Surgery or a long term rehab for back injuries?

[Pat du Golf]

Tiger, Day, Fred couples, etc. are prominent players with back injuries. We can't count how many surgeries TW has gone thru in a short period of time.

Interestingly, Steve Kerr (Gold State warriors coach) is advocating a full rehab and to never let anyone open up the back.

 

" I can tell you if you’re listening out there, if you have a back problem, stay away from surgery,’’ Kerr told reporters. “I can say that from the bottom of my heart. Rehab, rehab, rehab. Don’t let anyone get in there.”

 

Back in 2015, Nick Watney opted for a rehab as well.

 

Phil has relied on the Earnest Jones philosophy of swinging the clubhead to have a healthy back.....

 

Sources:

 

Steve Kerr quote. http://www.mercurynews.com/2017/04/24/is-warriors-coach-kerrs-stay-away-from-surgery-good-advice/

 

Nick Watney: http://www.espn.com/golf/story/_/id/17779661/with-ailing-back-nick-watney-took-different-route-tiger-woods-heading-safeway-open

 

https://www.nytimes.com/2016/04/08/sports/golf/the-achilles-heel-of-too-many-golfers-a-bad-back.html?_r=0

 

 

 

[whr]

Case dependent.

[Petunia Sprinkle]

I don't know why a golfer wouldn't start with a combination of 'rehab, rehab, rehab' and 'stop swinging like that' before opting for surgery, aside from a catastrophic injury (falling out of a tree, etc.).

[ALIF]

Case dependent.

 

^^^^^^^^This x infinity.

[playa]

I don't know why a golfer wouldn't start with a combination of 'rehab, rehab, rehab' and 'stop swinging like that' before opting for surgery, aside from a catastrophic injury (falling out of a tree, etc.).

It does seem pretty sensible that if swinging the club a certain way hurts your back you find a new way to swing that puts less pressure on the back. I know that's easier said than done, but tiger of all golfers has shown the ability to adapt to a new swing.

[RBImGuy]

Tiger, Day, Fred couples, etc. are prominent players with back injuries. We can't count how many surgeries TW has gone thru in a short period of time.

Interestingly, Steve Kerr (Gold State warriors coach) is advocating a full rehab and to never let anyone open up the back.

 

" I can tell you if you're listening out there, if you have a back problem, stay away from surgery,'' Kerr told reporters. "I can say that from the bottom of my heart. Rehab, rehab, rehab. Don't let anyone get in there."

 

Back in 2015, Nick Watney opted for a rehab as well.

 

Phil has relied on the Earnest Jones philosophy of swinging the clubhead to have a healthy back.....

 

Sources:

 

Steve Kerr quote. http://www.mercuryne...ry-good-advice/

 

Nick Watney: http://www.espn.com/...ng-safeway-open

 

https://www.nytimes....-back.html?_r=0

 

you will find the back injury will escalate the coming years for tour pros, more surgeries will happen.

no way around that with current theories.

[Bingo1976]

Rehab and strengthening first. Surgery as a very last resort (I might even take retirement over surgery if I am honest, and if I'd had enough of a career by then).

[lowheel]

I don't know why a golfer wouldn't start with a combination of 'rehab, rehab, rehab' and 'stop swinging like that' before opting for surgery, aside from a catastrophic injury (falling out of a tree, etc.).

It does seem pretty sensible that if swinging the club a certain way hurts your back you find a new way to swing that puts less pressure on the back. I know that's easier said than done, but tiger of all golfers has shown the ability to adapt to a new swing.

 

Tiger like Phil has magical hands so why couldnt he. I also refer you to Ernie Els. When he got to 38-39 he felt alot of tightening in his lower back regardless of all the core/back strengthening exercises he was doing. He decided to lift his left heel off the ground on his full swing and voila more hip turn more shoulder turn more free flow swing, less strain on his back. Its an individual thing for everybody though not an exact science

[lumberman2462]

I tried rehab for almost a year. Not because I wanted to or really believed it would work. I got to the point where it was constant 24 hour pain and couldn't really walk.

 

10 years later I'm pain free....I can't play a lick anymore but I'm also not laying on the couch in agony.

 

 

[caniac6]

I was given the option of rehab vs surgery for a shoulder injury. My regular Doc told me to avoid surgery. I figured I had nothing to lose by trying rehab, and it worked. Obviously not as serious as a back.

[Hawkeye77]

People are different, injuries are different, how people use their bodies is different.

 

Steve Kerr doesn't even know for sure what the result would have been had he not undergone surgery.

