The Golf Intervention
Welcome to The Golf Intervention, the podcast dedicated to helping golfers of all levels improve their scoring and enjoyment of the game using insights from scoring data, science, and proven teaching methods.
Whether you are a weekend warrior or an elite tournament player, we dive deep into process driven techniques which will take your game to the next level.
Featuring two award winning golf instructors and occasional interviews with some of the most influential people in the game, The Golf Intervention will always leave you with actionable insights into your golf performance.
The Golf Intervention
EP 48: The Truth About Pain and Golf Performance with Dr. Andy Royalty
đź“ť Show Notes:
In this episode of The Golf Intervention, we sit down with Dr. Andy Royalty from The Royal Treatment Physical Therapy in Midlothian, Virginia to explore a topic every golfer needs to understand: pain and its impact on performance.
We break down why ignoring pain or “toughing it out” on the course is not only unwise—but often the very thing that holds players back from real improvement.
Dr. Royalty shares clinical insights and practical advice on:
- Why you can’t ignore pain and pretend it won’t affect your swing or results
- The two primary types of pain (acute vs. chronic) and how they’re best treated
- The leading causes of back and elbow pain in golfers—and how to prevent them
- What treatment paths can actually get you out of pain and back to better performance
- Whether or not you should continue playing through injury or after a planned surgery
If you’re a golfer trying to balance the love of the game with the limits of your body, this conversation will give you clarity, direction, and hope.
đź”— Resources & Links:
- Learn more about Dr. Andy Royalty and The Royal Treatment PT: https://www.theroyaltreatmentpt.com
- Subscribe to our newsletter: https://thegolfintervention.substack.com
- Follow us on Instagram: @golfinterventionpod
🎧 Listen now and take your first step toward a pain-free, high-performing golf game.
Today's episode is brought to you by the premium content subscribers on the golf intervention substack. And we would of course like to thank all of our listeners for tuning in, you make it all worth while. If you would like to support the show or sign up for our free newsletter, you can do that at thegolfintervention.substack.com or follow the link in the show notes.
Eric:Welcome back to the Golf Intervention Podcast. have a special guest on the show tonight, Dr. Andy Royalty. He is a Doctor Physical therapy and the founder of the Royal Treatment Therapy and Performance. And I will say, Andy, if your last name is Royalty and you're a physical therapist, you have to name it the royal treatment, you have to, like you had no other choice, right
Andy Royalty:when I came up with the name, I was like, I, I ran the name different names of, you know, businesses by one of my good buddies who's a physical therapist. And, I was like, it's way too corny to do the royal treatment. He's like, no, that's perfect. It's perfect because you're, you know, you're last name and you're, you're going above and beyond for, for your clients. So yeah, that's kind of
Rob Failes:Oh, love it.
Andy Royalty:out.
Eric:You do treatment. So it's like, I, I just don't see how it could be anything else. I think you per picked the perfect name for your, for your establishment there. And Andy is, located here in the Greater Richmond area also where I am. So we have. Some clients who, who work with both of us. And, uh, we go to the same church. If you're watching this on the YouTube, you'll see the chapel hat that I've got on. So, um, anyway, a very, very good physical therapist and trainer and we're excited to have'em on. And really, the reason that we're having him on is because. I wanted to have a discussion around golf and pain. I think it's one of those things that people don't talk about, right? Especially on our end. And I mentioned this on the podcast to Rob before, I feel like people will just straight up lie to us in a like, Hey, tell me about your shoulder. Hey, something going on with that hip. And they'll be like, Nope. And I, and again, I don't think they're lying by the way. I think that they're trying hard to. Sort of ignore the pain, right? And so they have to have this mental place of like, ah, it doesn't bother me. It doesn't bother me. but we all know that golf performance is definitely affected when we have pain. And pain is gonna come from somewhere, right? And so I wanna say that there's, there's ways that we can address it, right? If you go see a, a person who's very smart and good at what they do, like Andy,, we. As golf instructors are not going to be fixing your pain in the golf lesson necessarily. Maybe with some golf swing stuff that we see. But if you need to get work, you're gonna go see a specialist. So we are glad to have you on Doc and really I think that,, a couple questions I had for you to start with before we get into pain discussion is if you go on and you look at his website, which I'll link in the show notes, you'll see he is at a golf course. Right. He's at,, independence Golf Club, which is
Rob Failes:Oh, cool.
Eric:Public facility here in Midlothian, which is a greater kind of greater Richmond area, and the host of the state open in Virginia. so golf is central to your practice. So has it all, have you always been a golfer? Have you always wanted to be. A physical therapist and a and a trainer that was working with golfers. And tell me, the origin story of Andy Royalty here.
Andy Royalty:Thank you Eric and Rob for having me on it. It's an honor. I appreciate it. Uh, but yeah, I mean, uh, I was pretty much a, a baseball player growing up and then it was through a couple shoulder injuries where I got into physical therapy. And then, uh, I've been a physical therapist since 2014, and then before that I was an athletic trainer. over 11 years I've been a pt. And it wasn't until, you know, we moved up here in 2020, um, with my wife, uh, two kids and a pregnant wife. And, and so we decided that, I was like, I'm just gonna start my own thing, because I wasn't with the way. Traditional physical therapy was going with a therapist, seeing, you know, 20 patients in a day, not really being able to give great care. And so it was a matter of me just being really passionate about, uh, golf. And I, I picked up golf, uh, my sophomore year of college, and that's where I, you know, got, got the golf bug. And, and so we had a, a course called Motor Learning in School. Uh, that was all about neurology and how the brain controls the body, and so one of the projects we had to do. Was be able to teach one of our classmates a skill that they were not used to doing. And so I had to teach the golf swing to of, uh, one of my classmates
Rob Failes:Nice.
