What to Expect from Tiger Woods in His Return from Back Injury

Will Carroll@injuryexpertSports Injuries Lead WriterJune 25, 2014

Tiger Woods gets set to swing at the driving range as he practices at the Quicken Loans National golf tournament, Tuesday, June 24, 2014, in Bethesda, Md. (AP Photo/Nick Wass)
Nick Wass/Associated Press

It's no surprise that Tiger Woods has returned from back surgery. The surprise is that he's done so several months faster than initially anticipated. Was it the siren call of a favorable British Open, or did something change after Woods' microdiscectomy? While Woods hasn't revealed much, we can take a look at how he's progressed up to this point to better make predictions about his return.

There will be many questions leading up to Woods teeing off at Congressional Country Club this weekend, so let's try to answer some of them.


What kind of surgery did Woods have?

Woods had a microdiscectomy to remove an impingement from his lower back. In the arthroscopic surgery, a piece of disc is cut away to make a tunnel for the nerve as it comes from the spinal cord. This is a very common procedure in both athletes and the general population. 

The best-known athlete to have this procedure is Peyton Manning, who had two microdiscectomies on his neck. He did eventually need the more invasive fusion that cost him a season, but Manning played well between having the microdiscectomy and the fusion.

In golf, Fred Couples has had a similar procedure, as have Vijay Singh and Hank Kuehne. Couples and Singh have also had Orthokine back therapy. Woods has had this type of blood spinning procedure on his knee, but it is unknown if he has had it done again on his back.


Did the surgery correct the problem?

Woods has been playing golf for at least a few weeks, which surprised some observers, including this one. At the time of his surgery, I expected that Woods would be out for all of the majors this season and that we would see a late-season cameo.

Given he's playing competitively, we have to assume that not only has Woods been cleared by his surgeons, but that he has expectations of playing at a certain level. If that's not the definition of successful surgery and rehab, I don't know what is. 

Woods appears to be playing without significant pain at this point, though he did say that "listening to my body, that's one thing that I have learned, stubbornly, over the years, that I have to do this," during a press conference (transcript via TigerWoodsFoundation.org) Tuesday on ESPN's SportsCenter. This sounds like he's pushing the rehab at a very quick pace, but has not had any major setbacks. 

Nick Wass/Associated Press


Why was the rehabilitation shorter than expected?

The standard rehabilitation timeline for this surgery and this type of athlete is three-to-six months. Woods is almost exactly at the three-month mark. Essentially, everything went right. There were no setbacks and no other delays to the return process. 

Woods was clear about this. He worked hard. At the Tuesday press conference, Woods credited his rehab team. "I healed fast," he said. "As I said, I've had great trainers and great physios help me every day with soft tissue work. ... When you get treatment all the time, it's amazing what you can do."

Woods did give us some interesting info in that quote, especially the fact that he used the term "physios," which is the word Europeans use for their first-line athletic medical staffers. In the U.S., the equivalent is the athletic trainer. (There are significant differences, but they're rough equivalents.) It leads to the possibility that some of his treatment was done overseas, which makes Orthokine a possibility.

We do know that Woods was rehabbing much of the time in Colorado and Florida, along with girlfriend Lindsay Vonn, who is rehabbing her own knee injury. Whether he made any trips for treatment or rehab is unknown, and Woods' representation would not comment.

The other clue regards soft tissue work. Obviously, the structural tissues and nerve impingements were addressed surgically, but if Woods can strengthen the muscles that support the spine as well as associated structures, he would be ahead of the game. It sounds like he gave a special focus to that, given he thought to mention it specifically.


Why is Woods electing to come back at Congressional?

The fact that Woods' own foundation is involved with the Quicken Loans National tournament has certainly been brought up. So is the fact that there is a new title sponsor this season. However, Woods' agent, Mark Steinberg, told Barry Svrluga of The Washington Post:

...If [Woods] hadn’t tested out his back under the conditions that he knows he needs to test it in over the last couple days, and if the back wouldn’t have responded to date the way it has, it wouldn’t have mattered if it was his tournament with a new title sponsor in Quicken Loans.

The course itself is not particularly suited to cover any holes in Woods' game—if there are any. The course may be known to Woods, but it remains long and with enough obstacles to really tax his back if he happens to fall into some of its traps. 

More interestingly, the British Open is coming up in a matter of weeks and will take place at Royal Liverpool, where he had a convincing victory in 2006. While this may factor in slightly, it appears that Woods' staff wants us to believe he is simply ready to play golf and that this timing is merely coincidental. 


Did Woods and his coaches make any changes to his swing?

This is the major surprise. While Woods hasn't made any public appearances, there doesn't appear to have been enough time to make major changes. Gary Huston, a golf coach based in Indianapolis, told me in March that "it all started with the knee."

Huston continued: "He used to have a one-plane swing and he would post that knee, really hyperextend it to create more force. Now he's shifted to an over-the-top Sean Foley swing with a soft knee. He simply can't make the same move and get the same results."

If Huston is correct (and several other golf coaches and observers I have spoken with believe he is), then Woods is going to have to make an adjustment not only to protect his knee, but to protect his newly repaired back. 


What should we look for when Woods gets on the course?

Woods told the media that he was "good enough to play." That doesn't sound like the normal ultra-confident Tiger Woods most are used to. Some of this is Woods keeping expectations down, but the fact is that he is probably just good enough to play at this stage.

Not only has he not made any significant changes to his swing, he is still learning how his body will respond. He's played golf and likely simulated the conditions he is expected to face, but competition is always more difficult than simulation. 

Look for any changes in the way he pops his knee during his swing or if there are any problems with his rotation, on either the backswing or swing and follow-through. This will be especially key on long shots and late in the day when fatigue and heat might contribute to problems.

At just 130 days between hobbling off the course and striding back onto the big stage, Woods is taking a bit of a risk, but a well-calculated one. If Woods and his team did not believe he was prepared, he simply wouldn't be playing. Woods may not be ready to win, but he wouldn't be playing if he didn't think he could soon.


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