 

Another in a long line of back surgery threads with the same answer - it depends.

[VNutz]

I think in most cases, not back specific, rehab is the preferred route over surgery. But some things cannot and will not heal and thus surgery is necessary. The problem with back surgery is that it doesn't guarantee anything, and in fact can make things worse, like Steve Kerr is currently experiencing. I've seen it firsthand, I've got an uncle that had his first back surgery 15 or so years ago, not a golfer. He's had to have several others since, each with the hope that this one would fix it, and ever since his life has spiraled into a mess of medications and discomfort to the point I don't know how much longer he'll be able to handle it. He went from a vibrant, active, athletic person to one who could no longer physically hold a normal office job. It might fix things, but it might make them much worse.

[BlackDiamondPar5]

As others said, it's case dependant.

 

I had a portion of the disk between c6/c7 removed over 20 years ago. Tried the conservative approach for months with no relief... I was in agony. Fortunately for me it was a complete success.

 

I have a golf friend that had surgery in L region of the back after a long period of the conservative approach. Another complete success.

 

You can only avoid the knife for so long when therapy and rest doesn't work.

[No_Catchy_Nickname]

Case dependent.

 

Yep.

 

I had a back injury in my early twenties. I had to have it operated on because rehab alone couldn't fix it.

I do think it's better to avoid surgery as much as possible, but there are plenty of cases where you can't.

And obviously, prevention is better than the cure.

[mosesgolf]

Yes. Case dependent. Over the years I've heard and read about back surgeries working and not doing a thing. It seems like it's 50/50. But surgery should be an absolute last resort. I've had a few back issues over the years one that kept me bed ridden for 2 weeks and another nerve issue that caused excruciating pain. Fortunately those resolved on their own.

[Sun Devil]

analogy. Older car with a lot of miles on it. fix one thing and then another part breaks. A back has a lot of moving parts. Fix one part and you move the stress to another worn out part. In certain cases (herniated disc with nerve impingement) ..... Surgery will provide immediate relief. In performance/sport related stress injuries .... Surgery will only delay the inevitable.

[cardoustie]

I am on the fence

 

My sciatica is gone now but it took a while after multiple surgeries 12 years ago. (2 microdisckectomy's and a laminectomy). All done on L4-L5. My L5-S1 is also herniated but not impinging .. so far

 

My back can still go out for 4-5 days but I now longer have the crippling sciatica which caused me to collapse at times in pure agony. (think crawling up the stairs whimpering sort of pain)

 

Case dependent. The best candidate will have one blown disk and fixing it will make a world of difference .. if their other disks are healthy

 

If all your disks are degenerating (like mine thx to a poor genetics lottery) ... going in can be a crap shoot

[tbowles411]

It is case dependent. I'm in chronic pain. The doc told me to stop golfing altogether. After I told him what to do with himself, we're managing the pain before, the day of and after I play. He said surgery was an option but in his words, he said, "I can cure you to a point, or paralyze you." So I have no doubt going the conservative route was more attractive to Tiger. He's clearly a better athlete than all of us, but being able to manage pain is a challenge for anyone. He caught hell for saying his glutes weren't firing. But that's a function of the nerves leading from the back, down your butt and into your legs. If pain signals are being sent, he's fighting what his body want him to do instead of the other way around.

 

I don't envy him. But the folks who are crass about all of this, I caution you. As you begin to age and play golf, this will begin to become an issue. I don't wish it upon you, but things start to wear out and his back was bad for a long time before it really gave out. Rory is having back problems, JDay is having back issues, and those are just the high profile guys. I'm sure many more are as well.

[Forged4ever]

First off, and I loved Kerr as a Player and as a coach, however he's an athlete/coach, not a neurosurgeon or orthodopedic spine guy.

 

As WH stated along with TB above me, it's case dependent, basically depending on WHAT you have, WHERE ya have it, and WHAT your activity/life style goals are.

 

Just as there is no "blanket" diagnosis, there is no "blanket" treatment plan, any more than there is for a knee, elbow or shoulder injury.

 

That being said, there is an a little saying within the surgical community and ya usually only hear it out of the mouths of residents(like teenagers, they may be talented but they are naive and prone to saying stupid shat at inappropriate times, lol), just as they are the only ones prone to describe any surgery as "simple/minor," and that is that when ya(a surgeon) cut a guy/gal's back, you've just gotten a patient for life, versus the vast number of other surgeons perform the surgery, fix the problem, and the patient goes out the door following the appropriate post-op follow-up to resume their lives.