Andy Royalty:went over the steps on how we taught that. It was really, where it kind of started for me. And then. When I had golfers come into the clinic, when I was working down in Greenville, South Carolina, uh, I used to get super excited. Like I was just like, I couldn't wait for them to come in and me be able to work with'em. They wanted to get back to golf and that's where I was like, gosh, this doesn't even feel like a job to me because I'm teaching somebody how to get back into a sport that they love and they're motivated, they're gonna do everything you tell them. They tend to be much more motivated to get better. Uh, and so that's where I found that like. These people were gonna meet me, you know, halfway. I was gonna give them all I had and they were gonna work as hard as they could to get back to the sport that they loved. And that's kind of where it started. And, and I just, I mean, honestly, like every day that I, you know, 65% of the people we work with play golf. And so just being able to work with those people is. It's honestly like it's a dream. Being able to help golfers get back to playing golf, pain free, that is, that is like my passion and I love doing it. So that's kind of where it all started. And I mean, it's just been one patient after the other, and other people telling other people. It's just been really neat how, you know, we came into contact with each other, Eric was just, you know, a matter of just working with people in the Richmond area and, you know, word of mouth spreading. So it's been, it's been awesome. I love it.
Eric:What percentage of your clientele is more athletic training versus physical therapy?
Andy Royalty:say because we have, I would say it's 50 50 within the 65% of the golfers that we see. So 50% are golfers that are dealing with some type of pain, and they want to just be able to play like. whole 13 without their back killing them. Uh, and then you've got another half which don't have any injuries. They are just in a position where they're losing distance, they're getting older, they know they're losing flexibility. They need, they know they need to do something to essentially get their bodies in shape to be able to hit the golf ball further or just be able to maintain the distance that they have. So. say it's 50 50 as far as the, the golfers that we work with.
Eric:That's super cool. It's, it's fun too. I know on our side with the teaching end, like Rob and I do. It's fun when people come in and they want to, they really want to do better, right? They're, they're, they're coming to see you in that sense.'cause they're like, Hey, here I am and I wanna do better. And so much of our teaching is kind of like, Hey, I'm actually doing worse than I used to and I just need you to help fix me up a little bit. So there's the fix me part of it. And then there's the long term growth part of it, right? Which is super cool. And, uh, through my years in Richmond, it's been 20, almost 20 years in Richmond, I've worked with a bunch of different trainers and physical therapists that I've come to know at the country club away from the country club. And that team approach to coaching is, I think, so important, you know, that we could kind of communicate with one another like you sent me,, a voice, uh, note about a student that we both work with some of the stuff that he was dealing with. And, um, and, you know, we can communicate back and forth about things like that. And I think that's really. It's almost imperative to have that team of people that you can really communicate with. Do you find that golf professionals that you've been communicated with are open to you being a consultant on their students' performance, or is it a little more closed minded or do you get kind of a mix of things?
Andy Royalty:are definitely open to it because they really enjoy what they're doing. They, they want to be able to provide the best. Lesson to the client that they're working with. I think others are so overwhelmed with but then they have the administrative tasks of the, you know, running the golf shop. They've just got so much on their plate.
Rob Failes:Yeah.
Andy Royalty:the last, the last thing they want to do is or answer a text or, or do something extra beyond what they're currently doing. I mean, lot of these, these PGA pros, they're, they're putting in more than 40 hours a week and,
Rob Failes:Oh yeah.
Andy Royalty:know, they're, they're getting a little, they're getting spread thin. And so I that. And so I'm, I try to say, Hey, like, I'm here for you if you want to bounce ideas off of me. And in summer, open and willing to, to chat. And Eric, you're one of those people that, that I love being able to hear from and just being able to bounce ideas, um, back and forth. So, uh, so yes, it is. It is sometimes challenging, but. Uh, you can only just be there for them if they want to be accepting of wanting to discuss, you know, some of the challenges and physical limitations that some of their students are having. Then, uh, some, because, you know, some of these instructors as they're working with their, their students, you know, they're, they're telling'em, Hey, you know, I need you to turn a little bit more into the backswing, or, I want, I want your hands to, you know, not get as steep, but. In all reality, they may be dealing with some type of flexibility limitation that just doesn't allow them to get into that correct position. And so just being able to communicate with the PGA instructor on those limitations can a lot of times allow them to work around them or just know that, hey, maybe we can work on a few other things while they're improving that flexibility or they're working on it over these next couple weeks. So it just gives them a better understanding of how they can work around some of those limitations and, and ultimately. Is gonna help the student, you know, long term and, and be able to provide, you know, the best instruction that you can during those lessons. Does that make sense?
Yes. That makes great sense. Thank you. And that, turns me to my next question here. So everybody, no matter what, wants to hit the ball farther, right? They want to hit the ball a lot longer. And I think that as soon as they think that in their mind, they're jumping to how fast can I swing the club? You know, there's also. A launching of the ball element to it that I think we can accomplish in lessons that are way easier than just swinging and hitting it harder. But also when you take on club head speed as an improvement, there's some real considerations there. Are there not Andy,'cause I think that if, if the body isn't really ready to take that on, can't that be really detrimental and potentially even leading to injury in a way that's really gonna set the player back. Where do you see him from that standpoint?
Andy Royalty:Right. Yeah, I, I think that in regards to, there's so many ways to hit the ball further. So I mean, there's people that can, they can have the same exact swing speed, but still hit the ball further. I mean, a matter of just hitting it more on, the center of the club face is gonna allow for you to have a better smash factor, which is gonna lead to more ball speed. Um, there's things you guys can do by having them shallow out the club a little bit more, change the angle of attack, decrease spin rate. So there's a lot of things that. That, that you guys can do on your end to be able to help them hit the ball further. And then there's other things that, you know, we can do from a physical therapy, uh, training perspective, uh, where we can essentially get their body moving a little bit more efficiently so that they can increase the swing speed. Um, so I think it's kind of multifaceted when it comes to. People wanting to increase swing speed and there's the hot topic of speed sticks and, you know, super speed protocol, the stack system. And I think those are good and people can get more swing speed by using those things. But oftentimes what can happen is if they don't have the adequate flexibility, the adequate strength, uh, to be able to contain, uh, be able to handle that speed Can, you know, uh. Result from that. So that's something that we've seen before too, where people have come to us when they said, Hey, I've been doing speed training and I, you know, pulled something in my back when I was, you know, you know, level three trying to really push it. Uh, and that's where we kind of have to sit back and say, Hey, like you're, we gotta take it a few steps down and really focus on flexibility first before we start really implementing the speed training. Uh, but I don't want to get too much into a, down into a can of worms yet. Uh, but yes, I. I see that pretty often.
