Opinion & Analysis

Jason Day’s shoulder: More concerning than it seems?

Published

8 years ago

May 19, 2018

If you watched The Players Championship last weekend, you probably saw Jason Day tweak his shoulder on the 16th hole on Sunday. He addressed the injury in his post-round press conference and it caught my attention. Check out this video of the press conference to hear the entire clip.

A few things about what he said stuck out to me:

“Every now and then it happens where my shoulder feels like it pops out, but it’s like more of a sting”
Feeling a “pop” and “sting” in his lead (left) shoulder
Pain is usually during the transition from the top of the backswing to the downswing
He’s been doing shoulder exercises to “stay loose”

Just by watching Jason Day’s swing, it seems pretty evident that he is a hypermobile athlete. This simply means that his joints tend to be naturally looser, enabling him to achieve the tremendous positions he does in his swing. This can become problematic, however, when hypermobility becomes instability. Instability of the shoulder can lead to recurrent and frequent subluxations and/or dislocations of the glenohumeral (shoulder) joint.

Shoulder Injuries in Golfers

Photo Credit: Arrow PT

Shoulder injuries account for 8-18 percent of all golf-related injuries. The most common shoulder injuries to the lead shoulder are posterior instability and acromioclavicual (AC) joint injury. Both of these injuries tend to be painful at the top of the backswing when the lead arm is in near-maximal horizontal adduction (reaching across your body). This position creates a compressive force through the AC Joint, which may cause pain.

Maximal horizontal adduction also places stress on the posterior capsule of the shoulder. During the transition from the top of the backswing to the downswing, the hips and trunk begin to rotate towards the target. In elite golfers, the arms tend to lag behind, creating a tremendous amount of torque. This can lead to something termed the “adduction stretch” in the swing when the arm bone contacts the rib cage and the humeral head exerts a posterior force. Repeated over thousands of times, this can lead to posterior instability of the shoulder (especially in a naturally hypermobile person).

Notice that Day’s hips have fired towards the target, but his shoulders are lagging behind. This is a move that creates tremendous torque and clubhead speed but also stresses the shoulder joint and capsule.

Golfers with posterior instability may suffer from posterior subluxations. A subluxation is when the shoulder slides out of the joint and immediately slides back in. This is different from a dislocation, where the joint remains separated until it is physically put back into place.

Photo Credit: Back And Body Clinic

Symptoms of a subluxation include:

A feeling of the shoulder moving out and in of the joint
A feeling of looseness in the shoulder
Pain, weakness, or numbness of the arm

Should Jason Day Be Concerned?

I’m not here to diagnose Jason Day with any medical condition. I have not evaluated his shoulder, and I do not have enough information to make any kind of an informed diagnosis. But, if it barks like a dog…

Is Day’s shoulder injury something that could negatively impact him in the foreseeable future? I would argue yes. If he does indeed have posterior instability of his lead shoulder with recurrent subluxations during his golf swing, this may be a problem that nags him for a while to come.

Conservative treatment for posterior instability typically features physical therapy focusing on improving rotator strength and stability. The rotator cuff can help stabilize the shoulder during the golf swing and prevent excessive motion of the humeral head within the socket when it is functioning properly. Medical research shows that conservative treatment of posterior instability is often successful, but not for every person. One study reports only 25 percent that golfers with posterior instability were able to return to golf after undergoing physical therapy. This study is old and has a few issues, but still, this is a pretty low percentage.

Surgical treatment of posterior instability is an option. The surgery includes tightening the capsule to prevent further subluxations. One of the major drawbacks of this surgery is that it may be tough to get full cross-body range of motion back after the capsule is tightened. This can make it difficult for golfers to get back to their old swing style after surgery.

Surgical repair of the capsule showing the tightening of the capsule.

Overall, shoulder injuries, particularly to the lead shoulder, can be problematic for golfers of all ability levels. I sincerely hope that Jason Day is able to overcome his shoulder pain and continue to play at his current level.

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Mike Scaduto

Mike Scaduto is a physical therapist who is passionate about educating educating golfers of all skill levels about performance enhancement and injury prevention. He currently works as a PT at Champion Physical Therapy and Performance in Waltham, MA, where he supports high-level and youth athletes on a daily basis.

