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Golfing With Arthritis

Updated 5/24/21 by Cory Calendine, MD, Orthopaedic Surgeon

Phil Mickelson Becomes Oldest PGA Championship Winner

This past weekend, Phil Mickelson become the oldest professional golfer to win a PGA championship in the 161 history to championship PGA play. Phil has been open about his diagnosis of Psoriatic Arthritis in 2010 and has credited his struggle with arthritis pain as a motivation to stay active and live a healthier lifestyle, especially after the age of 50.

One in twenty adult Americans who have psoriasis (usuallybetween the ages of 30-50) also develop Psoriatic Arthritis. SometimesPsoriatic Arthritis occurs in the absence of noticeable signs skin findings andcan be difficult to diagnose.

Psoriatic arthritis is an autoimmune disease, meaning itoccurs when the body’s immune system mistakenly attacks healthy tissue, in thiscase the joints and skin. The faulty immune response causes inflammation thattriggers joint pain, stiffness and swelling. The inflammation can affect theentire body and may lead to permanent joint and tissue damage if it is nottreated early and aggressively.

Professional Golfers Winning with Arthritis

With more than 100 types of arthritis affecting more than 50 million adult Americans, it is no surprise that a number of celebrity athletes have been vocal about their diagnosis of arthritis. Symptoms typically include joint pain, stiffness, redness, swelling and decreased range of motion in the affected joints. We’re taking a quick look at 6 championship golfers that are raising awareness and giving hope by opening-up about their daily struggles with arthritis.

RELATED VIDEO:  What Is Arthritis? (video) by Cory Calendine, MD

6 Pro Golfers Living Successfully with Arthritis

Tiger Woods, 44

Osteoarthritis of Knee and Spine

You have likely heard about Tiger Woods' recent automobile accident and lower extremity injuries this past February. Tiger Woods is arguably the best known name in golf today. Prior to his most recent injuries, , a torn ACL in his left knee he suffered while running near his Florida home in 2007 began his development of arthritis symptoms. Osteoarthritis (the most common type of arthritis) is common following knee tendon or meniscus injuries.

Tiger’s knee problems would eventually be overtaken by back issues and nearly end his career. He had three failed back surgeries, starting in 2014 and missed almost all of the 2016 and 2017 PGA Tour. Tiger had one more back operation, a spinal fusion in 2017.  Spinal fusion is a complex operation but is among the top five operations in the US, with the vast majority being done for deteriorated disks. Only knee and hip replacement account for more inpatient hospital stays. According to a New York Times interview, all Woods was looking for when he decided to have back fusion was a “normal life”. He of course went on to achieve much more, including a new green blazer at the 2019 Masters. Tiger and his surgeons emphasized the importance of rehabilitation and physical therapy following surgery to produce the best outcomes.

Tiger Woods on golf course green prior to a putt
Tiger Woods wins 2019 Masters and gets 15th Major Championship

The Augusta National golf course is bustling with players in pursuit of a coveted Masters green jacket in the obvious absence of Tiger Woods. Woods is currently recovering at his Florida home from injuries to his right lower leg and ankle suffered in a motor vehicle accident on February 23rd. Although the next chapter in Tiger's professional golf life is yet to be written, he will certainly be continuing his daily battle to succeed despite joint arthritis symptoms.

Phil Mickelson, 49

Psoriatic Arthritis

Tiger squared off last year against Championship pro golfer Phil Mickelson in a Champions for Charity event. Phil recounts first noticing joint pain while preparing for the 2010 U.S. Open at Pebble Beach. He described the onset of joint pain in his wrist, finger and right ankle. Mickelson soon learned he had psoriatic arthritis (PsA).

Psoriasis is a fairly common, chronic skin disease that causes patches of new skin to grow too quickly and thicken - mainly over the joints. 1 in 20 psoriasis sufferers will develop Psoriatic Arthritis (usually between 30 and 50 years old). Psoriatic arthritis like Phil Mickelson’s is treated with a variety of medications including non-steroidal anti-inflammatory drugs (NSAIDs) and disease modifying anti-rheumatic drugs (DMARDs).