Rob Failes:Like you said, yet we are definitely going down the, the, into the can of worms, just not yet.
Andy Royalty:I, I have a quick Um, so. Have y'all, um,'cause I know y'all have had some other physical therapists on, on the podcast. you, have y'all, um, Rob, especially, have y'all worked with other physical therapists, uh, or, uh, personal trainers that have, uh, your students have been working with, that you guys have been open to, like discussing things
Rob Failes:Mm-hmm. For sure. Yeah. I've had at least three now, um, that I've kind of cycled through. Um, and then now it's to the point to where if they need help. Um, Dr. Michael k, he's a, he's a physical therapist out in. Uh, west Coast, uh, working with Tony Greco and Chris Walkie, um, and they've got an awesome online program that I'll, I'll send students to. That's, that's the limit, that's the limitations of what I've, what I've found. And, and, uh, I, I trust Dr. Mike with, um, my education and kind of what I do with my students on a daily basis. Um, so I have no, uh, no hesitation to, to send my students his way as well, so.
So now I want to get into pain, pain itself. I know there's a couple different types of pain. I'm not an expert in this, obviously, that's why we're having you on the show today. But, from my understanding, there's acute pain and there's chronic pain. What is the difference between acute and chronic pain? How do you address'em differently? What about the understanding of how that works and affects the person? And how does someone like you take that on to help alleviate whatever type of pain they have and put'em on a track to being a pain-free person in life? And golfer also.
Andy Royalty:Absolutely. Yeah. So you have acute pain, which is essentially pain that's been lasting less than six months. So once somebody's been dealing with pain for longer than six months, it becomes chronic. And so, uh, acute pain can be anywhere from, uh, an event that occurred where they just. They have been hitting off of a mat, uh, and taking a lot of swings and a lot of wedges, and they're somebody that takes, you know, more, more of a deep divot. Uh, and they end up with, you know, one swing and boom, my elbow's been killing me
Rob Failes:Hmm.
Andy Royalty:of like an acute event. Uh, but then you get people that been like, yeah, I've been dealing with this back pain, uh, for about a couple months now. It's still considered acute and it's just, it. I don't remember doing a specific thing that caused it. It just kind of came on gradually. with those people, I mean, uh. We find that if somebody's been dealing with symptoms less than six months, the chances of them getting better are fairly, pretty quick as far as timeline goes. Uh, somebody that's been dealing with symptoms for a while, uh, we have found that it's very interesting that. Because you get people that are like, oh, I've been dealing with back pain for 20 plus years, and it's like, okay, like what's exactly going on here? And we've, we've found that there's, um, Adrian Lowe is a PhD, uh, neuroscientist, that, that studies pain. And, uh, and he, they found that tissue healing takes about a year for tissues to heal. so, so why is somebody having pain past one year? And the question becomes is, is the, is. Is, is the tissue still injured and that's why they're having pain. But what they found is that that neurological signal, uh, in the body, you know, telling the brain that there's a threat, uh, going on in the body, which is like the pain system, uh, the
Rob Failes:Hmm.
Andy Royalty:system going off, they found that these people, their were healed, but they were still having pain. It was more of a. Neurological, uh,
Rob Failes:Wow.
Andy Royalty:that feedback loop was going so long. And so those are the down with and say, Hey, like, you know, it takes about a year for those tissues to heal and you're dealing with symptoms greater than a year. This is, uh, that's where you try to educate them and there's like a little graph, I'll draw people on like a whiteboard and kind of explain to them that we have to do exercises and things that are gonna help decrease that sensitivity of the brain and, and, and limit that sensitivity to where they can start to do activities and exercises that don't set that alarm system off. Um, and that's how you tap into the system. Uh, but those are, that's kind of. pain in a nutshell, but when it comes to working with people that are dealing with symptoms like less than a year or less than six months, usually what we're doing with those people is are trying to figure out like, okay, where's the pain coming from? Is this like a muscular problem? Is this like a, a tendon problem? Uh, is this a ligament problem? Um, tendons is what connects muscles to bone and ligaments is what connects bone to bone. Okay? And so people can be dealing with, with pain and it could be, you know, bone related or one of those soft tissue structure, uh, soft tissue structures that's causing the discomfort. And so really when I evaluate somebody, I figure out, okay, where's the pain coming from? So we'll do like special tests. We'll try to figure out. We'll palpate, we'll figure out like where's the pain coming from? The second thing we want to figure out is like, what is the underlying problem here? Like, why did this happen in the first place? Is it because of poor range of motion, or is it because of weakness around that area that. That is causing, uh, you're not able to control that joint very well. So you're putting too much stress in that area. So therefore you start to overload the tissues, which then leads to injury. Uh, so those are the things that we try to figure out during our exam. Um, and, but for example, most often, if we're dealing with somebody with low back pain, some of the things that we see with those people are. When the golf swing end, it's a, it's a violently rotational movement, and so you need to rotate through the hips. You need to rotate through the mid back, and oftentimes what happens is end up rotating too much through their lumbar spine, which is like the lower back. And that lower back isn't really made to rotate very much. There is a little bit of rotation involved in the biomechanics of the the golf swing. But most of the rotation occurs through that upper mid back and through the hips. And if somebody's tight through the hips and or through the mid back, their body's gonna try to get it through that lower back. And that's where a lot of issues can occur. So oftentimes when I'm seeing somebody with low back pain. Usually the first thing we're checking is like, how's their hip mobility? How is their thoracic spine mobility? And oftentimes they're stiff in both areas and so not so most physical therapists, they're gonna want to treat the low back, which I think is really good. But if you don't fix the underlying problem to why this happened in the first place, they're gonna end up going and playing multiple rounds and being like, gosh, my back flared up again. What the heck? What's going on here? So with those people. We'll do things well, I kind of separate it into three phases when I work with clients. Phase one is going to be to try to get their symptoms under control. So if it's like the muscles are guarded because they're, you know, the brain senses pain in that area lot, oftentimes they'll tighten the muscles around the joint to try to protect it. And that's like your body's way of like creating stability and. The muscles being really tight around that area can cause discomfort. And so if the muscles are really tight, guess what happens to the blood flow to that area? It gets restricted, and so oftentimes what we'll do is like we'll do some dry needling where we take really small needles like acupuncture needles, and go down into the muscle. And we will add in a little bit of electrical current to those muscles and get'em pumping. And that pumping effect causes fresh blood flow to come to those muscles, get them to release. Then from there we'll do like soft tissue work. Um, that's like in phase one. We'll do everything we can to get their symptoms under control. Um, that has been shown to be really beneficial. We had a
Rob Failes:Hmm.
