Will Tiger Woods's injuries end his career? An orthopedic surgeon gives his view

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The golfer is known for his supreme determination to overcome obstacles. But a return to professional sport will be tough after his car crash

Tiger Woods will need to heal his muscles as well as his bones
Tiger Woods will need to heal his muscles as well as his bones. Photograph: Phelan M Ebenhack/AP
Tiger Woods will need to heal his muscles as well as his bones. Photograph: Phelan M Ebenhack/AP
Jonathan D Gelber

Last modified on Sun 28 Feb 2021 10.55 EST

Once again the world held its collective breath when the scene of a car crash was broadcast on live television and the name Tiger Woods flashed across the screen. From what we know, Woods was involved in a motor vehicle accident early in the morning on Tuesday. His car rolled multiple times, but fortunately he was wearing his seat belt, which very likely saved his life. The golfing legend was transported to Harbor-UCLA, which is one of the busiest trauma centers in Los Angeles county and staffed with top-notch experienced surgeons.

Thankfully, his injuries aren’t life-threatening. We do have some clues in the released statements as to what injuries Woods has suffered. First, we heard about “compound” fractures, which are another term for an open fracture in which the broken bone pokes through the skin. Anytime the skin barrier is broken, bacteria and other contaminants can enter into the bone and possibly cause an infection. The first important step in treating open fractures is to get intravenous antibiotics coursing through the bloodstream to the bones and the rest of the body. Second, the bone ends are cleaned in the sterile operating room before being fixed straight again.

Woods is also said to have had a rod placed down a bone. This is one way to treat a fracture since bones are hollow. A stabilizing rod can be placed through smaller incisions, allowing the bone to heal in a better position. Sometimes, the patient can even put their full weight on the fracture if it is an isolated bone injury since the rod provides structural stability. Given the multiplicity of fractures, Woods may have also had plates with screws inserted, or something kept outside the skin called an external fixator, which appears like scaffolding outside the skin. This is most commonly used during a “damage-control” process with high-energy traumas.

The most recent statement concerning Woods mentioned releasing the covering of his muscles to relieve pressure. Of all the potential injuries mentioned, this is the most rare, and often the most serious. It points to a condition called compartment syndrome, which is a true orthopedic emergency. As bleeding or swelling occurs in the leg, the pressure can overpower the body’s ability to pump blood to the leg muscles. As a result, the muscle can lose blood flow and begin to die if the pressure is not released. This may require multiple large incisions around the leg. Once the swelling goes down, the skin can sometimes be closed again side-to-side, but other times the leg may require a skin graft.

Tiger Woods badly hurt in car crash but 'awake and responsive' – video
Tiger Woods badly hurt in car crash but 'awake and responsive' – video

We all tend to focus on the bones in these cases, but the bones may only take six to eight weeks to heal. The bigger issue for Woods may be the strength in his legs. High-level athletes use their whole body when competing. Whether it’s pitching, boxing or swinging a golf club, generating energy and momentum are keys to optimal outcomes. Woods has already had segments of his spine fused due to repeated surgeries to remove bulging disc material. Once parts of the spine fuse together, more and more rotation is lost. And with Woods’s powerful swing, every degree counts. Moving forward, he will need to heal his bones, but also his muscles. He will also need to strengthen those muscles and reestablish the orchestral performance that is a powerful golf swing. That can take a year or longer even with an arthroscopic knee surgery, let alone multiple fractures and compartment syndrome.

It is far too early to say whether he will play professional golf again, and there is no doubt his injuries are a severe impediment to his chances of ever returning to the tour, particularly because he is in his 40s, and has suffered other career-threatening injuries.

Woods’s tragedies are what makes him human, but his comebacks are what make him inspirational. He should make sure he is surrounded by a good support team, both physically and emotionally. He will need to turn to his family, which will likely be his No 1 priority. Woods’s story has been marked by several peaks and valleys. Let’s hope this is the deepest valley before the greatest peak.

Jonathan D Gelber, MD, MS is an orthopedic surgeon and sports medicine specialist. He is the author of Tiger Woods’s Back and Tommy John’s Elbow: Injuries and Tragedies That Transformed Careers, Sports, and Society. You can follow him on Twitter at @JonathanGelber

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