Tiger Wood's ACL Repair

Tiger Woods had his ACL repaired this past Tuesday in Park City, Utah. It is now known that he originally tore it in 2007 while jogging after the British Open. So what's in store for him and how long will it take?

I had my own ACL repaired in 1994 and have some experience with skiers ACL surgeries when I was involved in ski area risk management. ACL repair is common for skiers and that's why some of the best doctors in the world for this surgery are in Vail, Colorado and Park City, Utah. From what I know, here's what Tiger will go through. Immediately after surgery, Tiger's left leg will be hooked up to a machine that continually flexes the knee joint. In a matter of only a few days he will start physical therapy. Most likely he's already been fitted for a knee brace that he will begin to wear in a couple of weeks. In the beginning he will only be able to do exercises that are closed chain, meaning his knee can only move in one plane such as when you ride a bike. At this stage it is important that the knee is not allowed to move laterally, such as happens when you walk on uneven ground.

I can't say where they got the new ligament for Tiger's repair as different surgeons have different philosophies on this. Sometimes it comes from your own body, mine was a piece of my patella tendon, and other times it's from a cadaver. Perhaps in 2008 they have other options. The repair itself is done arthroscopicly. The operation is fairly straight forward and takes less than an hour if there are no complications.

The biggest issue with recovery is the fact that tendons have limited blood supply which translates into a long time before they get to full strength. As I recall this takes well over a year. I had to wear a brace while skiing - as a preventative measure - for two years and then was able to go without. The danger for most recoveries is that the knee will feel great even though the tendon is not at full strength, enticing athletes to over stress the tendon and tear it again. This happened to a good friend of mine who was a ski racer and soccer player.

You can actually ski normally without your ACL. I tore mine playing softball and decided to wait until after ski season to have it repaired. I skied with a brace and felt just fine. Normal skiing is basically a closed link activity and done with bent knees so the ACL doesn't come into play that much. Most skier injuries occur when they fall. I'm no expert on the motion of the knee during the golf swing, but I haven't heard that it's a normal injury for golfers to tear ACL's. More normally they mess up their cartilage.

Ernie Els has never regained his form after having his ACL repaired when it was torn during a water skiing accident. I'm not sure anyone knows if his problems have anything to do with his injury. His swing certainly looks good and he doesn't appear to be in any pain. In my limited experience the ACL either works or it doesn't. There's not really a middle ground. The bottom line for Tiger is that the longer he waits to return next year, the better his chances will be to not tear his ACL again. So which major will he wait for?