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 NCPAD Monographs
National Center on Physical Activity & Disability (NCPAD)
   Instructional Tips for Golfers with Disabilities

By Judy Alvarez, PGA/LPGA Golf Professional

INTRODUCTION

I learned along time ago as a PGA/LPGA Professional golf instructor that just about anyone can learn to play the game of golf. Since the game of golf is roughly 85% mental and roughly 15%, physical anyone can advance a little white ball around a golf course and swing a piece of metal - or I should say today graphite - back and forth. Where and how far the golf ball goes is a different story. Anyone should be able to play the game of golf or some version of it.

This is a photo of a golfer hitting a shot off a tee.
Golfer hits shot off tee. Photo courtesy of Judy Alvarez.
To me, as an instructor, the most interesting aspect of teaching golf is that it offers opportunity to different caliber players: from rank beginners and seasoned golfers to professionals and golfers with disabilities. The golf ball doesn't know if you are hitting it from standing or sitting position, or if you are swinging with one or two arms or on one or two legs. The golf ball is going to sit on the ground until you hit it. There are many options if your injury/illness prevents you from playing a regulation golf course (18 holes). Try playing 6, 9 or twelve holes.Try a short course (par three)a medium course (executive course). If the golf course appears insurmountable, try chipping and putting on the practice green or hitting balls on the driving range. Many people try golf because it is the thing to do or they are left behind while their friends or family go play golf for many hours. Once they get involved in the game they realize that chasing the ball and keeping score is only one aspect of the game. They soon find out what the game truly represents from forming life long friendships (the camaraderie, socializing, and spending the day with loved ones) to the competition, challenge, and the sense of accomplishment. This is a game unlike no other, and for the golfer who may be reading this, you know what I mean. For the skeptics reading this, I dare you to take the challenge and see for yourself what you are missing.

Okay, so you never learned or played the game of golf prior to an injury/illness and now you want to learn. Find an instructor and learn about the object of the game, rules, etiquette, and equipment, as well as putting, chipping, and full swing. Since the person who played prior to an injury already knows the basic rules, etiquette, and swing mechanics, they may have to modify some of their swing mechanics -if necessary - and some golf course etiquette if they will require special adaptable equipment for the golf course.

Depending on the injury/illness there are many devices, equipment, and teaching aids on the market today that could help. Between motorized golf cars called "single riders," gripping aids, luggage straps, flat golf clubs and short and flexible shafted clubs, you should be able to create a learning path to the golf course. The best way to accomplish that is to begin with a qualified golf instructor. Anyone who wants to learn the game of golf, able-bodied or disabled, should seek an instructor to learn the right way so they can be advised on the proper equipment and swing mechanics.

 

INSTRUCTIONS THAT FOLLOW ARE FOR RIGHT-HANDED GOLFERS. LEFT-HANDED GOLFERS SHOULD INVERT INSTRUCTIONS.

TIPS FOR PEOPLE WHO HAVE HAD A STROKE

This is a photo of a golfer hitting a shot out of a sand trap.
Golfer hits shot out of sand trap. Photo courtesy of Judy Alvarez.

Having worked with people who have had mild to severe strokes, I know that the severity of the injury will determine the extent to which a motorized golf car/wheelchair will be needed. Much experimentation will be necessary because what works for one person might not work for another.

One of my former rangers, Mr. L, had a beautiful swing, i.e., good tempo, good weight transfer and hit the ball well. He had had a stroke 5 years prior. I could not tell. He attributes his continued rehab exercises (long after his rehab was over) to his recovery and the game of golf. Mr. L. could maneuver himself around the golf course by driving a golf car on his own. Another student who had a stroke on the left side could walk independently with a limp and swing with his good arm. After many lessons he is back on the golf course with his wife and enjoying the game of golf after only 1 1/2 years of having the stroke.


