An amputee cannot generate a muscular force to cause the prosthetic joint to rotate other joints. Most frequently, the player’s hips must work significantly harder to enable the motion of a golf swing. For instance, a lower-limb amputee will not be able to push the leg from the ankle; instead, they will pull the leg from the hip. This change in harnessing ‘Ground Reaction Force’ can influence impact factors and subsequent ball flight patterns. Be aware of the positioning of the amputation, above or below the knee and above or below the elbow, as this can significantly influence mobility and elicit changes in movement patterns for golf.
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- Prosthetic limbs mimic actual limbs but more simply. The coaching techniques you usually use are an excellent place to start, but you might have to adapt.
- Ask the player if they had played golf prior to the amputation. This will help them modify their golf DNA to adapt to the amputation.
- Note in the two videos above (Juan and James) the difference in the movement patterns between the players with and without a prosthesis. Juan has a congenital amputation, and James played golf prior to his amputation.
- If the participant is limited by their prosthesis, work with them on alternative exercises – keep the approach simple and seek advice from the prothesis manufacturer to advise on ‘golf specific’ adjustments which may assist the player.
- Participants may use stump socks or liners to help fit the residual limb into the socket (like wearing socks in shoes). Participants will sweat in the socket, which can become swollen and uncomfortable, so give them time to change or remove their prosthesis during the session if necessary.
- Provide seating and introduce regular rest intervals.
- Some athletes may wish to participate without prostheses and support—let your golfer explore this option if requested, as the player can occasionally develop more sequenced golf motion patterns.
- To develop particular ball flight and ‘match up’ motion patterns, don’t be afraid to switch the player from playing from the trail leg to playing from the lead leg—simply by allowing them to experiment with right and left-handed clubs.
- Find out what the participant can do or what may be preventing them from participating (e.g., self-confidence, socket fit, pain, technology).
- Consider the individual’s physique, mobility, and application. Speak to the participant to understand their abilities and desires. This will allow you to better understand how these may affect their performance and the timeframe for achieving their goals in the game.
- Check the participant’s range of movement, as this can vary greatly.
- Constant and continual repetition and reinforcement can improve coordination and mastery but can cause skin breakdown. Talk to the participant about finding a good balance between repetition and changing the nature of the loading.
- Participants may have a slower response time when initiating movement on command due to their prosthesis.
- The participant may have limb movement restrictions. Therefore, they need to improve their fundamental movement skills through drills.
- Be aware of any balance and coordination problems and consider these when prescribing any drills or game play.
- Consider their balance, coordination and strength as a starting point before introducing any sport-specific technical modelling.
- Lay down solid foundations to build upon, and keep it simple.
- Discuss pain threshold and tolerance with the player to better understand specific issues and concerns, such as their pain management routine (e.g., use of medication). Using such knowledge and regular monitoring, it is possible to prevent or reduce the risk of aggravating an existing injury or creating future injuries. Where appropriate, make the necessary adjustments.
Levels of amputation
Mobility, range of movement, coordination, balance, and comfort vary greatly depending on the level of amputation. Generally, the more residual limb (stump length) an amputee has, the more mobile they will be.
Some common sites for amputation are:
- Partial foot or toe(s)
- Syme’s (through the ankle)
- Trans-tibial amputation (below the knee)
- Knee disarticulation (through the knee)
- Transfemoral amputation (above the knee)
- Hip disarticulation or hemipelvectomy
- Bilateral lower-limb loss
- Partial hand or finger(s)
- Wrist disarticulation
- Below elbow
- Elbow disarticulation
- Above elbow
- Shoulder disarticulation or fore-quarter
- Bilateral upper-limb loss
- Multiple amputations.
Note the differences in swing direction and energy loading in the following four videos. Two videos of player 1, playing with the lead arm. Two videos of player 2, playing with the trail arm.
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