Tiger Woods Left Knee Reconstruction - What impact will it have?
Our topic for this Blog is Tiger Woods’ knee reconstruction. The literature shows that following knee replacements that right handed golfers with left knee reconstructions (thus removal of both cruciate ligaments) have greater difficulty returning to the same handicap levels after surgery. Ernie Els took considerable time to recover to high level playing performance following his left anterior cruciate knee reconstruction. It would appear the rotatory instability is more problematic in the lead leg (left for right handed golfers) with a cruciate deficient knee - that is the rotatory forces (or torques) that need to be tolerated in the left knee through transition and impact are substantial. How long will it take for Tiger to return to his pre-surgical playing level? What technical problems do you see him having from a coaching or technical perspective? What specific training and rehabilitation exercises would he need to include at end stage to satisfy you that he was fit to return to high level competition? What time frame do you believe he will need to be completely recovered? Raise any issues that you feel will impact on his return to play. Have your say by clicking on the “comments” below and see what the rest of The Golf Athlete members feelings are.
The following is a chronology of the knee trauma/pathology since December 1994;
- December 1994: removal of two benign tumours and scar tissue
- December 2002: removal of fluid around ACL and benign cysts. Investigation through arthroscopy reveals anterior cruciate damage. Effective hamstring strengthening and rehabilitation is suggested.
- July 2007: Finally ruptures ACL when he missteps while running on a golf course after the British Open. No lasting pain following final this injury.
- April 2008: Arthroscopic surgery to repair the cartilage damage but puts off final ACL reconstruction. Damage was to the articular surface of the tibia and femur (and possibly in the Patellofemoral Joint). Still only mild instability at this time.
- May 2008: Now diagnosed with two stress fracture/reactions in the left tibia just prior to US Open.
- June 2008: Surgery 8 days after winning the US Open (after 91 holes) - ?quadricep graft from right leg and some further cartilage surface repair.
- 2009 ???
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November 22nd, 2008 at 10:53 am
My question would be do we really know the extent of the damage in his left knee?? We know there is cruciate damage but do we know whether ther is meniscal or more significantly chondral damage to the knee joint as this will govern the length of recovery and the rehab program. For example high impact loading would need to be avoided for a prolonged period and current evidence sugggests that up to 18months may be required for maximal tensile strength of the cruciate ligaments.
Regards
Ben Corso
November 25th, 2008 at 7:54 am
He’s got to be looking at 12 - 18 months before things start to get back to normal. Not sure if or how much cartilage damage has occured with the 2 # aswell.
Technique wise, the huge amount of force that he puts through the left knee causing the snapping into ext/hyperextension surely has to be changed to protect the joint.
He’ll still be up there as his short game and mid irons are so good, don’t think it will take as long as Ernie’s due to age and fitness levels.
December 14th, 2008 at 11:58 am
Michael, this topic is obviously an important one for all those physiotherapists/athletic development specialists who have to deal with post ACL golfers. My personal experience is that the longer the return to rotary activities is delayed the better - even with an uncomplicated, isolated ACL reconstruction. My opinion would be that full long game swings should be discouraged under six months. Rotary loading activities such as MB rotations with walking lunges, clock lunges with MB rotation etc should form the basis of early stage functional training for most golfers. I will be interested to hear the comments of others on the topic.
January 1st, 2009 at 6:43 am
I’m surprised that more ACL injuries haven’t occurred in the past with elite level golfers, or is it becoming more common now due to the body speeds of golfers, the methods employed by some swing coaches and the amount of golf these athletes play. In my studies i have just read a paper on knee joint kinetics and it states that the downswing phase creates vertical compression forces of up to 80% bodyweight on the left leg on impact. The left leg sustains large lateral forces (133N) and vertical (950N) compression forces and large rotatory torques (23n.m) 0.02 seconds after ball impact. It’s interesting comparing Woods swing when he was with Harmon and now with Haney. For all the published articles on the changes he has made under Haney and considering the history of his left knee there doesn’t appear to be a huge significant changes in his lower body mechanics- so with this type of force going through the lead leg are we to expect more injuries of this nature?
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