Andy Royalty:that had been, had been dealing with. Back pain for and he couldn't rotate in the golf swing. Once we dry needle his back and got him really loose, he was like, this is the best my back has ever felt. He was just like amazed at the, at the, the results of it. Um, but then from there we worked on. two, we started to work on more mobility through the hips, through the mid back. Uh, did what we could to, to loosen those areas up with some more manual therapy. We'll do like dry needling to those areas, or we'll do soft tissue work or we'll do manual stretching. And then we'll teach them exercises to start moving within that new range that they gain. And once they start to, to move through the hips and get those hips moving and start isolating those areas and the mid back. from there, they start to learn actually how to rotate through the mid back and the hips. And then from there, they're taking a lot of less stress off of the, the lower back, and so then they start to feel a little bit better. But then phase three is really all about strengthening and stabilizing that area and teaching those muscles how to control that movement, which is really, really important because that's, that's really where the rubber meets the road. Yes. We get them symptom free, we get them. Oh, uh, we get them symptom free and then from there we end up essentially strengthening and getting them to control that area, and that's what decreases the chances of like their low back pain coming back down the road. So that's really our focus when it comes to working with clients is a, figure out where the symptoms are coming from. B, figure out what's the underlying issue that's leading to this, and then three. You know, how can we keep this from coming back
Rob Failes:Yep.
Andy Royalty:And then from there they, they routine that they're to be working on like a couple times a week so that they can continue to build strength and decrease the chances of like, you know, these issues popping up again. Okay.
Rob Failes:Yep.
Andy Royalty:So that's, I would say that's the biggest thing in a nutshell, um, on when we're working with golfers that are, that are dealing with pain. Does all that make sense, Rob and Eric?
Eric:Oh
Rob Failes:For sure.
Eric:it makes
Rob Failes:Yeah.
Eric:sense. And think about, think about the, the, the normal American that's playing golf, right? We're sitting at a desk all day.
Andy Royalty:Mm-hmm.
Eric:are getting tight. We're staring at, we're staring at our phone. So we're getting the you know, like forward neck look,
Andy Royalty:Right.
Eric:a sudden Andy says, Hey, if you have a tight upper thoracic spine and bad shoulders and tight hips, you're gonna have a hard time. Uh, with your lower back and that guy's actually buying speed sticks and things and trying to hit bombs, and it's like, no, no, no. We've got some work here on the structure to deal with. Right? And I will tell you that this is what I see all the time, we can see it in the bay. Like we can see the, you know, you can see the look, you can see the hips and you're kinda like, know, you have to have a little bedside manner with the student at times.'cause you're kind of like, oh, well how's this feel? And how's that feel? And to offend anybody. But you also, when they're trying to
Andy Royalty:Correct.
Eric:sort of the high end of their performance, you also as the coach have gotta be like, Hey, um, maybe the capabilities aren't quite there physically. But maybe there is a solution to that as well. Right. So Rob fails, how do you, how do you take on that approach with the student who's you clearly see they don't have the movement capabilities, but they're trying to really get
Rob Failes:Mm-hmm.
Eric:it. So what's the, what's the discussion like for you on that end?
Rob Failes:For sure. Yeah. And just based off of my education, what I try to do is I try to give them the best starting point as I possibly can. Um, I see a lot of people who are, their center of gravity is pitched way, way, way forward. They do not have an ability to take a full inhale. Um, I see them walk poorly. I see them, um, just in general standing in a way. Um, that's decreasing that space, decreasing that ability to get air, to get blood flow into those places. So, um, I try to get their entire foot on the ground. I find like if I can get them to secure a heel, to secure a midfoot, to secure a base of the big toe. And then if I can get them to just give me a full inhale in a, in a way that is expanding the ribcage, is expanding the area around the pelvis as opposed to just keeping it up in the mouth. Um, and if I can get them to, again, just moved, it's just give me a little bit of like bounciness to what you're doing. Like gimme a little bit of like, you know, you can, you can skip, you can jump rope, you can, um, you know. Anything that you can do that's, that's gonna get, um, essentially your Dr. Kay calls it your guts, but like anything you can do to get your guts up off the pelvic floor, um, is what I try to, to encourage not only in the golf swing, but just. And the warmup even, uh, before they start swinging. So I try to get them into a warmup. I try to get them standing better. I try to get them breathing better. And then I see a lot of golfers who have concepts in their swing that's giving them a lot of pain too. So it's like side bend is like a good one. Like, okay, people have been told that they have to like side bend in their golf swing. It's like. Yes. Like if you hook me onto 3D, you're gonna see, like if you're separating these planes in motion, you're gonna see like the side bend graph going up. But does that mean that your spine is isolating this kind of very two dimensional kind of side bend movement? No, that doesn't happen in a golf swing. So. You know, from there it's a lot of concepts. Like they think they're supposed to turn in a golf swing, which is keeping everything kind of, all these segments kind of locked together and kind of moving all kind of in the same speed at the same direction. And I try to get them to actually separate and try to create, um, basically a relative motion where one side's moving forward relative to another. Um, and that's pretty much where I stopped anything as far as like, hey, but like, you know, what do you think about this? What do you think about that? I was like, all right, well that's a little bit above my pay grade. But what I find is that if I could just get people standing better, breathing better, um, then I just had a client the other day like, who, um. He, he kept kind of like referencing his lower back and I just had him stand in kind of like a fencer, kinda like a, like a warrior two pose and just breathe for me a little bit. And I just kind of cued him a little bit to like, Hey, can you get some, can you get some air down here? Can you expand back here? And like. You know, about 20 minutes into it, it's like, yeah, lower back feels better. So again, it's just a lot of that really kind of simple stuff that we learned from, um, Dr. K, but I don't wanna talk too much, Andy. It's, uh, it's, you're, you're the expert here, so, um, any thoughts on that?