TIPS FOR SWINGING WITH ONE ARM

It is interesting that golf instructors teach able-bodied golfers to "feel" their swing with a one-armed drill. So when I work with a person that has had a stroke and they have the use of only one arm to swing with, I can work with them. Balance, weight transfer, the grip, and length and arc of the swing are key areas to focus on.

Start with putting and chipping since these two swings require little movement compared to the full swing.

Putting: Since the putting green is where the ball is supposed to roll, do not drag your feet on the green. Start out with short putts (about 2 to 3 feet from the hole). Put your feet shoulder width apart or the best that you can. This will create a good platform to swing on and help you with balance. For right-side paralysis face the ball with your left shoulder on the target side. Place the ball in the center in your stance about 10-12 inches in front of you and place the middle of the club face behind the ball. While you are swinging look at the ball. Do not let your eyes follow the club head going back and through. Let your swing arm hand down naturally and grip the club with your thumb on top of the club shaft.

Start the "pendulum" swing by doing a little press forward with the hand toward the target and than swing back to the right about 8 to 10 inches. On the forward swing, swing the club head to the ball in an accelerating motion but let hand and arm pass the ball before the club face. In other words lead the club face with your hand and arm. You should always try to finish your swing with hand and arm on the target side of you. Do not look up to see where the ball is going until you have stopped swinging. Always aim for the back of the hole. In golf it is "cool" to hear the ball drop in the hole.

Chipping: Similar to putting only you will be executing this shot off the green anywhere from about 5-25 feet. Club selection may vary from a 5 iron up to a sand wedge depending on the desired outcome but the swing mechanics will be the same. This swing is similar to putting. In fact you can try this chipping swing with a putter to get the feel for the swing. But since a putter has very little loft on the club face (from 1 to 4 degrees) you will have a hard time getting the ball in the air. That is why a lofted club is preferred because chipping is one-third air time and two thirds roll time. The object is to get the ball in the air over the rough, land it on the green and than let the ball roll to the hole. Do not try to hit the ball and land it next to the hole because by the time it stops rolling the ball will be off the green and you will have to go and chip again.

To play it safe select a pitching wedge to get started. For the golfer who had a stroke on the right side, stand with your feet shoulder width apart for good balance. Play the ball in the middle of your stance (you will have to experiment here). Place the club head right next to the ball but do not touch the ball or allow the ball to move. If you can, put a little flex in the knees, angle your spine forward so your arm hangs under your chest. Then grip the club in your palm with your thumb on top of the club shaft. Press forward with the hand and swing in a pendulum motion back and forth from five o'clock to seven o'clock. Be aggressive in your swing, hit the grass under the ball, and swing through in an accelerating motion. Do not look up until you have finished swinging. Try to keep your head from moving up and down or from left to right.

Full Swing: There are basically two ways to take a swing with your left side if you have had a stroke.

1. With your left shoulder on the target side swing with your left arm across your body to the right and back down and through. This swing generates more accuracy and consistency in the beginning and easier ball contact. This is also very similar to the way you did it prior to your stroke. The key to swinging is to have good balance. Since you have limited balance on one side, swing within your means and at a speed you can handle. Swing without falling off balance too badly. Stand with your feet about 8 to 10 inches apart in a closed stance (drop your right foot back so your right toes are in line with your left instep). Put a little flex in your knees and maintain this throughout the swing. Angle your spine forward over the ball so your arm can hang down naturally. Using a 7 iron tee the ball up and play it either in the middle of your stance or slightly to the right. Experiment. Grip the club in the palm and put your thumb on top of the club shaft. Press your hand forward and swing to the right across your chest pointing your thumb and club up to the sky on the back swing. As you swing the club down let your hand pass the ball first - let the club head trail your hand - and follow through so that your left thumb is pointing over your left shoulder. Transfer weight to the target side if you can. Try to keep your head from moving up and down while you are swinging.

