Golf, a good walk spoilt?

Around the world in over 200 countries around 55 million people, of all ages and abilities, play Golf. Maybe not quite as impressive as the 250 million who play football or the 75 million who play tennis, but nevertheless still an impressive figure.

Whilst an individual’s health is dependent on many factors; their individual behaviour, their socioeconomic status and their occupation amongst other things, there is compelling and growing evidence that regular exercise has both physical and mental health benefits for people of all ages.

There is compelling evidence that regular exercise has both

physical and mental health benefits

A recently published review of 301 individual studies by Murray, et al, (2016) considered whether Golf in particular is associated with the same physical and mental health benefits. I have summarised their findings below.

One of the major advantages Golf has over many other sports such as football, is that you can continue to play Golf well into your old age. In fact, the relative contribution of Golf to a populations physical activity increases with age, not decreases as with many other sports.

Although energy expenditure amongst individuals playing Golf can differ widely, whatever your ability, age or gender, Golf can help you meet, and indeed exceed, the daily/weekly Government recommendations for moderate physical activity.

During an 18-hole round, golfers take between 11,000 and 16,000 steps

Studies looking at calorie usage during a round of Golf differ widely. However, the vast majority of studies classify it as moderate intensity exercise with an energy expenditure of anywhere between 260–450 kcal/hour, or between 530 and 2450 kcal per 18-hole round. Golfers walking between 4 and 8 miles during an 18-hole round will take anywhere between 11,000 and 16,000 steps. The intensity of exercise is obviously higher for those walking rather than using a Buggy, but even those using a Buggy will still take over 6,000 steps.

The intensity of exercise increases with a hillier course, with increased age, with increased weight and for those with low baseline fitness levels. This could be interpreted then as having added benefit for those that need it the most.

Lack of exercise or physical inactivity, is responsible for the deaths of between three and five million people annually, and is one of the top five causes of death in North America, Western Europe and Australasia. Interestingly, three regions where Golf is a popular pastime.

Evidence suggests playing Golf may contribute to increased life expectancy

Evidence suggests that playing Golf may contribute to fewer deaths and increased life expectancy. A Swedish study, Farahmand, et al (2009), compared 300,818 Golfers to non-Golfers, and found 40% lower mortality amongst Golfers. Because of the study design the reduced mortality cannot be directly attributed to Golf alone but the authors speculate that the results correspond to a 5-year increase in life expectancy regardless of gender, age or socioeconomic status.

In providing regular moderate intensity physical activity, it’s highly likely that Golf would have beneficial effects in the prevention of chronic diseases such as ischaemic heart disease, type 2 diabetes, stroke, and certain cancers. I think it is important to point out at this stage that other forms of exercise are available which may have increased health effects. For example, studies have shown that higher intensity exercise generates significantly improved cardiovascular adaption compared to playing Golf.

So, are there any downsides to playing Golf? Well, there’re certainly some to be aware of. For one, there is an increased risk of acute cardiac events during participation in any sport, and Golf in particular. One could argue that there is an even bigger risk by not participating in sport/exercise but anyone with new or existing cardiac symptoms should consult a doctor.

Whilst exercise has been shown to reduce the risk of some cancers such as colon and breast cancer, Golfers are at an increased risk of developing skin cancer due to their exposure to ultraviolet radiation. Appropriate sunscreen and protective clothing will dramatically reduce this risk.

Although a contactless sport, injuries do still occur during Golf. Studies quote the incidence of injury in amateur Golfers annually to be between 15% and 40%. Professionals play more, and are injured more, with annual injury rates of between 30% and 90%. The most frequent cause of injury in both amateur and professional Golfers is from the volume of repetitive practice. Hours upon hours spent on the Golf range!

Suboptimal swing biomechanics are a frequent and perhaps even the leading cause of injury in amateurs. Improving your swing with the aid of a few lessons from a Golf professional, a few minutes spent warming up before you play and improving your physical conditioning in general, all reduce your risk of injury.

The lower back accounts for the greatest overall incidence of

injury in amateur Golfers

The spine, and particularly the lower back, account for the greatest overall incidence of injury in amateur Golfers (18–36%), followed by the elbow (8–33%), the wrist and hand (10–32%) and shoulder (4–18%).

Golf is an infrequent cause of head and particularly eye injury. Injuries in children most often occur when struck by a club, mostly away from the Golf course. Adults on the other hand are more frequently hit by a ball on the course.

Although still infrequent, Golf is also reported to be the sport with the highest incidence of lightning strike, particularly in the USA.

There is conflicting evidence relating to the effect of Golf and other sports on mood and anxiety, with both positive and negative mood changes noted. Personally, whenever I’ve played any sport, if I play well and win my mood improves and my anxiety levels fall. If I play poorly and lose, the opposite is true, but then I’ve never bought into the old adage that it’s not all about the winning!

Improved wellness, self-esteem, group identity and

social connection related to playing Golf

Several studies have described benefits related to improved wellness, self-esteem, group identity and social connection related to playing Golf. However, there doesn’t appear to be any consistent evidence for the associations or effects of Golf on mental illness.

In conclusion, Golf provides moderate intensity physical activity and is an excellent step in the right direction to help you achieve Government recommendations for daily/weekly activity.

Golf is associated with physical health benefits that include improved cardiovascular and respiratory profiles, and improved wellness.

Although there is no consistent evidence for positive effects of Golf on mental illness, this doesn’t mean that there are no positive effects of Golf on mental wellness. I think it is important to reflect on this. In my experience, the social aspects of a regular round of Golf, the competition whilst playing and the reliving of every shot in the club house later, are as important as any proven evidence of physical benefits.

Would I personally encourage people to play Golf? Absolutely I would. Fresh air, stunning views, peace and quiet, birds singing, regular exercise, increased vitamin D levels, social interaction, the 19th hole! What’s not to like?

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