ALEXANDRIA, VA, February 27, 2009 — The world
watched Wednesday as Tiger Woods made his much anticipated comeback to
professional golf after undergoing ACL (anterior cruciate ligament)
reconstructive surgery. According to the American Physical Therapy
Association (APTA), rehabilitation with a physical therapist played a
large role in Woods' return to the golf stage.
"With all due respect and credit to Tiger's surgeon for
laying the foundation of his knee's health, the rehabilitation that
Woods has been undertaking since the day he emerged from surgery might
be the most important factor in this next phase of his career," said
APTA spokesperson, Stephania Bell, PT, OCS, licensed physical therapist
and ESPN.com's injury analyst correspondent. "Returning to play after an
ACL reconstruction can be daunting for any athlete, and some of the
challenges an athlete faces are specific to his or her sport. But, since
starting his rehabilitation for reconstructive knee surgery, Woods' has
been ahead of the game."
All athletes depend on the ACL to help control knee
stability. However, the physical therapist individualizes the
rehabilitation program to the specific needs of the athlete. Rotation is
a key component of golf and is addressed and incorporated into the
athlete's rehabilitation program. According to Bell, "Early in the rehab
process, straight plane movements are emphasized, meaning the body moves
in one direction - forward, backward or sideways." These movements
produce less force on the ACL during the critical, earlier stages of
tissue healing. The simple movements make it easier for the body and the
brain to adapt as the athlete relearns how to move properly.
Nevertheless there are basic, mechanical elements
emphasized in a post ACL reconstructive rehabilitation program. "Core
fitness is essential to train the muscles that support the pelvis and
spine, in particular the abdominal and hip muscles, which are essential
for the golfer's frame," Bell said. "Additionally, a stronger core
serves to enhance the strength of the limbs; the legs and arms move
easier and with less effort as an extension of a solid central
base."
APTA spokesperson Bud Ferrante Jr, PT, OCS, MTC, a
licensed physical therapist who works with both professional and amateur
golfers at his private physical therapy practice in Carmel, CA, says
that full recovery from ACL surgery typically ranges from six to eight
months when the ligament is completely healed. "Of course, every
individual is different," says Ferrante. "A typical golfer post ACL
surgery could be back on the golf course as soon as six months following
surgery — if the golfer works with a surgeon and physical
therapist and follows the plan of care."
Ferrante notes that the first week after surgery is
mostly about controlling swelling, pain, and getting patients to start
moving as soon as possible. "Individuals who undergo surgery similar to
Tiger's often use crutches for the first week following surgery to limit
the weight-bearing on the knee and then progress to one crutch or a
cane," he said.
Physical therapy starts immediately after surgery,
several times a day at first, beginning with very gentle knee range of
motion exercises, notes Ferrante. Depending on the extent of the
swelling, a physical therapist will then work with patients who undergo
surgery such as Woods' on progressive range of motion exercises that
focus on regaining any lost knee motion. Once the swelling has subsided,
the physical therapist focuses on helping the patient strengthen the
muscles around the knee, including the hamstrings, and quadriceps
muscles.
"The most important thing following ACL surgery is that
patients avoid any type of twisting motions of the knee and not overdo
the activity in the first few weeks of healing. The knee takes about
four to six weeks to heal. If swelling increases, this could impede
recovery," said Ferrante. Post-surgical ACL patients need to be careful
going down stairs and to avoid certain exercises such as knee
extensions.
APTA says that awareness of proper posture and the
importance of fitness and flexibility are just as important for weekend
golfers as they are for the pros. Golfers should have access to a
physical therapist who can assess their physical abilities and provide
individualized training programs that address musculoskeletal balance,
body mechanics, strength, posturing and cardiovascular fitness.
Just as in professional tennis, there has been a
significant increase in injuries among professional golfers, primarily
because the game has changed so drastically and training has become so
intense. According to APTA, it is now the norm, not the exception, for
professional men and women golfers to work with physical therapists on
improving these factors. But, it is vital that these programs be
tailored to their individual skills.
Professional golfers make it look easy, but the golf
swing is actually one of the most difficult and complicated movements in
all of sports, requiring stability in some joints and flexibility in
others. Having proper motion, strength, and function throughout the
swing play a large role in preventing injuries. The payoff of a better
swing is a more accurate ball strike, greater distance, and reduced
stress on the muscles and joints.
Physical therapists are highly-educated, licensed health
care professionals who can help patients reduce pain and improve or
restore mobility — in many cases without expensive surgery or the
side effects of prescription medications. APTA represents more than
70,000 physical therapists, physical therapist assistants, and students
of physical therapy nationwide. Its purpose is to improve the health and
quality of life of individuals through the advancement of physical
therapist practice. In most states, patients can make an appointment
directly with a physical therapist, without a physician referral. Learn
more about conditions physical therapists can treat and find a physical
therapist in your area at www.moveforwardpt.com.