce the burden of injury, future research attention should be directed towards the lumbosacral spine, knee and shoulder.

WHAT IS ALREADY KNOWN ON THIS TOPIC

• The International Olympic Committee’s Consensus on Injuries and Illnesses in Sport was adapted for golf and published in 2020.

• Large prospective descriptive studies identifying risk factors for injury in golf are lacking.

• The prevalence and severity of musculoskeletal complaints in amateur golf are similar to the general population.

• Golf participation has a low to moderate risk of injury per hour played compared with other sports.

WHAT THIS STUDY ADDS

• This prospective study demonstrates the incidence of musculoskeletal complaints in a large cohort of amateur golfers.

• Injury burden from golf injuries was highest in lumbosacral spine, shoulder and knee regions.

• Previous injury, increasing age and self-reported osteoarthritis were associated with a higher likelihood of self-reported injury.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

• Injury burden was highest in the lumbosacral spine, knee and shoulder region and clinicians should target prevention interventions to address this injury pattern in golfers.

• Treatment optimisation and injury prevention should be targeted across golfers of all ability levels.

Introduction

Golf is a sport that allows players of all ages and abilities to participate together. It is played in over two-thirds of countries, by more than 66 million people and there are now more women and men playing the game than ever before.1,3 Golf has seen a surge in participation following the COVID-19 pandemic, likely because it can be played outside safely.^{1 4 5} Playing golf provides mental well-being, social and physical benefits to a player’s health and playing for at least 150 min per week enables players to meet key WHO’s recommendations on weekly physical activity.⁶ A study reported that, after controlling for socioeconomic factors, golfers live on average 5 years longer than non-golfers.⁷

Although golf is associated with health benefits, there are injuries that can occur secondary to playing. A scoping review by Murray et al described epidemiological studies (both prospective and retrospective) reporting the incidence of injuries in amateur golfers to be between 16% and 41% annually.⁶ Prospective longitudinal studies analysing golfing-related injuries have reported low injury rates per hour played compared with other sports, at 0.28 to 0.60 injuries per 1000 hours in amateur players.8,10 A more recent study of injury incidence at the Rio 2016 Olympics found golf to have a relatively lower injury rate in comparison to other Olympic sports.¹¹ Injury rates in professional players are higher than in amateurs, perhaps reflecting an increased volume of training and play12,14 and typically affect the spine (lumbar spine followed by cervical spine followed by thoracic spine) and the hand and wrist.¹²

Most epidemiological studies in golf are over 20 years old. Such studies vary considerably regarding the reporting of the definition of injury, nature of the injury, injury mechanism, time to return to sport and potential causative factors. Consensus statements, injury forms, diagnostic coding and protocols for data collection have since been developed by key stakeholders in other sports including cricket,¹⁵ football,¹⁶ rugby union,¹⁷ rugby league,¹⁸ aquatic sports,¹⁹ tennis,²⁰ athletics²¹ and horse racing²² to ensure data from studies is comparable.²³ In 2020, the International Olympic Committee (IOC) consensus statement on recording and reporting of illness and injury in sport was published.²⁴ Shortly after, experts in the field of golf medicine and epidemiology published the International Golf Federation (IGF) consensus statement adapted specifically for golf.²⁵ There are currently no large prospective studies analysing the incidence and burden of injuries in non-professional nor professional golfers using the golf-specific consensus framework. Our author group have previously applied the IGF framework in a cross-sectional study reporting injuries among 1170 male golfers, finding that more than a third of the golfers reported low back complaints in the preceding 7 days, while other frequently affected body parts were the shoulder and knee.²⁶ Given this study used a baseline questionnaire at the start of the season, a prospectively conducted study to analyse the injuries and illnesses affecting golfers during the season, and furthermore, the risk factors for injuries and injury burden was warranted.

The main aim of the present study was to assess the prevalence, incidence and burden of injuries and illnesses among amateur golfers over a 5-month period using the IOC and IGF consensus statements methods. Our secondary aim was to investigate potential risk factors by analysing the associations of injury during the season with personal and golfing characteristics obtained at the start of the season.