Andy Royalty:uh, some of the guy or I, I feel like most men are very, uh oh, what is it? Very stubborn.
Rob Failes:Yes.
Andy Royalty:So they would rather take like four, 200 milligram than go see a physical therapist.
Rob Failes:Yes,
Andy Royalty:You know what I mean?
Rob Failes:correct.
Andy Royalty:way easier, right. don't have to spend time outta their day to
Rob Failes:Yeah.
Andy Royalty:So, um, I also find that as well, that. That some people are just like, yeah, yeah, I've been dealing with this back pain for a
Rob Failes:Yeah. Yeah.
Andy Royalty:okay. You know, it's, it's gonna be fine. I'll just pop a few and get through my round. Um, and so you try to work around that, right? Because you don't want to like
Rob Failes:For sure.
Andy Royalty:need to see this physical therapist. And in their mind they don't really have that, you know, so you
Rob Failes:Right.
Andy Royalty:figure out who you're working with. You gotta kind of like plant that seed and okay, this guy does seem very, or this female does seem very interested. You know, getting help. Um, so yeah, I see it both ways. Some people are willing to get the help. Some people are just like, Hey, I've been dealing with it for this long. I'm, I want to go ahead and, uh, and just continue on my merry way.
Rob Failes:Yeah,
Eric:It's that whole
Rob Failes:for sure.
Eric:thing, right? It goes back to, do I really wanna learn? Do I really want to improve? Can I get. Get something that's gonna help me grow as a person deeper, and then just like, does my back hurt a little bit. Like, I think you just have to take forward sometimes. Um, I had one though that was worse
Andy Royalty:Yeah.
Eric:this is kind of what brought up the, the idea of having you on, because I had someone come in to
Andy Royalty:Yeah.
Eric:was a great athlete, never met him before, and he was like, Hey, um. Yeah, I've played golf on and off because I've got the, I've got a herniated disc and I go, I get, you know, physical therapy. He's young. A lot of speed, tons of speed, essentially taught him how to stand like Robbie just said, like, this is someone who was taking golf lessons and getting physical therapy, and I simply asked a question like. What did they tell you about your swing that's causing the pain? Because it's from golf, right? He's like, yeah, and he said Nothing. They told me nothing. I said, not the physical therapist. Not the golf instructor, no. So he clearly went to a physical therapist that wasn't focused on golf, right? Like they were trying to help did a good job of it, like he was feeling better. But
Andy Royalty:Right.
Eric:we gotta figure this out right now, or you're gonna keep going down this road. And so. Um, you know, we, we did it from our end, like working on standing like, like Rob said, and try to get him. And it, if he, it immediately helped him, like immediately. He came back a month
Rob Failes:Yeah.
Eric:yeah, I'm playing the best golf of my life. I don't have any back to speak of. um, but
Andy Royalty:Awesome.
Eric:part to me is like both us as the PGA golf instructor and hopefully as like in the bigger medical sense like. If someone's having pain from golf, do you think they should probably go see a PT that has a little bit more golf centric experience? Is that I think that would probably like, I think the assumption that every PT understands the golf swing is probably not true, but I'm assuming that. What would you say about that in your
Andy Royalty:Yeah, that's so, so yes, I think there's PTs that are gonna help some of these golfers get out of pain, but if the reason they're getting into pain is, uh, they've got pretty good mobility and flexibility, they may have some weakness. And so the PTs gonna work on some strengthening, but they may be doing something mechanically that's just putting a ton of stress. Uh. You know, on their elbows or, or their back. And so that's one of the things that we like to do is take a down the line and a face on view of the swing and just see it. Is there anything excessive going on in the swing, uh, like reverse spine angle or, um, or they're, they're, they're, you know, casting significantly, um, causing that medial elbow pain from. Uh, you know, on the trail side. So those are some things that we look at our risk position at impact, um, in regards to elbow discomfort. And then also, you know, if they're doing some excessive bends, uh, during the swing that we, you know, want to take a look at that and see if that potentially is a reason, um, that they're having issues. So
Rob Failes:Can we back up to the, um,
Andy Royalty:Yep.
Rob Failes:can we back up to what you found with, with. Is there a correlation in risk, position, and impact with pain that you've found?
Andy Royalty:somebody's dealing with, like, if they're writing and they're dealing with medial elbow pain on the right side, which is their trail side, usually in the position of, so you have muscles on the inside of the forearm that. Grip and they flex the wrist. And so those muscles right there attached to the of the elbow. What we find is that when they're coming into contact with the ball, at impact, they're casting or they're scooping and their wrist, it's in this position. At impact and everything's really tight, and then they're making contact with
Rob Failes:Mm-hmm.
Andy Royalty:and so it's putting a lot of stress on the inside of that with somebody that's having trailside lateral epicondylitis on that outside elbow. They tend to have their hands more forward,
Rob Failes:Hmm.
Andy Royalty:rare. It's usually, um, If they're gonna cast or scoop it's pain on the inside of
Rob Failes:Mm-hmm.
