Dr. W. Gifford-Jones: Suppose an ACL tear had happened to a young Tiger Woods

Dr. W. Gifford-Jones

Three letters, ACL (anterior cruciate ligament), could end the golfing career of Tiger Woods.

As much as he tried, it was impossible for Woods to keep his pain to himself as he held his left knee, and limped and grimaced through 91 holes of the U.S Open. But was it prudent for Woods to play with an injured knee and risk further damage to this vulnerable joint?

A British study shows that legs account for 75 percent of all sport injuries, and one-third of them are knee disorders. Unfortunately, it’s the complex anatomy of the knee that is the Waterloo of so many athletes. Just ask hockey legend Bobby Orr how hard it was to play competitive sports after knee surgery. After several operations, he had to give up the fight.

The most common knee injury is the one afflicting Woods, a tear of the anterior cruciate ligament. It’s a band of fibrous tissue at the center of the knee that helps to stabilize the joint.

Some reports claim Wood’s ACL was injured while he was jogging. But it was probably triggered by the thousands of repetitive stresses the ACL suffered when Woods delivers his well-known violent swing. For right-handed golfers, it’s the left knee that takes the most stress. In 60 percent of cases, golfers know the ACL has been torn when they hear a sudden “pop.”

I asked several sports specialists about Wood’s future. They suggest he is such a fierce competitor and so dedicated to physical training that in all probability he’ll win other majors.

But there’s one thing that even dedication and training can’t overcome in the years ahead. Woods has already had three knee surgeries, and the end result may be arthritis in the knee which could either slow down or end his career. The knee problem will in all probability be the thing that beats Woods.

Luckily for Woods, the ACL tear did not occur when he was younger and still growing. This might have ended his career as it’s hard to repair an ACL tear at that age without damaging the growth plate.

A Harvard report says ACL tears are now happening to those engaged in Pee-Wee Football and other sports. The prime reason: Young players are concentrating on one sport, and in some areas are able to play 12 months a year. The ACL suffers.

Whatever happens to Woods, one thing is certain: He will never again have as good a knee as before these surgeries. With hindsight I suspect there was nothing Woods could have done to prevent this complication. No one has ever accused Woods of being in poor physical shape.

Was it wise for Woods to play with an injured ACL? One might argue that it was a good decision as he won the U.S. Open in spite of this disability. But only the future will tell whether it was short-term gain for long-term losses. And I have to assume the decision to play with a torn ACL was Woods’ own decision.

What would have happened if Woods had been playing in the NHL or NBA and an MRI had diagnosed a torn ACL? The decision would not have been Woods’ to make and he would have been immediately removed from the game. But the PGA has no regulations that can force golfers to stop playing.

So as much as I admire Tiger Woods, his drive to play the U.S. Open is not sending the right message to other athletes. It has never made sense, and never will, to make an injury worse before it’s treated. We may never know, but Tiger Woods, by delaying treatment, may have caused serious damage to other structures in the knee.

Today young players are being trained to circumvent ACL tears with tips on how to bend knees and physical conditioning exercises. But they can never escape the sudden unexpected torsion of the ACL ligament.

So if there’s ever a sudden pop, followed by swelling and pain in the knee, it’s the time to stop playing. Time may prove that this is true even if you’re trying to win another U.S. Open.

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