Methods

Study design and participants

This was a prospective cohort study of 910 amateur golfers over a 5-month period, 767 from the USA and 143 from Switzerland. The breakdown of demographics by country can be seen in online supplemental appendix 1. The mean age of the cohort was 56 years (range 18–80, SD=14) and it included 733 males (81%) and 177 females (19%). The methods applied to this study were consistent with the IGF statement of reporting injuries and illnesses in golf. Ethical approval was granted by the Ethical Committee of Canton Zurich on 14 May 2020 (BASEC Nr.; 2020–00477) and by Belmont University Institutional Review Board, protocol 1112 from 26 April 2021. All golfers provided written informed consent to participate in the study.

Recruitment and inclusion criteria

The inclusion criteria were amateur players (defined as recreational, subelite or elite who do not play on professional tours for money) aged 18 years or older who had played at least one competition in the last 12 months and who are currently playing golf on a course or driving range. Exclusion criteria were those with a golfing handicap over 40, those playing golf where a full swing is not taken (for example those that only putt, or play crazy/mini golf), those with a current injury/illness limiting golf training or competition, significant systemic disease (for example cancer or unstable cardiovascular disease) or professional golfers (defined as those who play on professional tours for money).

The participants received information about the objectives, methodology, inclusion criteria, data protection of the study, and were requested to fill in the informed consent form and an online questionnaire on personal and golf-specific characteristics as well as on their medical history and current complaints at the start of the season, and a weekly questionnaire on injuries and illnesses during the season. The IOC Consensus on Injuries and Illnesses in Sport adapted by the International Golf Federation for the recording and reporting of epidemiological data on injuries and illnesses in golf was used for this study.²⁵ The specific data gathering forms from the consensus guidelines included (1) Baseline Questionnaire, and (2) Weekly Self-Report of Health Complaints and Exposure to Golf. All questionnaires were written in English. Those who completed the entirety of the questionnaires were included.

Injury data collection

Data were collected using a web application and short messaging service (AthleteMonitoring, FITSTATS, Moncton, Canada), with the study questionnaires integrated into the software. Each participant received a username and created an individual password. Once the baseline questionnaire was completed, weekly follow-up reminders were sent to the designated e-mail address of the golfer.

Weekly self-report of health complaints and exposure to golf

This questionnaire was created as part of the IGF consensus on injuries and illnesses reporting in golf.²⁵ It was designed to collect data from players without the need for researchers/medical staff to be available to conduct weekly monitoring. The report form was filled in by the athlete regarding health complaints that affect them but might or might not receive medical attention. These include current injuries or other health problems occurring in the preceding 7 days. It also included questions covering the participants’ golf exposure (hours or balls hit). The questionnaire included the four questions of the Oslo Sports Trauma Research Centre questionnaire on health problems (OSTRC-H2) which recorded the consequences of health problems on golf participation, training and performance, as well as the degree of symptoms the player had experienced in the preceding 7 days. Based on the player’s responses to these questions, a severity score ranging from 0 to 100 was calculated each week for each health problem.^{27 28}

Definition and classification of health problems

Golfers were asked to record all health problems, irrespective of whether they sought medical attention or whether the problem affected their golf participation (ie, we applied in ‘all complaints’ definition).²⁵ Consistent with the IOC and IGF consensus recommendations, health problems were classified as injuries or illnesses, and injuries were classified as gradual-onset or sudden-onset injuries. Health problems were considered ‘substantial’ if they lead to moderate or severe modifications to training, moderate or severe reductions in performance, or cause the participant to be unable to participate in golf. Burden was a combined measure of the overall effect of a health problem and was expressed as time-loss days per player-year.²⁹

Prevalence calculation

We calculated weekly prevalence by dividing the number of participants reporting health complaints by the number of questionnaire respondents. The average weekly prevalence with 95% CI was calculated for all health problems, substantial health problems, all injuries, substantial injuries, all illnesses and substantial illnesses.

