Thursday, June 12, 2008

Originally on redanman.com post-Masters Part ll

Conspiracy Corner or Not?

Whenever Tiger Woods has knee surgery, it requires an opinion from me. There is this time yet again - to an Orthopedic professional - a great deal of mystery surrounding exactly what is going on with Tiger Woods left knee. Once again we are told that he had some cartilage work done. Don't ever forget that there are two kinds of cartilage in the knee the articular cartilage which is intimately attached to the ends of the bone that make the articular or joint surfaces and also the meniscus cartilage, that most like a chamfered washer which more perfectly make the articulation of the upper bone(Femur) to the lower bone (Tibia). There are two of these medial (inner) and lateral (outer). The knee which has a lateral meniscus reduced in mass is much more poorly tolerated than that on the medial side, especially when on the periphery. We don't know which or if either is the site of the work.

His previous surgery we are told he had fluid removed from around his ACL as well as cartilage work, again, not specified. This professionally makes no sense whatsoever. Clearly his handlers are minimizing just what is wrong with his knee. Articular cartilage shear can be mowed like the grass to reduce its impact on the knee. It does not grow like the grass however, eventually one runs out of it. Mr. Woods is a very valuable commodity to his sponsors and to the media, the obsfucation is of little surprise to me.

The early swing component for Mr. Woods that had him hitting against an internally rotated and extended (turned in and straightened) left knee may very well be responsible for his knee woes but certainly has caused the continued problem. The idea of that sort of swing is to allow one to flail wholeheartedly at the ball with reduced chance of lateral translation (sliding). The knee does not like to be loaded in this fashion and I don't recommend this move to anyone who wants his knee to hold up. It can lead to ACL partial tears (there is no such thing as a partial tear), stretching of the posterior-lateral capsule - a most important and poorly recognized laxity, even by experienced OS - and joint cartilage shear.

If Mr. Woods has a condition called Osteochondritis Dessicans (Of the lateral aspect of the medial femoral condyle, certainly not inconsistent with the straight knee flailing mode), it could be just a matter of how long will his knee hold up, even though he has abandoned that particular flawed swing method. Couple this with an ACL deficiency of any kind on a left knee and it is not a great combo - add in the posterior-lateral corner laxity and you might not have a very happy knee. Certainly not for very long.

The continued need for his left knee to have repeated surgeries is leading me to further believe that the articular cartilage is the source of the problem requiring cartilage work. He is a world-class athlete so he will do well, that is 3/4 of the battle, however if indeed he has O.D. and / or articular cartilage shear, it could affect his career no matter what he and his team do. No surprise that the story has so much spin as told in very tightly controlled, non-informational press releases as we are subjected to. He may know what his last rehabilitation program was but welcome to a new one. I'm guessing 4-6 weeks is optimistic.

At least we are done with the grand slam rubbish for the year, but we are bombarded with the triplets: woulda, coulda and shoulda. Now we have the reaason - the left knee which caused him pain (I really doubt pain was the problem, but most laymen relate best to pain) but more importantly functional alteration. Maybe woulda, coulda shoulda had the knee surgery in the off-season rather than much more urgently than admitted two days after failing to win the Mahsters.

Much of the media has been ready to crown Tiger the King from the very start, but we now have a new wrinkle that keeps deepening. My guess is that Tiger Woods will one day retire from competitive golf. I'll take the Ladbroke odds for less than two weeks before the next knee surgery when he does retire.
This week we've seen Byron Nelson's eleven straight and the calendar (True) Grand Slam odds just change.

Arthroscopic surgery to remove fluid from around the ACL - hmmmm. Sounds like an ACL deficient knee to me.


As an update, it has been made aware to me from Geoff Shackelford's fine site that Tim Finchem expects 5-10 years of Senior (Champion's) Tour golf from Tiger after regualr competition. I'll take the odds on that right now that we'll never see Tiger give a rodent's derrière about any Senior title except perhaps the USGA Open so that he can increase the total of USGA Championships that he will have won to an ungodly record total.

To be more specific, I'll give really long odds right now that we'll never see Tiger Woods in something as fine but undistinguished as the very well run Commerce Bank Championship at the Eisenhower Red on Long Island (I'll have some from there pretty soon). Mr. Finchem, I want to share that pipe in your pocket the next time I need a dose of optimism.

the redandoc

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