It is a beautiful, sunny day--the kind that was made for golf. You are on the fifth tee and you have parred or birdied the first four holes. You are on today. You line up your tee shot on this long par four and you swing like there is no tomorrow. Then you feel it. A sudden twinge of pain in your left shoulder. First it just stings, but as you walk towards your badly sliced ball, it begins to burn. Now what?

The sting often represents an injury to the rotator cuff of the shoulder. The cuff consists of four muscles that form a tendon cuff just underneath the bone on top of the shoulder. What you want to know is "Did I tear the cuff or just bruise it?" If it is torn, it typically should be surgically repaired, now usually done by an arthroscopic procedure under local anesthesia. If it is bruised, it can usually be healed with careful exercises and anti-inflammatory medications. Your orthopaedic surgeon can accurately diagnose by an examination, sometimes with an arthrogram or MRI. But first, your mission is to prevent having the injury. Here's how.

Faulty swinging mechanics, overuse, poor posture, and muscle weakness can all lead to shoulder problems. First and foremost are posture and mechanics. Faulty posture in day-to-day activities will be that much more apparent once you swing a club. Good posture also keeps all of your bones and muscles in their optimal position so that they can be most effective. Spend some time working with a partner or golf pro to make sure that your swing mechanics are smooth. Repetitive, irregular motion causes selective weakness in some muscles and overpowering strength in others. The imbalance leads to inflammation, injury, and double bogeys.

Regular strengthening programs should focus on balancing the rotator cuff muscles. Try these few exercises to get started. Warm-up and stretch prior to exercising and golfing. Better yet, warm up and stretch before going to work every day and enjoy the benefits that a loose body can provide to a relaxed mind.. Get to the club house early and loosen up by practicing swings and performing some of the following exercises before walking out to the practice range or the first tee.

Lie on your left side with your right arm at your side and bent 90 . Put a pad under your right arm and hold your 7-iron in your right hand at mid-shaft. Rotate your arm up and down keeping your elbow bent until you begin to feel a burn in the muscles in your shoulder (15-40 repetitions). Perform a second set and then repeat the same on the other arm. As your strength improves, use a heavier club or progress to two clubs.

The second exercise is standing straight with your elbows at your sides and bent 90°. Grasp the end of a club in your right hand so you thumb is facing upward and hold the shaft of the club in your left hand with your palm facing upward. Pushing with your left arm, resist the movement with your right as you rotate your arm outward, then push back with your right arm inward while resisting with your left hand. Repeat this sequence 10-20 times for two sets and then perform the same in the opposite direction.