If you’ve noticed knee pain creeping in during or after your round, there’s a good chance it’s your lead knee, the front knee closest to the target during your swing. Research into golf swing biomechanics has consistently found the lead knee experiences greater load during the downswing and follow-through than during normal walking, and repeated exposure to that load over thousands of swings is where problems tend to start.
Why the Lead Knee Is at Risk
During the downswing and follow-through, the lead knee undergoes rapid rotation while relatively straight, a combination that places real strain on the ligaments and joint surfaces of the knee. This pattern, high rotational load at low knee bend, has been linked in research to increased stress on the structures most commonly associated with knee osteoarthritis and ligament strain.
Golfers with a pre-existing knee condition are particularly susceptible. Some research suggests that around a third of golfers with previous knee pain feel that playing golf makes their symptoms worse, which points to golf-specific loading as a genuine aggravating factor, not just general wear and tear.
What the Research Says About Reducing Knee Load
A 2022 study examining lead knee biomechanics during the golf swing found that swing setup genuinely matters. Golfers using a narrower stance width at address, combined with a greater weight shift through the swing, showed a reduced knee adduction moment, the specific loading pattern linked to medial knee osteoarthritis risk. Separately, opening the lead foot outward by around 30 degrees at address has also been shown to reduce stress through the inner (medial) side of the knee, a common site for arthritis-related pain in golfers.
These aren’t dramatic swing overhauls, they’re small, evidence-based setup adjustments that can meaningfully change the load your knee absorbs on every single shot.
Common Causes of Knee Pain in Golfers
- Repetitive rotational loading: The lead knee rotates rapidly at a low degree of bend on every swing, thousands of times per season.
- Pre-existing knee conditions: Osteoarthritis or previous ligament injury can be aggravated by the specific demands of the golf swing.
- Swing setup: Stance width, foot position and weight transfer all influence how much load passes through the lead knee.
- Reduced hip mobility: Limited hip rotation can force more compensatory rotation to occur at the knee instead.
How to Prevent Golf-Related Knee Pain
- Consider opening your lead foot slightly at address to reduce medial knee stress
- Work on hip mobility and rotational control, so the hip, not the knee, absorbs more of the rotational demand
- Build lower limb strength to better tolerate the repetitive loading of a full round
- Get a proper assessment if you have a history of knee pain before assuming golf isn’t the cause
Common Questions About Golf and Knee Pain
Which knee is most at risk in golf?
The lead knee, the front knee closest to the target for a right-handed golfer, that’s the left knee, typically experiences greater rotational load than the trail knee during the swing.
Can I still play golf with knee osteoarthritis?
Many people with knee osteoarthritis continue to play golf comfortably, particularly with some setup adjustments and an appropriate strengthening programme. It’s worth getting individual guidance rather than assuming golf needs to be off the table.
Do I need a referral to see a physiotherapist for golf-related knee pain?
No. You can book directly with a physiotherapist without a referral.
How BeFit Can Help
Our Sports Physiotherapy team can assess your swing-related knee loading, identify contributing factors like hip mobility and stance, and build a plan combining movement assessment with a targeted strength and conditioning programme to help you keep playing comfortably. If neck pain is also part of the picture, our companion guide to golf and neck pain covers the other most common area golfers run into trouble.
Book an appointment at BeFit Training Physiotherapy — no referral needed.
Edgecliff: (02) 9327 7749 | Coogee: (02) 7205 2805
References
Kim SE, Segovia Pham N, Park JH, Ladd A, Lee J. Potential Biomechanical Risk Factors on Developing Lead Knee Osteoarthritis in the Golf Swing. Sci Rep. 2022;12:22677.
Australian Physiotherapy Association. Clinical guidelines. physiotherapy.asn.au.