11 Comments

Kevin

May 20, 2018 at 5:26 pm

What jason experiences is actually the anterior impingement which means soft tissues (primarily tendons) get pinched in the frontal compartment. It is likely to be caused by the posterior instability given jason is such a gym nerd. It wont be surprising if he suffers shoulder pain from doing excessive (compared to what a golfer actually need) weight training. Treatment for the antierior impingement requires addessing the posterior laxity too.
When we look at jason and aaron wise, plus other young fella who drives the ball long and accurately utilising a traditional swing with modern tweak, what is the point of heavy weight training.

Reply Report comment
- Mike Scaduto
  
  May 20, 2018 at 8:26 pm
  
  I would agree that there is probably a combination of posterior instability and anterior impingement/subacromial impingement. The two seem to go together in golf shoulder injuries. And I agree that that could be secondary to posterior impingement.
  
  I wouldn’t necessarily blame that on working out, however. I’m not sure what he does it in the gym and his routine could definitely be contributing, but there are a ton of golfers who lift weights and don’t feel like their shoulders are popping out of the socket during their swing.
  
  Thanks for the read and the comment, appreciate it!
  
  Reply Report comment
Hawkeye77

May 20, 2018 at 11:53 am

Not going to diagnose, but pretty much did, lol. A good read/reminder for anyone experiencing shoulder issues and author may be proven correct in his non-diagnosis. Something feels odd folks, get it checked out!

Reply Report comment
- Mike Scaduto
  
  May 20, 2018 at 8:30 pm
  
  Again, I don’t know the complete picture of Jason Day’s shoulder by any means. His recent injury/media coverage provided a good platform to discuss the most common shoulder injuries in golfers. Although how he describes what’s going on does seem to point in the direction outlined in the article.
  
  Thanks for the comment!
  
  Reply Report comment
ray

May 20, 2018 at 9:58 am

Day is the biggest wimp on tour. If he injured his ankle like Tony Finau did at the Masters, he would be in a full body cast and traction for 6 months.
Capsulorrhaphy (capsule tightening procedures) are fraught with complications and can often result in poor outcomes and severe arthritis.

Reply Report comment
- Mike Scaduto
  
  May 20, 2018 at 8:33 pm
  
  He has certainly had a few medical issues, but I wouldn’t call him a wimp. When your greatest asset is your body and health and millions of dollars are on the line, it is probably wise to be cautious.
  
  Medical literature seems to be saying that capsular shifts/capsulorrhaphy procedures have poor outcomes. They are being done less frequently, especially in relatively young athletes.
  
  Reply Report comment
Point misser

May 20, 2018 at 9:24 am

Smart – swing so hard that you hurt yourself. 0% chance this guy is still able to play when he’s 40

Reply Report comment
JM

May 20, 2018 at 7:07 am

Wow, this hits home because I suffered (I feel) something similar recently. Would golfers with posterior subluxations show up on an xray and/or an MRI? I had something going on for weeks and all of a sudden something felt like it shifted big time in my shoulder and the relief started. I’m sure the cortisone shot shortly after that helped as well. Initial reports on my MRI show nothing abnormal but I couldn’t do things in the gym or play golf for weeks. I found that to be very unusual for someone under 40.

Reply Report comment
- Mike Scaduto
  
  May 20, 2018 at 8:59 pm
  
  JM– Sorry to hear you’re experiencing shoulder pain.
  
  Diagnostic imaging can be a helpful tool assisting in the diagnosis of shoulder pain, but it is not 100% reliable by any means. X-rays would be able to detect any fractures in the bones while an MRI would be able to assess whether ligamentous structures are intact. MRI would not be my go to tool to diagnose posterior instability, unless it happened during a traumatic event (ie car crash)
  
  As a PT, I try to rely more on the subjective history (what the client tells me happened) and actually moving their shoulder around than on MRIs. Research supports this in most cases, the exception being a traumatic injury.
  
  I would suggest seeing a qualified PT to help reduce pain and promote strength and stability in your shoulder! Thanks for the comment JM.
  
  Reply Report comment
Butch Harmon

May 19, 2018 at 9:55 pm

When i saw this story i guessed 2 things. It was his left shoulder and he let go of the club with his right hand on the followthrough. I found the swing on youtube and it confirmed both of my guesses. Jason, do not let go of the club with your right hand!!

Reply Report comment
John

May 19, 2018 at 7:16 pm

He’s made favorite player… but he’s made of glass

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