Andy Royalty:side. Elbow and pain on side or the outside of the lead side elbow is what we find is most common, these players because as you know, wrist position, uh, hands a little forward and impact is, is a great position to get into, uh, for a lot of the golfers. And so if they're doing that casting, they tend to cause a lot of discomfort on those elbows. Does that make sense?
Rob Failes:Yeah, for sure.
Andy Royalty:Okay. Yeah, we had that so, he was dealing with like significant low back pain and we took a down the line of view. And we saw hi, his feet were so closed to the target and, and, and I think one of the instructors was having him, you know, try to do inside to out swing. So he was having him start with his feet
Rob Failes:Hmm.
Andy Royalty:closed,
Rob Failes:Yeah, it's unfortunate.
Andy Royalty:out swing. was just and just torquing the heck out of his low back. We had him just open his stance up a little bit where he lined his feet up with the target and then line his shoulders up with the target to, to even those out. And all of a sudden he's like, gosh, my back feels way better. I'm not like, you know, coming across and just torquing the heck out of it. I mean, little simple things like that if, I think it's really
Rob Failes:Yeah.
Andy Royalty:to be able to look at the swing because most physical therapists, they have no idea at in the swing. And that's, you know, going through the, the TPI Medical level two certification just allowed us to look at a lot of the mechanics and things that golfers can go through that, um. That are some red flags that are happening. And this is something that we love. Like, Hey, this is what I saw during the video when I was looking, you know, and passing that information off to you guys to say, Hey, what are some things that you guys can do mechanically from the swing to be able to potentially offload some of those structures? And I think that's where the communication is really key. And then a lot of the students are like, wow, like. I feel like a PGA tour player, like I've got a team around me communicating. This is awesome. So
Rob Failes:Yeah.
Andy Royalty:it's just a, a great way to provide a high level of service for the students.
Rob Failes:And then what are some kind, I mentioned earlier about concepts, but what are some of the, the concepts in terms of how we're standing. Even in swing that you find that are problematic, more from like a, you know, in all of your experience, what are some of the more common, common concepts that that golfers need to get away from? I.
Andy Royalty:of the big ones for us, we'll see down the line. Is extension that occurs where somebody, they, they come into the back swing and their hips, we draw a line on the back of their hips and they look really good. Their right butt cheek, if their right is on that line. And then when they go to, to start the downswing, they tend to stand up or move closer to the ball and don't learn how to actually rotate the pelvis. Uh. Sometimes what we find is these people early extend because they're starting with weight through their heels or their center of gravity is actually back behind their ankles. And so one of the things that we like to look at from down the line is, is the outside hip bone. their greater trocanter here on the outside of the hip, which is like right near the pocket line. Is that directly straight down over the lateral ankle. So like the outside ankle bone here, see that outside ankle bone. So we like to see is that in line? Sometimes these people's hip bones are behind their. Ankle bone. And so in order to gain balance or uh, in order to keep balance and stay upright, their center of gravity has to move forward closer to the ball, and that can cause a lot of issues. They move closer to the ball and all of a sudden they gotta bring the hands in and go more out to any type of swing. So then they come. Have an out to end swing path of like four degrees and then they have to open the club base and actually in order to actually get it to go straight, and then they end up with a high spin rate and they have loose distance. So that's kind of one of the things I see when it comes to people standing is they're just, they're set up, they're center of gravity is so far back that when they go to swing, in order to maintain their balance over their base of support, they have to move closer to the ball. Does that kind of make sense?
Eric:Oh yeah, that,
Andy Royalty:Yeah, that's one thing I'll see.
Eric:observational, but that, alignment, of the hip sitting
Andy Royalty:Yeah.
Eric:behind the ankles. Is
Andy Royalty:Mm-hmm.
Eric:one when typically when people are having back pain, I see that a lot, but the, probably the people who come in and say, Hey, I've got the worst pain. Like I want to quit golf right now, which I get probably several times a year. Is that set up? And then also way too much like excessive lateral motion of the pelvis, so they're moving forward'cause they sat back too much and then they're sliding left knee, staying like very soft and the left hip is then extending over the front foot and then all of a sudden, you know. They're just, they're toast at that point, you know, the, the lower back has taken so much and they're, you know, to Robbie's point, they're trail side bending at the same time because their hips are far forward. And it just, all that pressure that
Andy Royalty:Yeah.
Eric:that seems to build up in the hips and the lower back, just really hard to
Andy Royalty:Yeah, we'll see. We'll see. Uh, so lack of hip mobility, so inability to be able to rotate the pelvis. Um, so one of the things we'll see is, is people, uh, they'll sway and then they'll slide towards the target to create that momentum, um, or that swing speed. And they don't really have the adequate hip mobility to be able to turn the hips and be able to kind of stay centered. Uh, and so they end up. Swaying a little bit too much, and then that causes them to feel their head's moving and then they're like, okay, they're trying to hit a moving target. So that can lead to poor ball striking. So that's another thing that we'll see is, um, from the face on view of if they're swaying or sliding too much. Yeah, the human body is, it's pretty amazing. The human body is amazing and just being able to understand the biomechanics of the swing and being able to, uh, figure out like. I think it's just so cool. Like, that's the reason I love what I do, is because you're almost like mechanic for a car. You're, you're a mechanic for the human body. You're trying to figure out, like based on their swing, you're using all of this data and all of these, these, uh. All, all of these, uh, inputs of measures, tests, range of motion measurements, strength measurements, coordination, uh, you're looking at their swing on video and you're, you're putting all these pieces together and you're creating like, okay, this is what's going on, and if you can figure it out. Then come up with a game plan to be able to solve it. I mean, these people will, they'll be like, man, I've been dealing with this for like five years. Nobody's been able to figure it out. And like finally somebody's able to tell me, Hey, this is your issue. And for you to be able to like, show it to them and, and say, Hey, this is exactly what's going on and this is the plan that we need to do to, to get it going and get it to improve. And then they're like, okay, let's, let's go for it. And then you start to. Implement that plan. They start to do the homework that you give them. And like that is so addicting they come in after weeks of working with you and they're like, is the best I've ever felt. I've even shot, you know, a better score. I mean, we had a guy. The other day, uh, last week, he came in and he was like, man, my back's feeling loose. Now I can actually create a good turn. And I just, I broke 80 for the first time in over a year, and he was like ecstatic about it. I mean, like, that is so addicting to be able to help people through that. It's like it's, you're not working in your life when you have people go through those experiences. So anyway. I love it. I mean, you guys have people come in and tell you like, I shot scratch for the first time ever.
