The Straw That Broke Tiger’s Back

As you may have seen in the news recently, former World #1 golfer Tiger Woods spoke a little bit about his recent string of back surgeries, and how he’s coping after his latest that was undergone in late October of this year (see BBC article here).

According to the surgeon, his surgery was successful, whatever abnormality that was seen on imaging was corrected, and structural integrity was restored. Tiger tells a different story however, being unable to do little more than walking at the moment and hoping for the day he can kick around a football with his kids. This all occurred after he went in for a surgery that he didn’t expect to have.

Over the month leading up to his third surgery, he felt some pain in his hip, and on a routine scan, his consultant did not like something and took him in for immediate surgery – looking to correct this structural fault, which I’m assuming he thought was resulting in Tiger’s pain.

Pain however is a funny thing, especially persistent pain. Although pain in most cases is initially linked to some sort of tissue harm, it is dangerous to assume that pain is solely linked to tissue damage or more specifically what you see on imaging. Without getting too far into it (another day’s blog), pain is an output from the brain, and although initially it may be experienced as a response to nociceptive input (e.g. touching a hot stove), with time and depending on the severity and other psychosocial factors (e.g. causing him loss of world #1 ranking) pain can become a part of our brain. It can become engrained in certain movements, and associated with certain tasks, positions, and even contexts.

In relation to imaging, research has shown for a couple of decades now that imaging doesn’t always tell the whole story, and that abnormalities are pretty normal in all of us (examples comparing imaging of those in pain and those without here, here, and here). So jumping right in to correct the small “abnormality” in Tiger’s back may not have been the best way to approach the hip pain he was getting. Perhaps more conservative management may have been the answer, however we can just speculate and wish Tiger a speedy recovery and hope it’s not the last time we see him on the course in his Sunday reds.

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