Tiger Woods Will Play Golf Again. Don’t Expect It to Be on the PGA Tour
As a physical therapist, one of the first thoughts I had about Tiger Woods after hearing of his injuries was how difficult the road to recovery would be.
The rehab process for Woods will be long and arduous.
First, his bones need to heal. There is a difference between healing and retaking pre-injury form.
Dr. R. Malcolm Smith, the chief of orthopedic trauma at UMass Memorial Medical Center in Worcester, Mass, estimates Woods has about a “70 percent chance of it healing completely.”
Depending on the severity of the bone injuries and level of blood flow compromise, bone healing may require up to 12–14 months. He will be limited in the amount of weight he can place on his legs during the healing time. There is a risk his bones will never fully heal.
This is only the beginning.
Woods will experience significant atrophy — loss of muscle. His strength, power, and mobility will all worsen. The accident caused severe tendon, ligament, and muscle damage as well.
The extend of potential nerve damage is unknown. If a nerve injury occurred, the 70% chance of recovery estimation will plummet.
Even if he does heal and is able to recover muscle mass and strength over time, the pins, rod, and severity of the injuries will likely limit his range of motion permanently.
What will rehabilitation look like?
The initial stages of recovery will focus on healing.
Woods will likely start non-weight bearing while the bone recovers. This will result in further atrophy and weakening. Even once he can bear weight, the progress will be slow. Nutrition and sleep will be key components of recovery.
There are strategies people can use with weight-bearing restrictions. Woods can perform upper extremity exercise for cardiovascular health and maintaining upper body strength. He can do non-weight-bearing exercises for his legs. As weight-bearing restrictions are lifted, he can focus on high repetition, low resistance exercises to build endurance and slowly restore muscle mass.
We have to consider his age as well. Woods is a phenomenal athlete, which will help the recovery process, but at 45years of age, he will not recover as rapidly as most athletes.
Alex Smith “only” fractured his leg and was 34 years old at the time of injury. It still took him 2 years and 17 surgeries to return. True, Smith developed an infection and sepsis, but his injuries were not as extensive. Furthermore, Woods is still at risk of developing an infection due to open fractures.
The process will not be linear. He will have good days and bad days, but the progress will trend positively. The issue, however, is not in his ability to resume walking and restore muscle.
His physical therapist will be able to tailor an exercise program to his healing progress. This issue is his ability to play golf.
The challenge of returning to golf
Golfers are picked on as not being “real” athletes. While they don’t run, jump, or tackle people (remember, Happy Gilmore was not real), golfers display immense power and control of their bodies. Hitting a drive over 350 yards down a corridor only 15 yards wide requires refined and precise control of the entire body.
Woods swings a driver with a clubhead speed topping out at 130 mph. If the timing is off by fractions of a second, the ball ends up on the wrong fairway. To hit with precision and power, Woods requires complete control over every part of his body.
This accident will limit that control.
If you watch a golf swing, you will see substantial rotation in the lower legs and ankle during the swing and follow-through. This is necessary for energy transfer to generate power. The pins in Woods’ feet and ankles will limit his rotation. This can impede the backswing and follow-through.
Additionally, it will take over a year for him to develop muscle mass and restore the power he lost. He will then need to rework his swing within the new range of motion.
Woods has changed his swing numerous times in his career. He made alterations following his back and knee surgeries. The lumbar fusion specifically limits the range of motion, but not in ways that significantly influence a gold swing.
The lumbar spine primarily bends forwards and backward. He also did not fuse the whole lumbar region, allowing for compensations. Woods can still fully rotate his spine — most rotation comes from the thoracic spine — allowing him to perform nearly the same motion as pre-surgery.
The foot and ankle pins provide a much different challenge.
The foot and ankle move in all three planes of motion. As a right-handed golfer, the right foot and ankle need to be able to invert — lift the inside of your heel off the ground — during the backswing and plantarflex — pointing the foot forward — during the follow-through. He will not be able to side-bend, rotate, flex his foot and ankle as he did prior to the accident. The pivoting and shifting will be limited.
This will shorten his swing, reducing the amount of power he can develop. Physical therapy is often used to restore mobility, but no amount of exercise or manual therapy can reshape bones or alter surgical hardware.
Another concern will be his durability.
Whether you want to acknowledge it or not, golf is fatiguing and requires endurance. Professional golfers walk 7000-yard courses over a 5 hour period. Not the same as running 7000 yards, but fatigue does set in. Will his foot and ankle tolerate the prolonged walking over undulating landscapes? Throw in 30–40 high effort swings (putting and chipping shouldn’t be affected) and performance may degrade throughout the round.
This will be another primary emphasis of his rehabilitation. Physical therapy will need to replicate the demands of golf. Woods will likely return to a golf course to build up his resilience. The question is whether he can ditch the golf cart and keep up with the best players in the world.
Will he return to the PGA?
I do not believe he will. I think he will return to the golf course. He can still be one of the best putters and chippers in the world, but his power will be sapped. He will also struggle with durability.
There is a vast difference in performance between scratch golfers and PGA tour professionals. I have no doubt Woods can still be among the top 1% in the world, but his days of being among the world’s elite are likely over.
Granted, the human body is resilient, and Woods has an impressive set of genetics. If anyone can return it is him. If he does, however, expect it to be at least 2 years from now and expect Tiger 3.0 to look much different.