Desert Springs Physical Therapy - Silver City, NM

With powerful swings generating significant stress and torque on various body parts, many elite golfers often suffer from a wide variety of ailments — from sore hands and feet to achy wrists and tender elbows, wounded knees to balky backs. Everyone who plays the game knows how to spell ibuprofen, and they all have personal trainers, therapists, chiropractors and orthopedic specialists listed on speed dial.

“We just beat up our bodies,” Jack Nicklaus said recently. “It’s why I gave up golf.”

Woods, whose most recent surgery was the fourth of his career, is certainly the highest-profile golfer to have coped with significant injury, but he’s far from alone. Phil Mickelson incurred a wrist injury last year while practicing for the 2007 U.S. Open at Oakmont and needed most of the second half of the season to recover. Michelle Wie hurt her wrist in a fall while jogging last year and only now seems to be getting back to full strength.

Davis Love III and Fred Couples have been nursing sore backs for years that have limited their schedules. And recent U.S. Open runner-up Rocco Mediate said he nearly gave up the game last year because of a surgically repaired back that wouldn’t allow him to swing properly until he finally found a therapist who figured out a way to get him back on the course.

“The human body was not necessarily designed for this activity,” Allan Mishra, a professor of orthopedic surgery at Stanford University Medical Center and an avid golfer, said in a recent telephone interview. “As a result, we see every type of injury you can imagine, whether it’s a professional golfer or a recreational player.

“The big difference between the weekend golfer and a professional is the weekend guy is more likely to injure his back. The pros are more likely to injure wrists, elbows and shoulders because they do hit so many balls, which leads to tendinitis.”

The more they play and practice, the more chronic those injuries can become. It’s the main reason so many players now spend as much time in the gym as they do on the practice range.

“The body is like a set of tires,” said NBC Sports golf analyst Johnny Miller, who no longer plays competitive golf because of knees that have required four surgeries. “You can only go down the road so many times before the tread starts to come off.”

Jan Anderson, a therapist at Advantage Physical Therapy in Gainesville who specializes in rehabilitating golf injuries, also said she sees far more back problems than she does knee injuries among the amateur golfers she treats.

“Amateurs generate more abnormal forces to the spine because we probably swing too hard, do reverse pivots and don’t have the same fitness level,” she said. “Then we go out at 6 a.m. totally cold and hit the golf ball as hard as we can. We don’t warm up properly, we don’t stretch properly, and as a result, we get injured.

“I put golfers through a program that involves the back, hips and abdominal muscles. Golf is a rotational sport, and your primary rotator is your trunk. In golf, you want more stabilization between your thighs and your chest. And you want to stretch what’s tight and strengthen what’s weak. You want to have a body in balance, and Tiger Woods looks like he’s in total balance. He’s what we should all strive for in our preparation to play.”

Right-handed golfers “pivot on [their] left knee,” Mishra said in a recent interview with MedicineNet.com. “So it’s not surprising it’s his left knee versus his right knee. We’ve all seen Tiger and he puts an incredible amount of torque around his body, and he’s pivoting on his meniscus, on his knee. It’s just speculating, but that may be a part of what’s happening.”

No one knows for sure what is specifically happening save for Woods’s doctors, and they do not speak publicly about their very private patient. Thomas Rosenberg, the Park City, Utah, orthopedic surgeon who performed the latest surgery on Woods’s knee, did not return repeated telephone calls to his office.

Sherwin Ho, a professor of orthopedic surgery at the University of Chicago and the team orthopedist for the Chicago Blackhawks, had no reservations about predicting that Woods will continue to play golf at a high level.

“In his sport, he doesn’t have to jump or make sharp cuts. He doesn’t have to block a 250-pound linebacker,” he said. “Obviously, he puts a lot of stress on that knee. But the big concern now is how much damage has already been done. That’s something we don’t know. If it’s Grade 3 or 4, with Grade 4 being bone on bone, it will likely affect his swing and his game, and it may even shorten his career because it’s a precursor of arthritis. But the fact that he is so strong and so well conditioned is definitely in his favor.”

Other golfers surely can relate. Denis Watson, a 52-year-old native of Zimbabwe now playing on the Champions Tour, has had nine surgeries. Most of Watson’s problems stemmed from a 1995 incident in which he hit the stump of a tree with a 9-iron during the Goodyear Classic. He blew out his wrist, elbow and neck with that one swing, and at one point after his first wrist surgery he was told he would never play again.

After giving up the game in the late 1990s because of his various injuries, Watson has become one of the 50-and-over tour’s leading players, winning the Senior PGA Championship last year.

“When you get hurt, at first you’re in denial,” Watson said in an interview before Woods’s victory in the Open and subsequent revelation of the full extent of his injuries.

“You don’t perceive sudden changes. You’re able to compensate, do a few different things to ease the pain and still get the job done. But then you reach a tipping point and you really can’t get it done. Maybe it impacts you one or two shots a round, so that instead of shooting 67 or 68, now you’re at 70, 71. Then it starts to nag at you, and you get further in a rut. It becomes both mental and physical. You’re not playing as well, you’re hurting and you can’t get through it, so you go do something about it.”

The Effects of Playing Hurt

Kris Tschetter, the McLean-based longtime LPGA Tour player, is just now getting back to competitive golf after a long layoff because of hip and back problems. She had hip replacement surgery last July and didn’t play in her first tournament until 11 months later.

“I found that playing with an injury is just really tiring, at least my injury,” she said in an interview the week before Woods’s U.S. Open victory. “By the end of the round, you’re exhausted. I was never really conscious of the pain when I was hitting the ball. For me, just the walking was the hardest part. But hitting it, you’re so in the moment, so into the shot, the pain is actually secondary. In the heat of battle you just don’t feel it until afterward.

“While you’re out there, at some point you do start to anticipate it. But you’re playing and you have to swing and take what you get. Tiger playing in the Open eight weeks after knee surgery is really something. But he’s Tiger, so I guess I’m not really surprised by anything he does.”

In a brief interview during his media day appearance last month to promote this week’s AT&T National tournament, Woods did not reveal the extent of his knee problems following his April 15 surgery to repair cartilage damage. But he did say protecting that joint was “one of the reasons I changed my swing [three years ago] to alleviate some of the stress I was putting on it. It’s something I’ve always got to be aware of, and [the changes] haven’t hurt my game. You do what you have to do.”

What will Woods have to do now?

Watson has a pretty good idea because he has enlisted the same Las Vegas trainer and physical therapist, Keith Kleven, whom Woods has employed for several years.

“I had been told at one point I would never be able to play golf again,” Watson said. Kleven “told me, ‘I’ll get you back,’ and he certainly did. I had absolute complete and total faith and trust in what he does, and I know Tiger does, too. I would think the first thing [Kleven] will do is get him to quit running.”

Kleven did not return calls this week, but in an interview with Men’s Fitness magazine last year, he said “pound for pound, I put Tiger Woods with any athlete around.” In the same article detailing some of his workout regimen, including a heavy dose of weightlifting, Woods said he frequently trained by doing seven-mile endurance runs and three-mile speed runs.

“I’m sure Keith and his doctors are telling him he can’t run anymore,” Watson said. “This is a guy who was jumping out of planes and skydiving, and running a lot. I’m not so sure it was actually the swing that was doing all the damage. Now he’s got to stop that kind of stuff. He’s getting a little older, and your body needs more and more time to recover.”