Tiger Woods Has an ACL Tear:
We have all heard the news
, and now we are hearing a lot of rumors. Pro golfer Tiger Woods has limited the amount of information publicly released, and therefore the media is full of speculation about his injury. Let me try to shed light on a few of the speculations, and how much truth these rumors may hold.
Let me be very clear: I have no inside information about Tiger Woods. All I know about his situation has been released on his web site www.tigerwoods.com. What I am responding to are the rumors I have heard from various media reports. The statements below represent what I have heard on news and radio reports.
'Athletes are never the same after ACL surgery':
Not every athlete has a full recovery after ACL surgery
, but more than 90% of athletes are able to return to their pre-injury level of activity after ACL reconstruction surgery. Professional and Olympic caliber athletes have come back to compete at the highest levels of soccer, football, basketball and other sports. Having an ACL reconstruction surgery does not mean that Tiger cannot return to his pre-injury level of accomplishment.
'New surgical techniques will allow Tiger to return to normal':
ACL reconstruction surgery has been around for several decades. There are constantly refinements to the techniques of performing an ACL reconstruction, but little has changed about the fundamentals of ACL reconstruction in the last two decades. Athletes would have had a similar prognosis a decade ago.
'Tiger is going to have his ACL repaired':
ACLs that are completely torn are not repaired, they are reconstructed. The damaged ACL is completely removed as there is rarely potential for healing of a torn ACL. In order to have a functioning ACL, a new ligament must be created. The procedure is called an ACL reconstruction and not an ACL repair.
A good analogy to understand an ACL tear is to imagine what was once a tight rope being torn and looking like a frayed mop end. Sewing the mop ends together would make for a weak, poorly functioning rope. In order to repair the damage, a new ACL is needed.
'A golfer needs an intact ACL to play golf':
The ACL is one of four major knee ligaments that contributes to knee stability
. When an individual tears one of these four ligaments, the knee may become unstable
. Some people who tear an ACL don't have complaints of instability even when doing sports, others have instability episodes with even simple non-sporting activities. Some sports
almost always require participants to have an intact ACL, however, golf is not one of those sports
. It is certainly reasonable to try nonoperative ACL treatment for a return to golf, even with a Tiger swing.
'ACL surgery will involve large scars and significant pain':
As mentioned previously, ACL reconstruction surgery is constantly being refined and specialty trained surgeons are able to perform this as a minimally invasive procedure. In skilled hands, incisions can be kept small. A better understanding of pain control, including preemptive pain control techniques (controlling painful symptoms before
they start) can make ACL reconstruction well tolerated by most patients.
It is becoming more and more common to use cadaver grafts (donated ACL grafts) rather than a tendon from the patient. When a cadaver graft is used, incisions are minimal, less than a few centimeters total.
'Tiger will need more surgery on the knee down the road':
Who knows? I heard one radio host speculate that it was normal after this type of surgery to have periodic arthroscopic surgeries down the road to "change the oil." This is a very misinformed statement. While no one can predict if Tiger will need more surgery, the goal of his surgeons will be to repair the knee so that it functions normally. Once an ACL has been reconstructed, the expectation is that it will function normally for the life of the knee.
'Tiger will be immoblized for a lengthy amount of time':
does take a minimum of several months, but that does not mean patients are sedentary. Most modern ACL rehab protocols
get patients moving right away after surgery. In my ACL rehab protocol, I have patients start motion exercises the day of surgery.
I agree that a patient like Tiger will need to be managed carefully, as his urge is going to be to perform more than his body is able to tolerate.
'Athletes are never the same':
This statement is the one I disagree with more than any other. In my experience, high-level athletes often come back from injury better
athletes than before their procedure. The reason, I believe, is that these athletes focus their rehab on areas of strength that have often been neglected. By focusing on core strengthening and flexibility
, elite athletes can gain a competitive advantage.
Elite athletes can regain their sport-specific skills relatively easily. Tiger will not forget how to swing a golf club. But he may be able to devote more energy to some aspects of training he may have otherwise neglected.