Injury incidence and burden

The injury incidence was calculated as the number of new injuries per golfer per year (365 days). Injury and illness burden was calculated factoring in both injury incidence and severity. For each injury type, severity was shown as the median number of days lost. To reflect the relative burden of sudden-onset injuries, gradual-onset injuries, and illnesses as a proportion of the total health burden, we summarised the severity scores for each health problem type and divided the result by the cumulative severity score for all health problems.³⁰ We created risk matrices to illustrate the severity and incidence of injuries in the most affected anatomic regions. This was performed for both sudden-onset and gradual-onset injuries, as well as illnesses, using two measures of severity: the average number of time-loss days per case and the average severity score per case.

Risk factor analyses

Information on the following potential risk factors was obtained from the baseline questionnaire: age, sex, previous injury, osteoarthritis, golfing handicap (dichotomised as ‘less than 6’ or ‘6 or higher’ as per the International Golf Federation consensus statement definition of subelite golfers),²⁵ average number of days playing golf per week, whether the player performed a warm-up prior to playing golf and whether the player performed specific injury prevention training. Associations between these variables and injury were analysed in R using the Ime4 package.³¹ Potential risk factors were entered into univariate generalised linear mixed-effects models with injury as the dependent variable and time as a fixed effect. All factors that were found to have a significant association with injury in univariate analyses were included in a multivariable model. The results are reported as OR with a 95% CI.

Results

Response rate to weekly questionnaires

We distributed 19 406 questionnaires and received 11 180 responses (57.6%). The average weekly response rate for the USA was 50.7% and Switzerland was 91.9% during the 5-month study period.

Participant characteristics

The median age was 60 (IQR: 47–67) and the median age to start playing golf was 20 years (IQR: 12–35) with the majority being right-handed (n=831; 92.7%). The median golfing handicap was 12 (IQR: 6–18). Most golfers (n=730; 81.5%) classified themselves as recreational players, 155 (17.3%) as subelite (PGA teaching professionals, amateurs competing in regional/county/state tournaments or with handicap 5 or less), and 11 (1.2%) as elite (amateurs competing in international/national amateur championships).

Prior to the study, participants reported the mean number of rounds of golfing per week was 2.3 (SD=1.3) and the median number of holes played was 36 (IQR: 18–54). The median number of balls hit on the driving range per week was 100 (IQR: 65–200) while the median number of hours per week used for golf-related fitness was 3 (IQR: 2–5). Injury prevention was performed in 44.5% (n=335) of the study population and 91.5% (n=689) performed a golf warm-up prior to playing.

Prevalence of injuries, illnesses and health problems

The overall prevalence of health problems during the study period was 13% (95% CI 11.4 to 14.6). Prevalence of injuries was 11.3% (95% CI 9.8 to 12.8). The prevalence of illnesses was 2% (95% CI 1.7 to 2.2). The onset of injuries and illnesses and their substantiality can be seen in table 1.

Table 1. Prevalence of health problems.

	Females (95% CI)	Males (95% CI)	Both sexes (95% CI)
All health problems	14.1 (12.1 to 16.1)	12.7 (11.2 to 14.3)	13 (11.4 to 14.6)
All injuries	10.7 (9.1 to 12.3)	11.5 (10.0 to 13.0)	11.3 (9.8 to 12.8)
All sudden-onset injuries	4.1 (3.0 to 5.3)	5.0 (4.2 to 5.7)	4.8 (4.0 to 5.6)
All gradual-onset injuries	7.0 (6.3 to 7.8)	6.7 (5.9 to 7.5)	6.8 (6.0 to 7.5)
All illness	4.5 (3.5 to 5.4)	1.3 (1.1 to 1.6)	2.0 (1.7 to 2.2)
Substantial health problems	5.7 (4.8 to 6.6)	5.8 (5.2 to 6.4)	5.8 (5.1 to 6.4)
Substantial injuries	3.3 (2.7 to 4)	4.9 (4.3 to 5.4)	4.6 (4.0 to 5.1)
Substantial sudden-onset injuries	1.6 (1.1 to 2)	2.7 (2.2 to 3.1)	2.4 (2.0 to 2.9)
Substantial gradual-onset injuries	1.8 (1.3 to 2.2)	2.3 (2.0 to 2.5)	2.2 (1.9 to 2.4)
Substantial illness	2.6 (2.0 to 3.2)	1 (0.8 to 1.2)	1.3 (1.1 to 1.5)

Incidence and severity of injuries, illnesses and health problems

There were 4.73 (95% CI 4.44 to 5.02) health problems per golfer per year. The incidence of injuries and illnesses was 3.79 (95% CI 3.54 to 4.06) and 0.94 (95% CI 0.81 to 1.07) per golfer per year, respectively. The number of injuries by body parts and the related median severity of complaints is presented in table 2. The injury burden by anatomical location can be seen in figure 1.

