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Wednesday's with WVPT
Author: Ryan Hubbard
February 22nd 2017 - Will Tiger’s back ever be...back?
 
For this week’s “Wednesdays with Willem Verweij” I thought the time would be appropriate to discuss one of my favorite topics and players in golf: Tiger Woods.  He’s one of my favorite talking points for a few reasons.  As a golf fan, Tiger has been gracing my television screen since I was younger than 10; winning countless tournaments and opening up my eyes to professional golf.  As a Physical Therapist on the other hand, his level of fitness, physique, and injury history (we’ll get to that) has intrigued me.  You might say that his level of fitness could be a reason why his career has been riddled with surgeries.   I would argue the opposite, it’s the way he trained that could have been better.
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Tiger’s injury history is well documented since his sixth full year on tour in 2002 after getting a cyst removed in his knee.  Then came an ACL tear in his knee in 2007 and an achilles tear in 2008, yet he was still winning golf tournaments.  All until 2010.  Tiger posted ZERO wins on tour, the first time he was shut out dating back to 1996.  Several other orthopedic problems followed until he actually started withdrawing from tournaments due to dreaded “back spasms”.  In 2014, Tiger then underwent a Microdiscectomy (see below), to decrease pressure off a pinched nerve in his back.  After a second Microdiscectomy in 2015 and Tiger missing all of play in 2016; here we are.  He has now withdrawn from the Dubai Desert Classic, sat out the Genesis Open this past weekend, and will not play in the upcoming Honda Classic.  He also had to cancel a recent press conference because of his back.  I repeat, Tiger Woods (formerly the most feared golfer in the world) wasn’t physically able to sit to field questions!
 
lumbar-spine.jpgI wanted to discuss Tiger’s recent back issues and in order to understand the back surgery he has gone through, it’s important to understand the anatomy of the lumbar spine.  There are 5 bones (vertebrae) that make up this area, all which sit upon the tail bone (sacrum).  In between these vertebrae are our discs that act to cushion the spine.  The nerves that feed your legs exit the spinal canal through small holes on the side of your spine called foramen.  Sometimes these holes can become smaller due to a disc protruding outside the limits of the bone or bony compression due to loss of disc height.  When this gets severe and people start to feel pain, numbness and weakness orthopedic surgeons might opt to perform a Microdiscectomy.
 
The Microdiscectomy is a minimally invasive procedure, the surgeon uses modern tools to remove bone or portion of a disc that may be putting pressure on a spinal nerve exiting the spine.  This procedure usually takes about an hour depending on the severity of the compressed nerves.  Physical Therapy is often recommended postoperatively by the second week.  In the early stages the focus is to promote normal scar healing to prevent skin or soft tissue adhesions.  Core exercises are appropriately progressed not only for strength, but for proper timing of your core stabilizers.  Pain in itself and a resulting surgery can negatively affect what is known as “neuromuscular control”.  In Physical Therapy, we focus on retraining your muscles to perform properly and activate when you need them.  The main muscle for this is the Transverse Abdominus, which essentially acts as a corset around your spine.  This muscle needs to be firing whether you’re sitting at your desk, lifting objects overhead, or swinging your driver on the weekends.
 
Here are some basic core exercises that strengthen the deep core stabilizers to give you a proper foundation for your swing:
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  1. Transverse Abdominus Activation, 3 sets of 10:
On your back with knees bent and feet flat on floor you want to activate your core, visualize tilting your pelvis back just slightly and drawing in your belly button toward your back bone (basically like trying to zip up a tight pair of pants). You should feel a muscle muscle pull in and away from your fingers in between your hip bones. HOLD 5 sec and repeat.
 
2. Dead Bug Opposite Arm and Leg, 3 sets of 10
            http://www.mytpi.com/exercises#dead_bugs_opposite_arm_and_leg
 
3. Quadruped Hip Extension, 2 sets of 10 each side
            http://www.mytpi.com/exercises#bird_dog_hip_extension_with_knee_straight
 
 
The Tiger fan in me is clinging to the small sliver of hope that Tiger will someday be “back”.  Are you wondering if you will ever be able to be back to the course? Want to swing with less pain? Please contact us at (603)335-4700 or email me directly at ryan@wvphysicaltherapy.com We would be more than happy to help!
 
 

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