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Surgery could have long-term effects or make him good as new
By Patrick McManamon
Beacon Journal sports columnist
Published on Sunday, Jun 22, 2008
The venerable Times of London saw no need for prevarication: ''Tiger Fights to Save Career'' blared its headline the day after Tiger Woods said he would miss the rest of the golf season to have ACL surgery on his left knee.
Overnight, we went from saving a ligament to saving a career.
The danger in this business is always to overreact.
Then again, the necessity in this business is to wonder and to ask.
So it can happen with Woods, who has had ACL, ligament and stress-fracture issues with his left leg since last July.
Could these issues compound themselves and affect Woods?
Let's take them one by one — through the eyes of two local experts in sports medicine and athletic training, with the caveat that both cautioned that it's impossible to diagnose Woods' case with certainty because they had not seen all the MRIs and X-rays and SATs and GPS readings.
• Woods tore his ACL while jogging last July and continued to play golf through the season. He won several tournaments with a torn ACL, and he started this year winning with the same injury.
It's not that outrageous.
''Generally, you can do OK without them,'' said Aaron Lear, a doctor in Sports Medicine at Akron General.
''You can play with cruciate-deficient knees,'' said Joe Congeni, a surgeon and sports medicine expert and athletic trainer who works through Akron Children's Hospital. ''You won't have the internal stability, but if you get the muscles strong around the knee and wear a brace, you can play.''
A guy like Woods, who has redefined the word ''sculpted,'' finds a way to get things accomplished.
• Woods had surgery in April to repair cartilage damage in the left knee.
Safe to speculate that this problem probably was caused by the ACL damage. Lear and Congeni said a knee that has an ACL problem is more susceptible to cartilage damage.
''And you're more likely to have arthritis,'' Lear said.
''With him in his sport, there is significant torque that one could tear up cartilage, or tear up the lining of the knee, which can lead to arthritis,'' Congeni said. ''It's a significant risk, but athletes for certain situations decide to accept risk.''
The stress fracture happened during Woods' rehab from the cartilage surgery, and it probably was caused by the repeated stress on a knee weakened by ACL damage and cartilage surgery.
• Did he make the knee worse by playing in the U.S. Open and walking 20 miles in five days?
''That's hard to comment on,'' Lear said. ''He certainly didn't make the stress fracture better. But the people who push it are athletes of a certain mind-set. They push until they can't push anymore.''
Congeni said the risk was higher, that ''you couldn't design a worse post-op rehab than Tiger went through.''
''He goes out to one of the longest courses in the U.S. Open, with a lot of ups and downs to it,'' Congeni said. ''He's hitting out of deep rough, he plays an extra round and then he plays an extra hole in the round.''
• Does Woods' swing — which results in the club moving at 130 mph through the ball — put so much pressure on his knee that future problems are inevitable?
Congeni said he uses Woods and LeBron James as role models for athletes in how to build their bodies. Both strengthened their core, their trunk, prior to building their arms and legs.
But Woods' swing also puts him in uncharted territory. Nobody has hit a golf ball the way he does, so nobody knows if it will take a long-term toll.
Lear, though, pointed out that Woods hurt his knee jogging, not playing golf. And other injuries followed.
''It's impossible to say with any certainty if the torque [from his swing] led to this,'' he said.
• What about Wood's long-term health?
Here the two differed, but Congeni was looking more from the risk perspective, Lear from the treatment perspective.
Lear said Woods can come back and ''probably be as good as he always was.'' He pointed out that football player Kellen Winslow and Willis McGahee had severe knee injuries, and both came back (though both could have long-term problems in those knees).
''There's no reason to think he won't be playing Augusta in the spring,'' Lear said.
Congeni thought about 30 years from now, when the long-term effects could show. He mentioned words like arthritis and even threw out ''knee replacement'' as one of the worst-case scenarios.
''We always talk about risk-benefit ratios,'' he said. ''Tiger can outdrive anyone on tour. But his swing puts tremendous stress on his knee. He's had surgeries there, which is not necessarily a good picture for the future of Tiger.
''All those majors are a big focus for him. But what he gave up in that risk-benefit ratio is there may be some real health concerns down the road for him.
''The stress on that knee is No. 1 on top of that list.''
So . . . is Tiger fighting to save his career?
Probably not. There's little reason to think Woods can't come back. But . . . whether he comes back and can play as well as he has simply remains to be seen.
NBA DRAFT: Cavs not likely to add star at 19
The NBA Draft arrives this week and barring a trade the Cavaliers will pick 19th.
Here's a list of guys who have been drafted 19th the past few years (and the teams that took them):
Javaris Crittenden, L.A. Lakers.
Quincy Douby, Sacramento Kings.
Hakim Warrick, Memphis Grizzlies.