 

The other thing that is not spoken of outside of a surgeon's lounge is that back surgery doesn't really "fix" anything long term it sure the hell does not permanently.. The "whys" are too numerous and detailed for this kind of discussion however most spine guys, and I'm speaking to THE Best of the Best, are just trying to buy the patient some time, to relieve them of their present pain level and in a few rare cases get them back to pre-surgical activity levels(Rocco and Freddy come to mind).

 

That is it-

 

Nothing more-

 

How they tell a patient that is an individual thing, just as the conditions are.

 

But one thing that you can take to the bank and that is that just as there are no mulligans or "re-dos" on the golf course, very very very rarely is there one on a man's/woman's spine-

 

EVERY single time that they have to go back in there further reduces the prospects of that patient EVER regaining their pre-operative activity level, especially at the world's highest level.

 

That's about it, haha. Mine is the long winded version of WH's thoughts with the added thought that if he's smart, he puts aside the ego, listens to the appropriate people in his life and gets to the point where he will be able to goof around with his children without having to sit on the porch and watch them.

 

Well, the weather here sucks, I've got a radiation session today which doubly sucks and I gotta run for a bit.

 

Have a great day Gents?

RP

[Forged4ever]

analogy. Older car with a lot of miles on it. fix one thing and then another part breaks. A back has a lot of moving parts. Fix one part and you move the stress to another worn out part. In certain cases (herniated disc with nerve impingement) ..... Surgery will provide immediate relief. In performance/sport related stress injuries .... Surgery will only delay the inevitable.

Now THIS is a great friggin post!!

 

Very Nicely Played?️

 

All the Best,

RP

[Forged4ever]

The age old axiom, "rehab and strengthen" is a very dangerous one and for the most part, you will only hear it uttered by idiot PCP's and chop surgeons(if ya ever hear this advice regarding a rotator cuff TEAR, run, not walk, sprint as fast as your fat arse can out of the office and go find yourself a real shoulder guy). It was used when the thinking was that there was enough soft tissue surrounding the injured area or soft tissue that one could strengthen the surrounding soft tissue(tendons, ligaments, muscles, etc.) and basically "hide" the injured soft tissue/area until it healed.

 

They've come to find out that the body don't work that way, lol, nor does recovery.

 

Google a schematic of the spine-

 

Heads up....

 

It don't work that way?

 

My Best,

RP

[cardoustie]

Oh and I will say try injections in the lower back around the disks that are NFG

 

Did this for 3 years and it helped a lot

 

You can do epidurals (every few months) or weekly appts with numbing agents

[rcain1us]

For us mere mortals, most insurance companies will not let a surgeon touch you until you try PT and rehab first.

 

The problem these millionaire athletes have is they want the quick fix.

[No_Catchy_Nickname]

One more thing, though this may apply only to the UK, if you have a spinal disc problem, in the UK go to a neurosurgeon rather than an orthopedic one. I was given that advice from a relative who got completely messed up by an orthopedic surgeon before I had my surgery, and I was glad I listened. I have since heard similar stories of orthopedic surgeons cocking up spinal surgery, and neurosurgeons doing a better job, though I am sure there are exceptions.

 

/side anecdote: the chap who operated on me was brilliant but a bastxxx to work with, apparently. About 5 years after my surgery, I read in a newspaper he was struck off for harassing nurses.

[Forged4ever]

For us mere mortals, most insurance companies will not let a surgeon touch you until you try PT and rehab first

THIS is true though a lot goes into HOW the Surgeon classifies and documents his/her findings and what they put in the chart. Unfortunately, with health care today(in the US), where the bottom line, at least to the insurers, IS NOT the patient but instead the dollar bill, the onus falls on the Physician to not only know how to appropriately diagnose and treat the patient, but also what to say and how to say it just so they have the opportunity to treat that patient as their medical/surgical knowledge dictates.

 

It sucks but we asked for it and they only gave us what we asked for, lol

 

Putzes ?

 

Nice Post?

 

All the Best,

RP

[dan360]

I was a very fortunate 21 year old kid who on March 31,1999 went under the knife for a back surgery done by one of the best in the country.

 

Lots of stars aligned to have him in town doing microsurgical clinics for other neurologist/neurosurgeons and he was willing to use me as an example.

 

18 years later, I have not followed his recommendations very well--I'm fatter, not as flexible, have not adjusted much in my life post surgery as far as activities go--yet I'm for the most part pain free. Relative to things that are my own doing.

 

The old way of back surgery was like the carpet bombing approach. "Exploratory" many called it. Cut a big gash and root around in there looking for what that grainy CT scan showed them. Rods. Screws. Plates. All that.