2. In this set up you will be swinging with your right shoulder on the target side. Swing your left arm away from your body to the left and then across your body to the right. In this case you will need left-handed clubs. This swing is designed to get more distance because of the wider arc and length of the swing arc. Good balance and timing are essential here. Start out with a 7 iron and tee up the ball. Position the ball off your left heel with your feet about shoulder width apart. Drop you left foot back so the toes are in line with your right instep. This will encourage some body rotation. Grip the club in your palm and put your thumb on top of the club shaft. Press your hand forward and swing to the left away from your chest pointing your thumb and club up to the sky on the back swing. As you swing back to the ball, let your hand and arm pass the ball first - let the club head trail your hand - and follow through so that your left thumb and club are pointing over your right shoulder. Depending on the severity of your stroke transferring weight to the target side will be somewhat restricted. Maintain your balance on your left side and swing primarily with your arms, shoulders, and chest. Try to keep your head from moving up and down while you are swinging.


TIPS FOR SWINGING FROM A SITTING POSITION

I have seen a variety of swings from different sitting positions. It depends on the severity of the injury, the individual, their athletic ability, strength, coordination, and guts. For golfers who need to sit and swing, they can swing from either a wheelchair or motorized car. A motorized car comes with a swivel seat and usually some sort of a seat-belt device. Luggage straps can be used if the car does not come already equipped. If a single rider car cannot be found, a regular golf car (without the top) can be retrofitted by removing the bench seats and installing swivel seats. Now finding one to retrofit could be hard and this usually requires buying one or contacting municipal, county, or state operated golf courses. When I was the Head Pro at a county operated golf course, we applied for a grant from the USGA to buy and retrofit two golf cars. At one point we even used swivel seats from an old fishing boat.

Some people like to swing out of a chair and others prefer to swing out of a motorized golf car. Sometimes a motorized golf car is not available so use your chair.

Once in the golf car and in position to swing (beginning with a 7 or 5 iron), set the parking brake and turn the swivel-seat 90 degrees to the side or 180 degrees to the back of the car. Keep your feet on the ground for support and balance. The trickiest part is positioning the golf car to enable hitting the ball towards the target. To reduce back pain, use pillows for support if you are leaning away from the seat.

For a wheelchair user there are two positions from which to hit the side or the front of the chair. Apply the brakes before swinging in either position.

This is a photo of a golfer practicing a one-armed swing from a wheelchair.
Golfer practices a one-armed swing from wheelchair. Photo courtesy of Judy Alvarez.
This is a photo of a golfer using a one-armed swing to hit a ball from the front.
Golfer uses one-armed swing to hit ball from the front. Photo courtesy Judy Alvarez.
From the side:

This position allows for only a one-armed swing. Use a 5 or 7 iron that is about 21 to 24 inches long to get started. Tee up the ball parallel to your shoulders. Let your arm hang to the side naturally and grip the club firmly but not too tightly and swing. The swing should be with a controlled tempo. Do not try to hit the ball hard. Swing with only the force that allows you to remain seated in your chair. You may have to remove the armrest as an option. One of my students had a stroke that left him paralyzed and very frail. Since he did not have a lot of energy and fatigued quickly, this position was recommended. Even though he did not hit the ball very far, he was back playing golf with his wife and grandchildren.

From the front:

This position is recommended for someone with a stronger upper body. Position the ball in the middle of your legs. Spread your legs to the side of the chair and use pillows, if necessary, to support your back while swinging. Use a luggage strap around your waist or under your armpits to secure yourself in the chair while swinging a 5 or 7 iron. You will need to experiment to learn where best to apply the strap. Try to keep your spine from moving and rotate your swing around your spine. Try to keep your head from moving while swinging. Use a lightweight club with a flatter lie.