Rob Failes:Oh yeah.
Eric:it's,
Rob Failes:Yep.
Andy Royalty:I mean, is that
Eric:to your
Andy Royalty:or what?
Eric:it's, it's very But the most rewarding is, like you were saying, when
Andy Royalty:Yeah.
Eric:Performance plus feeling better. And I tell people all the time, and this is for the listener, okay? Like if you have a golf issue, like golf performance and you have pain, you don't have two issues. You have one issue, which is you gotta get the pain figured out, performance piece of it is so.
Andy Royalty:Yep.
Eric:compared to what's going on in your body, right? It's something that you have to listen to it's one of the only reasons, and we, we talk about this
Andy Royalty:Yep.
Eric:of like development in the swing, which I don't know if you, if you've heard that episode, Andy, that we did about sort of like when, when is the right time to change your swing? And we, we kinda laid out that the number one right time to change your swing is when it's either causing you pain or about to cause you pain. it's like,
Rob Failes:Yep.
Eric:that's the number one deal. And, um, I think that I, I believe that 100%, but I think that golfers don't ever think about that. I mean, general, I'm making generalizations, but hey, I wanna play better. You know, I need to swing better. I need to swing faster. I need to do this better. But there's a whole hierarchy of like understanding how the body works and how the swing works and how you develop skill and pain is absolutely a huge part of it that nobody talks about. And I'll tell you, I'll tell you a quick story. I had this guy I taught, I've taught him for 20 years,, and he's a good friend of mine and we joke around a lot. We were working on his game, he was playing bad, he was frustrated, and he was coming to see me like it felt like once or twice a week. And we're doing lessons and, and he's like, yeah, I'm just not playing well, I played terrible one to this. And then he's like, limping off the range tee. And he's like, oh, and by the way, uh, I'll be out for six months. I'm getting my hip replaced. And I'm like, well,
Rob Failes:Nice.
Eric:it was like three months or something. And I said. You're just telling me now that you're getting your hip replaced. Like think about all the
Rob Failes:That's fantastic.
Eric:he's a listener to the show and you know who you are, sir, you're listening to the show right now.'cause we joke about it, but the fact of the matter is think about all the things that went on for months and years leading up to needing a hip replacement that in your golf, you're just like, eh, you know what? It doesn't bother me. You know, like I can it or whatever. And. You know, we're like that.
Andy Royalty:Yeah.
Eric:be a little bit resilient. Men and women both. a man thing generally, and so you,
Andy Royalty:Right.
Eric:be, if you, if you're dealing with something, you have to realize that it affects your golf game. Let me ask you this direct question, Andy. Somebody comes to you and says. I saw the, I saw the orthopedic. He says, I need my knee replaced. Okay, but it's June and I'd like, and I'd like to do it in November so that I can kinda rehab during the winter and then start in the I know what they, I know what I tell
Andy Royalty:Right.
Eric:they ask me that and say, Hey, can you help me get through the season? I've got some advice on that. my side, golf performance wise, what is your advice there from the PT side of it? Do you take that on or do you offer them advice, uh, in a
Andy Royalty:Oh, absolutely. So this is great because this has happened. This happened last year. This has happened. This is happening currently right now with someone so. I, it really comes down to how bad is it for them. So if it's like debilitating and they're like, gosh, I can't even sleep at night. It's killing me. They've done injections, we've had Synvisc shots, um, I've done pt. Like, it's just not improving. Then. they're like, I just gotta get this thing done. Then it's up to them. It's really, it's kind of like, okay, well, all right. Go ahead and get the knee replacement and then just know that you're gonna be outta golf for the rest of the season, and then by spring you're gonna be really rehabbed and ready to go. But most of the time, I'd say 90% of the people they want to keep playing golf and they want to push it off till November. And I'm all for that. And most physicians, especially the ones that play golf, they, they understand, right? Because golf is great, and especially during the warmer months. So they'll say, all right, we're gonna, we're gonna try to push this off as long as you can until November. And they're gonna give them more, you know. Uh, conservative type treatments like the injections, the cortisone shots, or, um, vis shots, uh, or like a knee brace or, or some type of, um, ster, uh, like a, a heavier non-steroidal anti-inflammatory, like meloxicam or some type of, um, oral, uh, medication that they can take to kind of like keep, get them through the rounds. Uh, and so. That's most of the time what people are doing. And then they'll, they'll opt in for the surgery. And I, I think getting, if I was to get a knee replacement, it'd probably be November timeframe because, you know, winter time you're not really gonna be playing much golf, and then by March, April, you're, you're golden. You're ready to go. So that, I would say that's kind of the answer I have. It just depends on the person and what their overall goals are and how bad it is.
Eric:Yeah, my, my worry
Andy Royalty:question, Eric. I love it.
Eric:the ch is how much the swing changes when you're compensating for the then you're gonna work into a new swing.
Andy Royalty:Yeah.
Eric:then you're gonna come out of it. And it goes back to what you mentioned earlier about the pain still on in your brain for afterwards, right? So
Andy Royalty:Yep.
Eric:it's like I'm gonna
Andy Royalty:Absolutely.
Eric:compensation, probably put some stress on the other side of my body that's undo play crummy.
Rob Failes:In Whack-a-Mole, right?
Eric:Yeah, play crummy golf anyway. Take a bunch of anti-inflammatories that are terrible for my guts and then I'm gonna get the surgery done and then I come back and have to fix, I have to fix all the that I made in my swing, and there's no right answer. And I get, I
Andy Royalty:Yeah.
