Wednesday, June 18, 2008

Tiger Woods and me and Rich Lerner

Surprising news in the golf world today, shocking actually, that Mr. Tiger Woods the 108th USGA Open Champion indeed has an ACL deficient knee - and more. But those that follow this writer should have known it was coming. We do know now that he is not a model patient either, how much has he hurt his future being so bull-headed?

What to do now?

*Tiger apparently has two Tibial (shin bone) stress fractures - these will heal since he didn't break them through last week (You can do this). These are less of a big deal than you might think. It is most likely that running for training did this. Running really isn't all that good for you, there are other ways to get cardio. Running always reminds me of that cartoon Shoe - from late political cartoonist Jeff MacNelly. Shoe is a great big fat know it all bird and there are all his regulars, Skyler, Roz and the Senator Windbag, etc. Anyway, one day Skyler was reading in the paper where he read aloud that "Doctors agree that running is good for you". Shoe, ever the curmudgeon glibly replies with his cigar hanging off to the side "Especially if they're Orthopedic Surgeons." They can also be called G.I or March fractures (stress fractures) because green recruits get them in basic training. Heck Tiger's getting older, he needs to lose the running. Enough said, they'll heal, since he didn't fracture through, it's a nothing.

*ACL Deficient Knee

How much do you want to know? I could give you about 40 pages easily. I've done too many of these myself to count starting from doing a softball player in San Jose who got a full-page article out of it for her and me back in the early 1980's to the last one in PA in 2002 that I did just before health caught up with me and I had to abandon the ortho surgeon's life.

During that time I also personally had a knee (not patella) dislocation in Bermuda that I reduced myself. I needed and had my own ACL done - maybe 5 weeks later. More on that later and what it means in all of this, but it really wasn't all that painful, but then again I (skillfully) shoved that sucker back in place within 10 seconds before the muscles even had a chance to start hurting. The near-compartment syndrome I had that night was another story, I went back to the Hospital for some hydrocodone. Later I puked my guts out and just dealt with the pain.

So anyway I worked the quad, got the range of motion back, we got the swelling under as good of control as we could and when the knee inflammation was down we got the surgery done. I had peripheral lateral and medial meniscus tears by definition, but they healed by the time I had the surgery and other than some shear articular cartilage damage and shredding on the medial meniscus that needed cleaning up everything went OK. Except I had such a big capsular tear posterior-laterally that my leg swelled 2-3x normal size at surgery (at least that's what Pete, my usual surgical assistant who scrubbed in on my surgery to keep old Dougie boy honest said). It still works OK 11 or so years later.

I am also because of what I currently do as a consultant in Occupational Medicine somewhat an expert on orthopedic rehabilitation anyway. I got a lot of OTJ just from myself.

I know the golf swing very well.

Does that give me enough cred?

Tiger, what about Tiger?

We'll likely know about Tiger at about three months post op.

We don't know what his "cartilage damage" is. If he's shredded his lateral meniscus and needs a transplant as well as an ACL done, that knee is not going to be very happy very soon. We still don't know the state of his articular cartilage (see original article below), his handlers have been rather mute about the truth and although he is the world's most dissected athlete his medical data is private and protected by HIPPA. Big problems for anyone leaking an MRI or an operative note. To that extent, it's his own damn business. considering he's a cash cow for thousands of people, it's actually a serious bit of fiscal information that is critical for many to know.

There is only so much speculation one can do at this point about his future. He'll certainly play again and barring an infection, arthrofibrosis, pulmonary embolism, very serious articular (joint) damage (and several other things) he'll certainly live and play a high quality of golf again.

Will he play as he did before?

I dunno (Insert dumbfounded, shirking smiley character here), but I beginning to wonder if I really don't think so. Look at Els, he did everything by the book, took care of it and did not screw it up by disobeying his doctors and he's still struggling, what 18 months later? Same knee, he did a lot less to it, you decide.

This whole story is not even beginning to sniff Hogan. I understand TGC's Rich Lerner implied this. So Rich Lerner, e-mail me, I'm in your old hometown. We need to talk, maybe you should have me on the show.

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