As Tiger Woods embarks on his long road to recovery after a car accident that smashed his lower right leg, there are many questions about the American golf star’s future.
Woods underwent emergency surgery that involved inserting a rod to support multiple open fractures into his right and fibula bones. Pins and screws for ankle and foot support have been placed on the same leg.
Nobody knows if the 45-year-old winner of 15 major titles will be able to compete again at the highest level, and only those closest to his treatment have any knowledge of how the next weeks and months of his recovery will develop.
But with the limited details published, experts can identify potential scenarios. As a former PGA Tour player, Bill Malone Well positioned to provide an informed opinion after having studied at Duke University School of Medicine and qualifying as an Orthopedic Surgeon.
Malone worked in emergency rooms to deal with post-automobile accidents similar to those that Woods had on Tuesday. Malone now works for Hilton Head, South Carolina, and is the editor of the Journal of Shoulder and Elbow Surgery.
We asked Bill 10 key questions.
1. How severe are his injuries?
It’s dangerous for sure, but I’m not sure I can put a numerical value on it. These are the things you see all the time in orthopedics. It is not an uncommon injury by any means. It’s not as if no one has recovered from this, rather, most people do.
Injury to the right leg is common in a car accident because you place your right foot on the brake pedal and stabilize against it. When you have a front collision, it pushes the front of the car into your leg and squeezes it.
American football player Alex Smith had a similar injury to his tibia, an open, comminuted fracture (fracture in more than two places) in 2018 and had all sorts of complications. He nearly lost his leg and ended up undergoing 17 surgeries. I guess because this is still fresh on the minds of the American sports public, they extrapolate it to Tiger and assume he will experience the same thing.
This is not necessarily true and Alex Smith is the exception. The normal situation is to recover, not catch an infection, and be able to walk again.
2. How important was it that Tiger was running so fast after the accident?
It is very important to reduce the risk of developing a leg infection. If any dirt gets into the wound or there is any contamination, it should be cleaned as soon as possible.
There was also a possibility of compartment syndrome, which is the increased pressure on muscles, nerves, and arteries that can cut off blood supply to the lower leg. It was very important to treat this as quickly as possible so that blood flow would not be cut off and lead to the death of muscle and dead tissue in the lower leg.
3. Will he experience severe pain and how is this dealt with?
Tiger has a small history of drug problems after two surgeries in his back. These would definitely be painful injuries and we usually give patients painkillers to deal with them. Tiger will have to be careful about how much he uses and doctors will know this and be wary as well.
We are more aware in the United States now of what has been happening in the last few years with the opioid crisis. We realize that many people have overused this, but Tiger’s past history means he will need to be closely monitored.
4. How important is the postoperative period?
They will look at how things are doing well in a tiger’s leg and check the blood supply. Their wound dressings may be changed or they will wait two days, depending on the surgeon’s preference.
In the hospital they will check his vital signs to make sure there is no fever or anything that indicates an infection is developing. They will check this blood count as well as it is a major surgery and he might have lost some blood.
5. What will his treatment program be?
It’s hard to say without seeing fractures and x-rays, but, most likely, it will be placed in some sort of protected weight-bearing condition. He cannot bear the full weight. In orthopedics we have degrees of weight bearing status.
I can’t say how far it will go, but it will be protected by either a treadmill or more likely a small walker where you put your bent knee on the treadmill and sort of walk on your left leg and roll to the right.
Ideally, you want to bear the weight of the leg now that you have a rod inserted but this process is more difficult due to the multiple fractures of the ankle and foot. It’s a little bit of concern but we’re dealing with these issues. It’s not something we haven’t dealt with before.
6. Is its age a factor?
In terms of golf, people talk about he’s 45 years old and he’s kind of outdated, but in terms of bones, we’d say he’s still a bit young. Still a good time to heal things up at 45.
7. What is the speed of recovery?
Most fractures heal well within six weeks to three months. In the lower extremity it is usually three months or so. I don’t know the extent of the soft tissue damage. The more the blood supply is interrupted and the more it heals with the blood supply, it can delay healing a little.
I still think that in three to four months he might be able to get a full weight bearing condition for that leg. The good thing about Tiger is that he has always been in excellent health. He trained, and his muscles strong so he would have fairly good blood flow for that leg.
The problem is that we do not know how much was cut due to the soft tissue injury.
8. Does the fact of his recovery from back surgery complicate matters?
I don’t think so in terms of leg healing. But the leg problem may complicate matters on the back. He might not be able to do some of the back rehabilitation that he’s been doing. It is possible that he has had some bumps, perhaps slight, to the back as well which Tiger, given his history, does not need.
9. What are his chances of playing again?
Assuming a tiger’s leg heals without injury, the next problem is the other fractures he suffers in his foot and ankle. It might cause arthritis on the way. But even if he gets to, I think he will walk again and I think he will likely be playing golf again.
He might be able to play competitive golf again, too, but after a year he – he won’t be playing this year, I don’t imagine.
10. Does the fact that his right ankle make him more beneficial for golf?
Yes, for a right-handed player, your left ankle will be under much higher pressure because this is the leg that twists and rotates when you go down on a collision at high speed.
The right leg is under more pressure in the back swing, but this pressure is much less than what the left leg feels during the downward swing and impact.
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