Tiger Woods’ historic return from 8 knee and back surgeries

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By Shamard Charles, M.D.

On Sunday, Tiger Woods won the Masters for the fifth time — his first since 2008.

What makes his return to prominence, at 43 years old, nothing short of miraculous is that it came after a series of well-documented back and knee problems, leading many to question if his dominance was coming to an end.

Here we chronicle Woods’ historic comeback and how he successfully returned from four knee surgeries and four back surgeries:

Injury timeline:

December 1994: Undergoes first knee surgery on left knee to remove two benign tumors and scar tissue.

Dec. 13, 2002: Undergoes second knee surgery on left knee to remove fluid inside and outside the anterior cruciate ligament, or ACL, and remove benign cysts.

August 2007: Ruptures the ACL in his left knee while running on a golf course after the British Open, but is able to keep playing. Wins five of the last six tournaments he plays, including the PGA Championship for his 13th major.

April 15, 2008: Has third knee surgery — arthroscopic surgery on his left knee to repair cartilage damage.

May 2008: Advised weeks before the U.S. Open that he has two stress fractures of the left tibia and should rest for six weeks, the first three weeks on crutches.

June 24, 2008: Eight days after winning the U.S. Open, has surgery to repair the ACL in his left knee, his fourth knee surgery, by using a tendon from his right thigh. Additional cartilage damage is repaired.

December 2008: Injures the Achilles tendon in his right leg while running as he prepares to return to golf.

May 9, 2010: Withdraws from the final round of The Players Championship, citing a bulging disk. He later said it was a neck issue that caused tingling in his right side, and that it first became a problem as he began practicing harder for his return to the Masters a month earlier.

Aug. 21, 2013: Famously drops to his knees after one shot because of back spasms.

March 31, 2014: Has first back surgery for a pinched nerve.

Sept. 16, 2015: Undergoes second back surgery — a micro-discectomy — to remove a disc fragment that was pinching his nerve.

October 2015: Hasa third back procedure to relieve discomfort in his back and sets no timetable for his return to the PGA Tour.

April 20, 2017: Undergoes a fourth back surgery. The spinal fusion, labeled a ‘success’ by his surgeon, Dr. Richard Guyer, to alleviate pain he had been experiencing in his back and leg.

How his knee affected his back

“Knee injuries are often one of the first injuries we see in golfers,” Dr. Alpesh Patel, chief of orthopedic spine surgery at the Northwestern Memorial Hospital, in Chicago said. “Once their mechanics are off, then we’ll see back injuries secondarily. So, it’s not uncommon that in Tiger’s story we saw a chain link between one and the other.”

Patel notes that this sequelae of injuries doesn’t just happen in competitive golfers but also occurs in recreational golfers — except later in life.

“We may first see these arthritic issues starting in late 30s and early 40s — as opposed to the late 20s and 30s as in Tiger’s case — and then back injuries in mid to late 40s,” Patel said.

Dr. Todd J. Albert, orthopedic spine surgeon and surgeon-in-chief at the Hospital for Special Surgery, in New York, also notes the role that genetics plays in degenerative conditions that plague the knee and back.

“More than likely, Tiger’s knee and back conditions were related. His genetics might be such that he had some early degeneration of his cartilage in his knee that caused him to change his swing mechanics and exacerbated the degenerative cartilage in his back. In other words, his knee degeneration and his disk degeneration may be related,” Albert said.

The back fusion surgery that was key

According to TigerWoods.com, Woods’ bottom lower-back disc severely narrowed, causing sciatica and severe back and leg pain. He tried conservative therapy, which included rehabilitation, medications, limiting activities and injections, but it failed to resolve his pain, so Woods opted to have surgery. The procedure was a minimally invasive surgery called an Anterior Lumbar Interbody Fusion which entails removing the damaged disc and re-elevating the collapsed disc space to normal levels. This allows the diseased vertebrae to heal to the other. The surgery gave Woods the ability to stand pain free.

Dr. Richard Guyer of the Center for Disc Replacement at the Texas Back Institute performed Woods’ surgery.