TIPS FOR PEOPLE WHO HAVE LOWER BODY PARALYSIS

I have worked with many people that have lower body paralysis. The level of injury will define what options you have when learning to swing from a sitting position. One day on the way home from a baseball game when Don was 10 years old, he was hit by a car and lost the use of his lower body. An avid athlete, we met when he was in his 30s and he wanted to learn to play golf. After experimenting, it was in Don's best interest to hit from a retrofitted car because the angle of his knees sitting in his chair got in the way of his swing. Although he could hit the ball further, he had to have someone tee up the ball for him. He also had a buddy or a volunteer drive the car for him. To avoid becoming overly frustrated, it is important to have a buddy or loved-one to share in this experience. For getting around on the golf course, I have seen anything from chair golfers getting pulled by an electric car to their ball while sitting in their chair to sitting in an electric golf car while their chair is pulled from behind, than hopping into their chair to swing.

Playing from the front of a wheelchair or motorized golf car allows for a better shoulder turn. Also a bigger arc can be created using one hand rather than two. A bigger shoulder turn (turning your target shoulder to your chin) and a bigger arc (the more you keep your hands away from the center of the swing) gives you more distance. For a right-handed player the right arm is used to swing while the left hand is used to anchor the body during the swing. Spread your legs to the side so that the feet and knees are to the side of the chair. Start with a 5 or 7 iron. To be more successful, "flatter" clubs will be needed. See a local club fitter for help with your golf club selection. Your actual swing should be with a controlled tempo. Hinge your wrist as you swing your arm back so your right thumb points to the sky when your arm is parallel to the ground. Continue the backswing until your hand is above your head and then start your downswing. Your finish should be with your right hand higher than your left shoulder.


SWINGING ONE-ARMED ON A MOTORIZED GOLF CART

This is a photo of a golfer taking a one-armed swing from a motorized golf cart.
Golfer takes a one-armed swing from a motorized golf cart. Photo courtesy of Judy Alvarez.
Mr. M. didn't feel good one day and by the end of the next day he was paralyzed from the waist down from an infection in his spine. As a very successful doctor, who happened to golf, had to find a modified golf swing. Using a single rider car with a thick strap secured around his abdomen and his feet planted on the ground, he swings with his right arm and holds onto a handle with his left hand. I personally have seen this person hit the ball 180 yards down the fairway. Good upper body strength and having the ability to play golf prior to his injury helped.

Begin the backswing by turning your arm to the right and getting your right elbow into a 90-degree angle to your right side. Point your right thumb to the target (rest the club on your right thumb so it is pointing to the target). The downswing should be easy as you swing through the ball and complete your swing. If your arm hits your knee, try to move your knees more to the side of the seat. Keep your spine as steady as possible and swing around your axis. During the swing try to keep your feet firmly planted on the ground.

For the golfer who is an incomplete T-12 for example, pillows could be helpful between the golfers back and the back of the seat to help reduce spine angle problems and pain. Using a strap for support under the armpits should help to reduce excessive movement.

If someone cannot drive an automobile, it is unlikely a motorized golf car can be maneuvered. A loved one or a golfing partner or buddy will be necessary for assistance.

I worked with a thirteen-year-old who has Spina Bifida. Sitting in a wheelchair and never having swung a golf club, our future together began. During the summer he hit the ball 10-15 yards and learned how to chip and putt. After numerous operations and two years later, Karl now rolls into our golf lessons in his own single rider car. He swings with two arms and hits the ball 50 - 60 yards. He does all this with a specially made 5 wood flattened to 13 degrees and a Power Glove. It is the gleam in his eye and the sound of his laughter that shows me there is much more to this than the eye can ever see. It is in the heart and the soul that we touch by providing lessons and education for someone born with a disability or injured later in life. This makes me realize more and more frequently how important golf can be to someone.


TIPS FOR THE SIGHT-IMPAIRED

Blind golfers need what they call a "coach". Someone to guide them around the golf course and drive the golf car for them. I had the opportunity to play golf with someone who is blind. His coach would line him up and tell him what the yardage was and the golfer asked for the desired golf club. After he hit a great shot to the green, I thought to myself, she never told him about the water and two bunkers between him and the green. There is something to be said about not seeing all the hazards on the golf course.

