Tiger Woods withdrew from the Honda Classic this weekend due to severe back spasms. Woods was clearly in pain, dropping to his knees after a shot on the 13th hole. His decision to withdraw was appropriate and medically prudent.
Back spasms are painful and debilitating injuries that can take up to 6 weeks to resolve. Luckily, they NEVER require surgery. They do require considerable rest and non-operative treatment including non-anabolic steroids, stretching and physical therapy.
If a patient experiences any back spasms, they should stop what they are doing immediately. Trying to push through the injury will only worsen the symptoms and delay recovery.
The published research on back spasms in the golfer is marginal at best. There is some preliminary data that show decreased range of motion of the hips and muscle imbalances within the lumbar spine contribute to low back pain in the golfer. However, the jury is still out as to exactly why anyone gets back spasms.
Interestingly, disruption in the kinetic chain has been implicated in the development of low back pain in the athlete. The kinetic chain is the connection between the ground-foot-leg-hip-spine. Athletes with prior ACL injuries have a disruption of the kinetic chain. Even with repair of the ACL, the chain is never fully restored. Tiger Woods underwent ACL surgery in 2008 and this may be a component of his spasms.
However, there is no clear evidence that supports the theory that golf is detrimental to the lumbar spine, regardless of the patients’ anatomy. Many of my patients that have had spinal fusion surgery unrelated to a spasm have returned to an active golf lifestyle.
Regardless of the mechanism of injury in back spasms, their treatment cannot be rushed. In the acute setting, starting patients on high-dose steroids for 5 days, followed by stretching and physical therapy is helpful. The bottom line is athletes need time to recover.
Dr. Banco is a board-certified, fellowship-trained orthopaedic spinal surgeon. He attended medical school at Jefferson Medical College followed by an orthopaedic surgery residency at Thomas Jefferson University Hospital, both in Philadelphia. Dr. Banco performed his spinal fellowship at The New England Baptist Hospital in Boston, MA.