Tiger Woods Case Study Part 1: The first surgery
Tiger Woods, as we all know, dominated the golf world since his Jnr. amateur performances from 1991-1993 and amateur performances from 1994 to 1996. During this time, he won 3 consecutive Jnr. amateur AND 3 consecutive amateur championships. Finally in 1996, Tiger turned professional. Eventually, Tiger’s Career began to stall as chronic pain took over, leading to this…
The first surgery, 1994
During Tigers amateur career, he underwent his first surgery for 2 benign tumors on his left knee. I can’t find any details on the specific type of tumors these were, but I imagine they we most likely osteochondromas. An osteochondroma is an excessive bony growth with a cartilaginous cap on the ends. The reason I suspect this was the type of tumor removed specifically is because of the location of the tumor (distal knee) and the benign nature of it. Here are a few images of osteochondromas shown on x-ray…
Two Osteochondroma’s at the distal femur.
As you can see, sometimes these benign tumors can cause problems, such as pain, nerve compression, tendon irritation, or vascular compression. I imagine these were the reasons for the first surgery in Tiger Woods career.
Fluid Drain and Cyst removal, 2002
From 1996 to 2001, Tiger Woods become a professional and racked up 29 Career first place finishes (and 26.2 million dollars in tournament money…). In 2002, he had a benign cyst removed and fluid drained surrounding his left ACL in his left knee. The second invasive surgery around this knee. I want to highlight that up to this point, we can count on the formation of scar tissue, muscle and tendon damage, and potentially nerve damage. The potential for pain, mobility loss, and motor control deficits around this joint as well as compensatory motor pattern developments is high. At this stage, there are no reports of chronic or debilitating low back pain, but it seems the stage has been set for issues down the road.
Regional Interdependence
How can knee pain and/ or dysfunction lead to low back pain? Well, a key concept here is regional interdependence. Regional Interdependence explains that dysfunction as one or more joints separate from the site of pain can indirectly lead to pain, damage, and dysfunction at other regions. A classic example of regional interdependence in the golf swing is the missing ability to rotate through the hips leading to low back and/ or knee pain. What happens here is we have a mobility restriction in the hip, causing the golfer to either avoid or otherwise prematurely cease rotating through the hip before calling upon other structures to take up the slack (knee and low back).
What we have set up here is a history of knee surgery leading to high likelihood of dysfunction in Tiger Wood’s left knee from very early in his golf career. Further, these events alone won’t be the last of the trauma to his left knee. With pain and dysfunction in the left knee, we can imagine how the forces and power production through his kinetic chain may have favored the use of other supporting joints/ regions such as the hip and low back…
Conclusion
At the start of Tigers Woods professional career, he underwent a knee surgery to remove two benign tumors. He went on to dominate in his early professional years, again getting surgery on the same knee for a benign cyst. There is more surgery and trauma to come to this left knee that we will cover in follow up articles, but I believe these were the initial insults that led to compensations and tissue overload that eventually cripples Tiger late in his career. We’ll continue to discuss Tigers injury history as we move along his professional career accomplishments.
-Dr. Nick DC, MS, TPI, CSCS
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P.S. if you have mobility deficits, joint restrictions, pain, or injury that is limiting or holding you back in golf and fitness, consider how regional interdependence is at play and impacting your ability to recover, create swing faults, and lead to continued pain and injury.