Table 2. Injury incidence, severity and burden.

	Sex	Cases (n)	Incidence (95% CI)	Median time loss (25th–75th percentile)	Burden
All health problems	Both sexes	996	4.73 (4.44 to 5.02)	2 (0–5)	24.15
	Male	760	4.64 (4.32 to 4.98)	2 (0–6)	23.73
	Female	236	5.01 (4.4 to 5.68)	1.5 (0–4)	25.62
Sudden-onset injury	Both sexes	345	1.64 (1.47 to 1.81)	2 (0–6)	10.40
Gradual-onset injury	Both sexes	454	2.15 (1.96 to 2.36)	1 (0–3)	7.88
Illness	Both sexes	197	0.94 (0.81 to 1.07)	3 (1–7)	5.90
Head	Both sexes	4	0.02 (0.01 to 0.05)	3.5 (0–8.75)	0.11
Neck	Both sexes	39	0.19 (0.14 to 0.25)	0 (0–2.5)	0.40
Shoulder	Both sexes	69	0.33 (0.25 to 0.41)	1 (0–6)	3.47
Upper arm	Both sexes	6	0.03 (0.01 to 0.06)	1.5 (0.25–2)	0.05
Elbow	Both sexes	50	0.24 (0.18 to 0.31)	0 (0–2)	0.95
Forearm	Both sexes	17	0.08 (0.05 to 0.12)	1 (0–3)	0.58
Wrist	Both sexes	26	0.12 (0.08 to 0.18)	0 (0–1.75)	0.27
Hand	Both sexes	32	0.15 (0.1 to 0.21)	0 (0–3.5)	0.61
Thoracic spine	Both sexes	47	0.22 (0.17 to 0.3)	1 (0–5)	0.68
Lumbosacral spine	Both sexes	265	1.26 (1.11 to 1.41)	2 (0–5)	5.93
Abdomen	Both sexes	11	0.05 (0.03 to 0.09)	1 (0–2.5)	0.13
Hip/groin	Both sexes	53	0.25 (0.19 to 0.33)	1 (0–3)	0.77
Thigh	Both sexes	17	0.08 (0.05 to 0.12)	2 (0–10)	0.41
Knee	Both sexes	82	0.39 (0.31 to 0.48)	1 (0–4)	2.08
Lower leg	Both sexes	10	0.05 (0.03 to 0.08)	2.5 (0–4)	0.13
Ankle	Both sexes	16	0.08 (0.05 to 0.12)	3 (0–8.25)	0.50
Foot	Both sexes	46	0.22 (0.16 to 0.29)	2 (0–4)	0.97
Region unspecified	Both sexes	9	0.04 (0.02 to 0.08)	3 (1–5)	0.28

Figure 1. Risk matrix depicting the relationship between incidence (number of injuries per athlete per year) and severity (average cumulative severity score) of the six anatomical locations with the highest overall burden. Darker shades of background indicate a higher injury burden error bars represent 95% CIs.

Risk factors associated with injury

Univariate regression analysis revealed that injury was associated with increasing age, osteoarthritis, previous injury and undertaking injury prevention exercises. Sex, golfing frequency, warm-up and handicap were not associated with injury (table 3). Following multivariate analysis (age, osteoarthritis, previous injury and injury prevention exercises), all associations remained significant (table 4).

Table 3. Univariate logistic regression analysis of factors associated with injury.

