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Doctor: Knee injuries could be Tiger Woods' 'kryptonite'

As each week passes and Tiger Woods remains on his couch in Isleworth instead of on a golf course, the rumblings get louder. Will Woods ever return to the form that earned him 14 major championships and 71 PGA Tour wins? Will he ever return to golf at all?

Woods announced on Tuesday that he would not play in next week's U.S. Open due to a "mild'' left knee sprain and a "mild'' sprain of his left Achilles' tendon. The injuries occurred while playing out of pine straw at the Masters in April. Woods tried to play at The Players Champion­ship on May 12 but withdrew after nine holes because of pain in the knee.

Woods, 35, has had four surgeries on his left knee alone. How much more can he take?

"This could be his kryptonite,'' said Dr. Ronald Grelsamer, associate professor of orthopedic surgery at New York's Mount Sinai Hospital.

Woods is giving few specifics about the knee injury. He said he hopes to be ready for the AT&T National on June 30 and the remaining major champion­ships. Only Woods' doctors really know the severity, but it is clear that every new injury makes it harder for him to return to form.

"The key for the athlete is not only the ligament and the cartilage (in the knee), it's the joint surface,'' said Dr. Michael J. Smith of Tampa Bay Orthopaedic Specialists in St. Petersburg. Smith has worked with the Tampa Bay Storm, the U.S. women's national basketball team and several Major League Baseball teams.

"If he's had four surgeries, that means there may be some articular cartilage surface lining issues as well. As we get older it takes a little bit more to recover. And when you add in multiple injuries and multiple surgeries, it's going to take even longer.''

Like Smith, Dr. Koko Eaton has worked with hundreds of athletes. Eaton, who runs Eaton Orthopaedics in St. Petersburg and is the official orthopedic team physician for the Rays, said multiple knee surgeries could lead to more serious problems in the future.

"We all have cartilage in our knee, and it's like the gristle on a chicken bone,'' Eaton said. "We only have so much of it. When it's gone, it's gone. There's no technology yet to grow more back. Then it becomes arthritis. The problem with arthritis is that there is no cure. The only thing you can do is physical therapy, and that's what Tiger is doing. You can try to make the muscles surrounding the knee stronger.

"Tiger has the best orthopedic surgeons in the world, I'm sure, so they're doing all the right things.''

In Eaton's professional opinion, Woods will certainly compete again. But will he win again?

"He'll be able to play golf,'' Eaton said. "But the question is can he still be the best of the best? His swing is so powerful, and he's been doing it for so long. What he's going to have to do is pick the tournaments he's going to play in. He can't play every week or whenever he wants anymore. He's going to have to cut back a little.

"It's going to be a nagging, everyday problem for him.''

There is no way to hide a knee injury on the golf course, as Woods found out at The Players Championship. The legs are used in every shot. Woods has such a powerful swing, and has had one since junior golf, that he tends to put a lot of pressure on the knees.

"There's a lot of snap and torque,'' said Lew Smither, director of golf and PGA teaching professional at Cypress Run Golf Club in Tarpon Springs. "His left knee goes to a point and then it braces. He works upward through impact. If (the knee) is not in the strongest shape, you can see some injury there.

"He puts a lot of torque on that left knee. The legs are supporting a platform. There's going to be some torque no matter what. With the pros who are trying to create swing speed, there's going to be more resistance in the lower leg so they can get the swing speed they want. It will be interesting to see in the future how many of these young players have knee problems that we don't even know about yet.''

Most physicians are in agreement that Woods will eventually return to competitive golf. And most haven't ruled out a return to top form. But it also appears likely the Woods who plays from now on will be a creakier version of the one golf fans are used to.

"With every new episode, every new procedure, the odds of him having a complete recovery diminish,'' Grelsamer said. "The only reason I thought he might come back, and I still wouldn't rule it out, is because he is not your average athlete. Even in a worst-case scenario and he has a knee replacement, he could probably do everything he did before.

"I read that he had a Grade I sprain, but with somebody who has had this many problems with his knee, I'm thinking I'm not 100 percent sure I buy it. It could be true, but it's also possible that it's a smoke screen. We won't know for a long time.''

Tiger Woods injury timeline

June 7, 2011: Decides not to play the U.S. Open because his left knee and Achilles is not fully healed. It is the first time he has missed the U.S. Open since 1994, after he graduated high school.

May 12, 2011: Withdraws after nine holes at The Players Championship after a 42, his worst 9-hole score at the TPC Sawgrass. He had a noticeable limp over the final hour. "The knee acted up, and then the Achilles followed after that, and then the calf started cramping up. Everything started getting tight," he said.

April 26, 2011: Reveals he has a minor sprain of medial collateral ligaments in left knee and minor strain of his left Achilles, and he will miss the Wells Fargo Championship.

Dec. 11, 2010: Has cortisone shot in his right ankle because of lingering soreness in his Achilles.

May 9, 2010: Withdraws on the seventh hole of the final round at The Players Championship with what he fears is a bulging disc. He later says it was inflammation of a joint in his neck. He doesn't miss a start, returning a month later at the Memorial.

December 2008: Ruptures the Achilles' tendon in his right leg.

June 24, 2008: Eight days after winning the U.S. Open at Torrey Pines in a 19-hole playoff, has reconstructive surgery on the anterior cruciate ligament in his left knee and to repair cartilage damage. He misses the rest of the 2008 season and is out for eight months.

June 2008: Advised in the weeks before the U.S. Open that he has two stress fractures of the left tibia and should expect to be on crutches three weeks, out of golf for an additional three weeks.

April 15, 2008: Two days after his runnerup finish at the Masters, has arthroscopic surgery on his left knee to repair cartilage damage. Decides against repairing ligament to avoid longer rehabilitation and to play the other three majors. Misses Quail Hollow, The Players Championship and the Memorial.

July 2007: Ruptures his anterior cruciate ligament in the left knee when he took a misstep while running on a golf course. He wins five of his last six tournaments he plays, including the PGA Championship.

Dec. 12, 2002: Has surgery to remove fluid inside and around the anterior cruciate ligament. Misses the season-opening Mercedes Championship for the first time, and returns 10 weeks later to win the Buick Invitational.

December 1994: As a freshman at Stanford, has surgery to remove two benign tumors and scar tissue in his left knee.

Times wires

Doctor: Knee injuries could be Tiger Woods' 'kryptonite' 06/08/11 [Last modified: Wednesday, June 8, 2011 10:45pm]
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