Eric:that they make, but to your point, I guess
Andy Royalty:Yeah.
Eric:just not as bad as others. But man, it's, it's
Andy Royalty:I.
Eric:like, you know, maybe just. It. You gotta make a decision and realize like no matter what, you're still gonna play worse. Golf in those like four months. up to it and it's not gonna
Andy Royalty:Right. Yeah, you
Eric:you get an injection, in my opinion.
Rob Failes:Yeah,
Eric:that's what I've
Rob Failes:like if it's a, if I get it, if it's like a, uh, like a time like, Hey, I'm only gonna take this trip to Scotland once, this is the only time that I'm gonna have, be able to do this. So it's like. to, I want to go play in Scotland. Or it's like, Hey, I get to go play Pine Valley or Augusta. Like, all right, okay, whatever. Like, just, but if it's not something like that, then, then I'm with you, Eric. I think, um, I think you, you, you try to get it resolved as, as quickly as possible or as early as possible and just, just eat the, eat that one in season and just, and just, You know, accept it.
Andy Royalty:You don't want to poor motor patterns and have, and, and ingrained some, some poor swing habits.'cause obviously then you guys have to work a little extra harder to try to get'em out of that. I mean, it may be a good thing they may see you for more sessions or something now. I'm just kidding.
Eric:it's all good. Well, um,
Andy Royalty:Yeah.
Eric:you have anything you'd like to add here at the end of the, uh, at the conversation? having you on and, and, uh, either one of you, if you have
Andy Royalty:Yeah, man.
Eric:I just wanna say on. I know it's hard to. We're all in the
Andy Royalty:Appreciate it.
Eric:during the day and we got kids at night. We're trying to fit this in in between, but I kind of felt like there was a story that needed to be told, not my world. Right? And that's what I think that there is a line between people's specialties, right? And Andy Royalty will look at golf swings and try to help people, but not in a way that's overlapping, what a golf instructor's gonna teach from a golf skill standpoint. And I'm gonna have some thoughts on
Andy Royalty:Right.
Eric:And Rob fails will too, in a way that doesn't overlap.'cause it's not our area of expertise, right? That's why you have the name. Indy royalty, right? And so I just appreciate those relationships because if we could keep those communication lines going, golfers can just benefit in so many different ways. But end of the day, The golfer has to be open enough to be like, Hey, I can't just ignore what's going on or think it doesn't affect my performance. I've gotta at some point go, you know what? It, it may affect my like, oh yeah, my rotator cuff's partially torn, but it's not affecting my swing. No, no, no, no. That's affect. I
Rob Failes:No, it is.
Eric:hear that once a week and I'm like, no, no, no. Like that's definitely affecting your swing. We, we just have to accept it. I mean, we can maybe work around it, but it's definitely affecting the swing. So I appreciate you coming on and,
Rob Failes:I.
Andy Royalty:Yep,
Eric:and, I just wanted to say that, that think that there is a, there is a solution to some of this for people and if they just take the time to. To kind of work through it. It's not fun. I mean, I was dealing with some hip pain and I, I texted my friend, Dr. Andy Royalty and I was like, Hey man, I saw this Instagram post you did about hip pain. And I think that's me. Like, what do I need to do? And you help me out. And it was just is really nice. And it's helped my hips do not hurt anymore.
Andy Royalty:That's awesome.
Eric:and everything is fine. So, um, that's what I had time for in the moment. But I, anyway, I wanna say thank you for coming on. Any thoughts, Ralph fails for Andy. Before we give him the mic for the one last minute.
Rob Failes:No. Yeah, no. Appreciate you taking the time and coming on and, and sharing your expertise and, uh, yeah, looking forward to, uh, to hopefully maybe sending hope, hopefully not, but,'cause I don't want my students to be injured. But when, when, and if that's the case, send, send some folks your way, so I appreciate it.
Andy Royalty:able to, to, you know, make a text or a call and just say, Hey, you know, my student's dealing with this, this, and this. What are some things? Because if I can be able to add value to what you guys are doing and say, Hey, have'em tried these things, and it saves them the hassle of having to go, you know, jump through hoops to, to come out to see us, then to me, that's a win. So. Yep.
Eric:a
Andy Royalty:Thank you for having me. I appreciate it.
Eric:So we will link,
Andy Royalty:Yep.
Eric:The royal treatment. On the, uh, on, on our, on our show notes, you have to check it out'cause he has a good website and he does some good social stuff. So you wanna follow him on the socials and we'll link those there as well if I can figure out how to do that. And we just wanna appreciate you coming on, sir. Any last things you want to add to the people? Tell the people anything you want. Andy, the stage is yours.
Andy Royalty:Yeah, I think, um, you know, if you're somebody, and most of the time when we're seeing people, it's like, it's very rare. They're like, yeah, I've been dealing with this for two weeks. Usually it's somebody that's, they've tried a lot of conservative stuff, they've tried to rest, and it just continues to come back. And so, uh, if they're not fixing the underlying problem, then. They're just essentially gonna be going through that same cycle of they rest, it gets better and then, then when they play a lot of golf, it gets worse and then they rest again. So might as well just nip it in the bud and and fix the underlying issue so that they can essentially. Be able to, to get back to golf and not have to worry about, uh, the issue continuing to come back over and over again. So I love what I do and I'm excited to continue to help more of the, the Richmond community, uh, be able to play golf and enjoy it and, and just en, you know, enjoy what they're doing, not only on the course, but also off the course. So, yep.
Eric:Man. Oh, I appreciate you. And I think the, point of the story tonight of the tunnel. you can, you can actually work
Andy Royalty:Absolutely.
Eric:Feel better. play better. together. So thank you for coming on, doc.
Andy Royalty:Yep.
Eric:always, a pleasure to have you on. Uh, what a good episode. I think a lot of this, so Have a
Andy Royalty:Love it.
Eric:and
Andy Royalty:Absolutely.
Eric:in to the Golf Intervention Podcast.