Independent variable	OR	95% CI	P value
Age (per 10 years)	1.02	1.01 to 1.03	<0.001
Male sex	1.13	0.67 to 1.89	0.646
Golf days per week	1.05	0.85 to 1.29	0.654
Osteoarthritis	3.30	1.94 to 5.61	<0.001
Warm-up	1.29	0.58 to 2.87	0.529
Previous injury	3.29	2.05 to 5.28	<0.001
Injury prevention	3.97	2.57 to 6.14	<0.001
Handicap <6	1.00	1.00 to 1.00	0.549

Table 4. Multivariate regression analysis including significant independent variables.

Independent variable	OR	95% CI	P value
Age	1.03	1.01 to 1.04	0.002
Osteoarthritis	1.97	1.16 to 3.35	0.013
Previous injury	2.32	1.46 to 3.68	<0.001
Injury prevention	3.13	2.05 to 4.78	<0.001

Discussion

This study is the first to prospectively analyse health complaints during the season using the IGF guidelines for reporting of injuries and illnesses in the amateur golfing population. We found injury and illness rates to be similar or lower compared with those reported in many other sports. Injuries located at the lumbosacral spine, knee and shoulder had both the highest incidence and burden. Injuries were associated with increasing age, previous injury and osteoarthritis. We found no association between the self-reported number of days playing golf per week in the previous season and injury.

Since the publication of the IGF guidelines on reporting of injuries and illnesses in golf, this is the first study to apply the methodology in a prospective way on a large cohort. As golfing participation continues to grow, it is important that well-performed research into the sport is undertaken using comparable processes. Furthermore, golf’s contribution to population-level physical activity increases with age³² and as we have shown age to be a correlating factor with injury, therefore, clear understanding of golf injuries may lead to improved playing longevity and subsequently physical activity. A recent retrospective study showed musculoskeletal complaints in recreational male players to be comparable to injury complaints in the general population.²⁶ It is possible that this reflects participants reporting the musculoskeletal complaints that occurred taking part in daily life and other activities in addition to those sustained playing golf. When comparing the prevalence of injuries to other non-contact recreational sports using comparable methods, the results of this study suggest injury rates are substantially lower.33,35 In regard to the incidence of injuries in other non-contact, recreational sports such as running and tennis, rates of injury appear to be lower compared in our study.^{36 37}

The findings of our study do not pertain to touring professional golfers. A previous study of the incidence of injury and illness of professional athletes at the Tokyo 2020 Olympics found golfers to have a surprisingly high rate of health problems.³⁸ Golf had the highest rate of health problems of any non-contact sports over the 17-day period with an injury prevalence of 15% and illness prevalence of 6%. The relatability of these findings to the current study is limited by their professional athlete population and short study period.

This study is the first to report injury burden among golfers. Previous expert opinion has described the benefits of reporting injury burden in addition to incidence and time loss.^{30 39} The two concepts can be combined in a risk matrix as seen in figure 1 to give the relative importance of each injury. This has previously been used a number of times in a variety of sports including rugby, athletics, ice hockey and para-sports.3540,42 In this current study, we found the lumbosacral spine injuries to have both the highest incidence and burden. Knee and shoulder injuries were the next two most burdensome injuries. However, despite a higher incidence compared with shoulder injuries, knee injuries had a lower burden. Furthermore, sudden-onset injuries, despite being much less common, had a higher burden compared with gradual-onset injuries. Using the risk matrix demonstrated, researchers and clinicians involved in golf can focus their attention on reducing the most burdensome musculoskeletal complaints, identify when injury risk is at its highest and assess the impact of sudden-onset vs gradual-onset injuries.

The lumbosacral spine was the most common location of injury in recreational golfers in our study. This aligns with previous research, where lumbosacral pain has been found to contribute to 35% of all golf-related injuries^{9 30} and this is likely related to the high forces subjected to the back during the swing, as well as low back pain being a frequent complaint in daily life.⁴³ Knee and shoulder injuries were found to be the second and third most prevalent locations of injuries in golfers in previous cross-sectional research published.²⁶ The golf literature has previously shown that elbow injuries are the second most common injuries in amateur golfers.^{44 45} However, we found this to be only the fourth most common injury in this current study.