On the putting green blind golfers either walk off the distance from the hole to the ball and feel with their body the undulations of the green or have their "coach" speak to them from the flag and sense the distance by sound. For the partially blind or people who have limited vision certain colors like pink and yellow golf balls can be seen easier. Colored nail polish can be applied on the shaft above the hosel or on the top part of the club head so the club can be seen to be positioned to the ball easier.


TIPS FOR THE HEARING IMPAIRED

A golfer who is deaf or hearing impaired will be concerned about effective communication for the golf lesson. Consider contacting the program coordinator in advance to request an interpreter. The interpreter may only need to be used for the first couple of lessons until you develop signals with the instructor. Also consider bringing a pad of paper and pencil for exchanging information. Or ask the instructor to use a video camera for reviewing technique.

TIPS FOR AN AMPUTEE

Sam just pitched the winning game to take his team to the Little League World Series Championship. His parents sent him to his grandparent's farm for the day. Not paying attention, his arm got stuck in a tractor. He woke up in the hospital with half his arm missing. Year's later Sam learned to play golf and has been playing ever since. Sam didn't care if he had to swing one armed. He was still able to hit the ball and play the game. I have worked with numerous amputees and it depends on quite a few parameters and personal preferences:

  • Are you an Upper or Lower Extremity Amputee?
  • What is your level of Amputation?
  • What -if any- prosthesis are you using?
  • Should you swing across or away from your body?
  • Should you swing standing or from a sitting position?
  • Should you use shortened clubs, flexible clubs, flat clubs, etc.?
  • Should you use one or two upper extremities if they aren't they same length?


Lower Extremity Amputation

It depends on the level of amputation but listed below are some considerations to think about:

What prosthetic modifications or devices such as crutches or canes will be needed. A modified golf swing; course accessibility with a motorized golf car or wheelchair; and course conditions such as uneven surfaces, hazards, and rough. Watch your stamina/endurance, energy conservation, and proper nutrition.


Below the Knee:
If you are able to stand, play the ball (in relation to your feet) a little right of center. In the beginning use a 7 iron and take swings using 60% of your actual strength. Place your feet shoulder width apart and get balanced. Maintain good balance throughout the swing. As you take a back swing try to get your left shoulder under your chin keeping your arms extended throughout the swing. You will have to judge for yourself how much weight to transfer to your right side. Now transfer your weight to the left side as you are swinging the club down and finish with more weight on your left side than your right side.


Above the Knee:

Same as a BK but with a few modifications. You know how much weight you can bare on your right side. Since you may not be able to transfer enough weight to the left side you might have to aim more to the left to compensate hitting the ball to the right. See a local club fitter for flexible and longer shafts, grip size to fit your hand, and possibly a closed club face.


Swinging sitting down:

Get clubs that are "flat" and flexible. Set the club face up behind the ball and extend your arms in the shape of a triangle. Make a good shoulder turn to the right and to the left. Think of pointing your thumbs up to the sky on the back swing and mirror image the thumbs up to the sky on the left side of the swing. Tee the ball up in the beginning. Concentrate on swinging around you spine and stay centered.


Upper Body Extremities

It depends on the level of amputation but listed are some considerations: Level of amputation, prosthetics, gripping devices, using the unaffected extremity only, and altered club characteristics.

In order to get distance in golf there are certain principles to follow. One of them is the width of the swing arc. A student of mine, Larry, was an accomplished left-handed golfer before he became an AE on his left side. His swing arc was very small because he was swinging with his stump on the club. After numerous lessons and explanations Larry was hitting the ball further. He took his stump off the club increasing the width of the arc. Not every student is willing to try this. I gave him a lot of credit for trying to overcome his injury while persevering through something uncomfortable.