 

The new way--lucky enough I got it in '99--is small incisions. Less than 1" most of the time. Hard target focused efforts. MRI's *in* the OR. Minimally invasive. Still a major surgery and any Surgeon worth a darn will say that, but the recovery times are much quicker. That's relative though, as my doctor told me 6-8 months at a minimum, plan on one year.

 

It was one year to the day March 31, 2000 when I became completely able to say I was 100% again. Although you're never really 100%.

 

With the advancements in spine surgery I'm very alarmed someone like Tiger has had so many setbacks, however I can see it in his swing that until he fixes that, it will never stop.

 

This is rambling and done on a phone via in flight wifi so it may not even work but I can talk for hours about my opinions on successful surgical outcomes for minimally invasive spine surgeries.

 

1. Find a good doctor. I saw 9 before making a choice. Thank goodness he was available.

 

2. Do what they say for rehab. Don't cut corners. Do it right.

 

3. Change your ways. If that means no more extreme snowboarding or a different golf swing, you might look into it. Rocco Mediate changed his swing. He's had a better career post surgery.

 

4. Stay flexible. This should be #1 but I think a good doc is very important.

[eagle1997]

We can't count how many surgeries TW has gone thru in a short period of time.

 

what about your source in TW's camp? he can't count them?

 

still waiting on that retirement announcement you claimed was imminent.

 

that was 3 months ago, champ.

[Forged4ever]

1. Find a good doctor. I saw 9 before making a choice. Thank goodness he was available.

 

2. Do what they say for rehab. Don't cut corners. Do it right.

 

3. Change your ways. If that means no more extreme snowboarding or a different golf swing, you might look into it. Rocco Mediate changed his swing. He's had a better career post surgery.

 

4. Stay flexible. This should be #1 but I think a good doc is very important.

THIS should be pinned!!

 

Excellent advice?

 

Regarding finding the right doc, I couldn't agree more however if ya don't know anyone(be leary if blindly following. PCp's referral) to save yourself some time(this is for US members only :) ), not to mention some coin with your co-pays, PM me and if I don't know someone(orthopedics, cardio and neuro) in your area, I know someone who does and will get ya a name or two.

 

If I and they don't know anyone, take some perks, rehab it and live with it??

 

Great post Danno and continued good health?

 

My Best,

RP

[Pat du Golf]

We can't count how many surgeries TW has gone thru in a short period of time.

 

what about your source in TW's camp? he can't count them?

 

still waiting on that retirement announcement you claimed was imminent.

 

that was 3 months ago, champ.

I know, but I might not be wrong at the end of the day.... good call

[Forged4ever]

One more thing, though this may apply only to the UK, if you have a spinal disc problem, in the UK go to a neurosurgeon rather than an orthopedic one. I was given that advice from a relative who got completely messed up by an orthopedic surgeon before I had my surgery, and I was glad I listened. I have since heard similar stories of orthopedic surgeons cocking up spinal surgery, and neurosurgeons doing a better job, though I am sure there are exceptions.

 

/side anecdote: the chap who operated on me was brilliant but a bastxxx to work with, apparently. About 5 years after my surgery, I read in a newspaper he was struck off for harassing nurses.

In the US, the specialty of orthopedics is broken down into myriad subspecialties, i.e. Sports med, and while there are a few Hitters who do soft tissue knee repairs(cartilage, ligament and reconstructions) and say, elbows and shoulders, your top dogs and the one who did my two shoulder repairs does only upper extremity(elbows and shoulders), though for hands(carpel tunnel) I'd find a great plastics guy who does hands cuz your plastics guys, transplant and neuro Boys usually have the top hands in their respective residencies, joint replacement(hip/knee/shoulder), trauma(pelvic recon, etc) and then spine.

 

Usually orthopedic spine guys do from thoracic down(see diagram below). The neuros take care of the full spine, including the cervical area, which while I won't go so far as to say there ain't a pod doin em, I don't know of any nor have I ever come across one. As far as surgical abilities go amongst the very best, you can flip a coin between the two specialists. In fact, if you needed rods/plates/screws or any TLS work done in the WPa area, I'd recommend John Levy, a World Class orthopedic spine surgeon and a World Class Gentleman, which is an extremely extremely rare combination(He also comes on the board as a "lurker," lol. Hey Bro, I hope all's well :) ).

 

So while your observation may be valid in Europe, that is not the case in the US regarding the two specialties.

 

World Class is World Class and doesn't favor the one over the other.

 

Fairways & Greens 4ever My Friends ⛳️

RP