Most studies identify the volume of repetitive practice and suboptimal swing biomechanics as potential underlying causes of injuries in amateur players.^{45 46} We did not explore swing biomechanics in this study; however, we found no correlation between days per week playing golf and injury incidence. To fully elucidate the relationship between golf playing load and injury, studies specifically targeting this research question are necessary. We found that performing injury prevention exercises to be an independent risk factor for sustaining an injury. This association is surprising but may be at least partially related to the possibility that those who perform injury prevention exercises have sustained a previous injury and therefore, are more likely to sustain a subsequent injury.

The methods used in this study should have value if explored in elite golfers. Such methods including injury burden have been successfully applied in other fields of elite sport^{41 47} and if applied to golf, would add a great deal of understanding to the injury patterns as well as health problems sustained in this cohort of players.

Limitations

The study population contained a relatively high-level skill with a mean handicap lower than the world average. Furthermore, the average amount of golf played (both holes and driving range activity) is perhaps higher than what would be typical of the wider population of golfers. In addition, there was a high percentage of participants performing injury prevention exercises compared with previous studies.²⁶ Therefore, this may suggest the current study population’s volume of golf and preparation is not typical of the overall golfing population. This study was performed over a 5-month period, a typical playing season, and therefore, extrapolations have been made as to the injury incidence over the course of an entire year. In addition, the study size was not powered to a particular outcome measure. The response rate of our study was 57.6% and therefore, non-response bias is possible. However, research has reported the reliability and validity of prevalence data being unsubstantially affected with response rates as low as 18%.⁴⁸

The risk factors used in this study were self-reported, including playing load (ie, the number of days playing golf per week in the previous season). Previous studies have reported challenges in measuring load. We used self-reported injuries and illnesses in this study and recorded self-reported playing load. A previous study on elite cricketers showed poor validity between self-reported and independently observed throwing volume. There were 78% of players who had a level of error >10%.⁴⁹ Furthermore, golfing handicap was not significant as a risk factor for injury, despite previous studies reporting increased injuries with elite players compared with amateurs.⁴⁴ We did not record the nature of practice surfaces in this study. Some clinicians believe the nature of playing surfaces is associated with golfing-related injuries. This was not captured in the present study but may be worthwhile capturing in future work. Further, only two countries were included and future work may benefit from wider international data collection to analyse the spectrum of playing surfaces.

Using time loss as a measure of severity has some shortcomings. For example, long-term consequences beyond those directly related to golfing participation are not captured that is, later disability. In addition, it does not account for injuries where there is no time loss, but that may still limit athlete performance significantly, which is often the case for overuse injuries. This is particularly important in the case of high-level amateur golfers who may be keen to compete despite having ongoing injuries. This was mitigated in our study by using severity score from OSTRC which allowed us to quantify non-time-loss-related consequences. Finally, the side of injury was not recorded in this study. With differences in incidence of injuries in the lead and trail side of injuries, it would be helpful for future studies to record this.

Lower back pain is known to be a common complaint of the general population. We did not use a non-golfing control cohort to compare rates of lower back pain to the general population. This limits our confidence of the association between lower back injuries and its relationship to golf. However, previous studies have shown lower back pain to be higher in athletes⁵⁰ and previous biomechanical data has shown compressive forces in the back during the golf swing to be eight times body weight.⁴³ Mental health was not covered in the golf-specific statement and therefore, not reported in this study. However, we know the burden is high in professional golf⁵¹ and this has also been reported in elite amateur golf with 32.5% of players reporting mental health problems in the 4 weeks preceding a world championship.⁵² Further research should consider including guidance from the recent consensus statement on surveillance of mental health symptoms and disorders in athletes.⁵³

Conclusions

This is the first large prospective study to use the IGF reporting guidelines on injuries and illnesses in amateur golfers. The prevalence and incidence of injuries in amateur golf were lower compared with other similar sports. The lumbosacral spine, knee and shoulder were the anatomical locations with the highest incidence and burden of injury. Given the growing popularity of golf and the large number of players globally, researchers and clinicians should focus their attention on investigating the areas creating the greatest burden for players to further prevent injuries.

Data availability statement

Data are available upon reasonable request.