RECREATIONAL GOLF PROGRAMS

Alvarez Golf School
Villa del Ray GC
6200 Via Delray
Delray Beach, FL 33484
Contact: Judy Alvarez PGA/LPGA
561-498-9800 or 954-419-3136

Fore Hope
925 Darby Creek Dr
Prairie Township. OH 43119
Contact: Mindy Derr
614-870-7299

Fairfax County Park Authority
12055 Gov't. Center Pkwy, Suite 927
Fairfax, VA 22035
Contact: Cindy Walsh
703-324-8700

Edwin Shaw Hospital
Challenge Golf Program
Arkon, OH 44312-4495
Contact: Ron Tristano, PGA
330-784-1271

Noel Jablonski, LPGA
320 German Town Road
Oaktown, VA 22124
703-255-5396

Golf RX
1703 E. James
Baytown, TX 77520
Contact: Ja Ro Jones, PGA

Children's Golf Foundation
19111 U.S. Hwy 1, Suite 201
North Palm Beach, FL 33408
Contact: George McGrory
561-776-1387

MarionJoy Clinic
26 W. 171 Roosevelt Rd.
Wheaton, IL 60187 Donna Strum
630-462-4039

Conrad Rehling, PGA
48 E. Lynn Haven
Tuscaloosa, AL 35404
205-556-1455

You Can Make It if You Try
8210 Aquila St.
Port Richey, FL 34668
Dale Jones
727-856-6602

Kathy Corbin, LPGA
7141 N. 16th St. #223
Phoenix, AZ 85020
602-678-1832

Riverdale Golf Course
13300 Riverdale Rd
Brighton, CO 80601
Marcia Bailey LPGA
303-659-6700

Donna White, LPGA
1200 Century Club Way
West Palm Beach, FL 33413
561-964-4653

LITERATURE

Etiquette Seminar on Golf and Players Disabilities
National Center on Accessibility
(812) 856-4422 (Voice)
(812) 856-4421 (TTY)
(812) 856-4480 (Fax)
nca@indiana.edu

Modified Rules Book
United States Golf Association
P.O. Box 708
Far Hills, NJ 07931-0708
908-234-2300

Accommodating Disabled Golfers
National Golf Foundation
1150 South U.S. Highway One
Suite 401
Jupiter, FL 33477
561-744-6006
e-mail: ngf@ngf.org
Website: www.ngf.org

The Forgotten Foursome
Professional Club Makers Assoc.
70 Persimmon Ridge Drive
Louisville, KY 40245 800-548-6094

From Bag Drop to 19th hole: Tips for accommodating a golfer with a disability
National Center on Accessibility
(812) 856-4422 (Voice)
(812) 856-4421 (TTY)
(812) 856-4480 (Fax)

EQUIPMENT CATALOGS

Golf Around the World Catalog
1396 N. Killian Drive Unit B.
Lake Park, FL 33403
Gary Wiren
800-824-4279

McNichols Equipment Catalog
P.O. Box 30300
Tampa, FL 33630-3300
800-237-3820

Access to Recreation Catalog
Equipment Catalog
P.O. Box 708
Thousand Oaks, CA 91359-5072
Don Krebs 800-634-4351

About the Author
Judy Alvarez is a PGA/LPGA Golf Professional. She has been instructing golfers of various abilities for many years and leads the Alvarez Golf School at the Villa del Ray Golf Club in Delray Beach, Florida.

About this Article
This article was edited for the National Center on Physical Activity and Disability, a collaborative project of the National Center on Accessibility, the University of Illinois at Chicago and the Rehabilitation Institute of Chicago. NCPAD is headquartered at the Department of Disability and Human Development, University of Illinois at Chicago,1640 West Roosevelt Road, Chicago, IL 60608-6904. NCPAD is funded by the Secondary Conditions Prevention Branch, Office on Disability and Health, Centers for Disease Control and Prevention. www.ncpad.org

The National Center of Physical Activity and Disability, University of Illinois at Chicago, the National Center on Accessibility, and the Rehabilitation Institute of Chicago do not formally recommend or endorse the equipment listed. Individuals should investigate and determine on their own which equipment best fits their needs.




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