Dorell Wright, Miami Heat.
Sasha Pavlovic, Utah Jazz.
Ryan Humphrey, Utah Jazz.
Zach Randolph, Portland Trail Blazers.
Jamaal Magliore, Charlotte Hornets.
Quincy Lewis, Utah Jazz.
Crittenden was traded to the Grizzlies for Pau Gasol and played more as the year went on. Douby averaged 4.8 points and 11.8 minutes for the Kings this past year. Warrick averaged 11.4 points for the Grizzlies. Wright averaged 7.9 points for the Heat.
And we all know about Pavlovic.
Point is this: The 19th pick probably will not be a transforming selection. He could be a good player who contributes, but he's not going to be a star.
Not to say the Cavs can't find someone to help.
Randolph has turned into a very good scorer. Magliore was a decent big man.
The best 19th pick?
Choose from Dee Brown (Celtics), Rod Strickland (New York Knicks) or John Paxson (San Antonio Spurs).
Brown played 12 years and was a good player but never averaged more than 15.6 points in a season, and he finished his career with an 11.1 point average. Strickland was a good guard who was second team All-NBA once when he led the league in assists, but he bounced around to nine teams. Paxson won NBA titles with the Chicago Bulls and made a title-winning shot once. But he was a role player who was in double figures in scoring twice in 11 years.
The Web site http://www.basketball-reference.com figures a player's hall of fame chances.
Brown's is zero. Strickland's four-tenths of 1 percent and Paxson's one-tenth of 1 percent. (Randolph's is three-tenths of 1 percent.)
Total years played by these ''best of'' 19th picks: 32.
Number of All-Star appearances: 0.
This is not to say that the Cavs can't find a decent player. They sure can find one better than their last first-round pick: Shannon Brown.
But dramatic improvement?
Not going to happen.
If this team is to make dramatic improvement, it will come via trade. Not the draft.
Random thoughts
The Boston Globe's Bob Ryan is the finest basketball writer in the country.
He ranked all-time Celtics' teams and called this year's team the second-best.
Ever.
Better than any of the Bill Russell teams. Or Dave Cowens teams. And many of the Larry Bird teams.
Second. Best. Ever.
Chew on that one for a while.
• Ryan also evaluated the Celtics' playoff series and had this to say about the Cavs: ''One word will suffice: LeBron. Yeah, they did a nice job on him, but the road thing persisted. You saw Game 7. If Pierce doesn't pull a Larry, it would have been over right then and there.''
• The trade rumored on ESPN.com that has the Cavs sending a No. 1 pick and Anderson Varejao to the Golden State Warriors was shot down immediately in California. So it's not going to happen.
• Didn't seem to add up, either. The Cavs should get more than one player for Varejao and a No. 1 pick.
• They should at least get some tickets to Warriors games or something like that.
• Indians manager Eric Wedge will not give up on this season, but it's becoming pretty clear the Indians can't compete without two starting pitchers and their Nos. 3 and 4 hitters.
• Which means all the rumors about a trade of C.C. Sabathia will intensify.
Nothing seems imminent, but General Manager Mark Shapiro isn't exactly going to start broadcasting his plans.
• The Indians have scouted other teams' minor-league talent, so they will be ready to make a deal. ESPN reported that the Indians have told teams they will not provide a window of any kind for a team to renegotiate and extend Sabathia's contract.
The Indians merely want a straight-up trade.
• It's wise to make that deal. Still say if Sabathia really wanted to be with the Indians, he would have signed a long time ago.
He loves it here, but as usual, it's about the money . . .
Or so it seems. . . .
• Be gone the next week to take my girls — that's daughters — to Yellowstone. Home of Yogi Bear and Boo Boo.
• ''Heeey, Booboo . . . let's go find some pic-a-nic baskets.''
• Camping is not the forte, which is why we will stay in lodges and motels. Civilization has come too far to share space with bugs.
Besides, they crawl and bite.
• Imagine the Griswolds being chased through the woods by a ticked-off beaver. You get the idea.
• They say one can see bears, buffalo, elk — all kinds of animals — at Jelly . . . err . . . Yellowstone. If a jackelope hops by, it'll be really impressive. And if one of the bears walks on hind legs and wears a little derby, it's time to up the medication.
• Barring buffalo attack or being carried off by a mosquito, I'll be back July 2.
• Until then . . . there you have it.
Patrick McManamon can be reached at pmcmanamon@thebeaconjournal.com. Read his blog at http://www.ohiomm.com/blogs/mcmanamon/.
The venerable Times of London saw no need for prevarication: ''Tiger Fights to Save Career'' blared its headline the day after Tiger Woods said he would miss the rest of the golf season to have ACL surgery on his left knee.
Get the full article here.
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