Tiger Woods and Phil Mickelson walk together on golf Course at 2020 Champions for Charity
Tiger and Phil Mickelson at The Match: Champions for Charity is set to raise $10 million (2020)

Mickelson has been back on his professional golf game for several years thanks to the early diagnosis and treatment of his psoriatic arthritis. Psoriatic Arthritis is a lifelong disease with no cure. But with the help of powerful arthritis medications, a healthy diet, and plenty of exercise, Phil Mickelson continues to play golf — and is still winning.

RELATED: Nashville's toughest golf courses

Ranked by Carol Smith, Research Director, Nashville Business Journal, April, 2020

  1. The Grove
  2. The Golf Club of Tennessee
  3. The Governors Club
  4. Richland Country Club
  5. Twelve Stones Golf Club

Source: Top of The List: Greater Nashville's toughest golf courses, Nashville Business Journal

Kristy McPherson, 38

Juvenile Rheumatoid Arthritis

LPGA golfer Kristy McPherson picked up a golf club for the first time at age 7.  Just 4 years later,  she was diagnosed with Still’s disease, a rare form of juvenile rheumatoid arthritis, now called systemic-onset juvenile rheumatoid arthritis. She remembers initially being told that she would never play sports again. Thankfully, a rheumatologist at the Medical University of South Carolina who helped make her diagnosis and treat her condition told her that even with Rheumatoid Arthritis, she could still do whatever she wanted. That was all she needed to hear, and McPherson hasn’t looked back since.

Now 38, McPherson has good days and bad days, and explains that the best thing she can do for her health is to stay active. As a member of the Board of Directors for the Arthritis National Research Foundation, Kristy is an inspiration to the 300,000 kids in America with juvenile arthritis.

Nancy Lopez, 63

Osteoarthritis of Knee

Nancy Lopez is a legend of the LPGA tour, a 48-time LPGA winning golfer and the youngest person ever inducted into the LPGA Hall of Fame.  Following a knee meniscus injury as a young adult, Nancy dealt with increasing osteoarthritis pain in her knees throughout her career.  By the age of 40, Nancy described the pain

“as if there were little pebbles in between the bones of my left knee. When I walked, I could feel the knee grinding.”

Initially, Nancy employed daily exercise, anti-inflammatory medications and joint injections to maintain her active lifestyle.  After 20 years of conservative treatment and increasing  joint pain, Nancy decided to have knee replacement surgery.

NANCY LOPEZ gives lesson on golf course
Nancy Lopez turned professional, joining the LPGA Tour in midseason 1977

When non-operative methods have failed to make arthritis pain bearable, surgery is often the best option. According to a study by the American Academy of Orthopaedic Surgeons, total knee replacement dramatically improves a patient's quality of life, provide better joint function and significantly reduces long-term treatment costs.  At 63 years young, Nancy remains active in  senior golfing tournaments and hosts 30+ charity golfing events each year.

John Daly, 54

Osteoarthritis of Knee

As a popular and polarizing figure in golf, John Daly made headlines again this past May after applying to use a cart through the Americans with Disabilities Act at the PGA Championship. Daly explained that osteoarthritis in his right knee had become so severe that it prevented him from walking downhill. The frustration of dealing with knee arthritis pain can be heard his explanation in a USA Today article prior to the Championship.

“Osteoarthritis is a tough thing, brother. If my knee was broke, I would have had it fixed. But my situation is totally different. It's painful as h*** is all I can say. As was Tiger's, I'm sure.''
John Daly, Knee arthritis patient, continues to play golf after knee replacement surgery
John Daly underwent knee replacement surgery November, 2019

John was also diagnosed with diabetes in November and was dealing with chronic liver issues. He explained that he had been told by his doctors that he was not a candidate for knee replacement surgery at that time. People often wonder when they should consider having knee replacement. Joint replacement is a major surgery, and the decision should be individualized depending upon a person's activity level, pain, functional needs, and general health. John underwent knee replacement surgery degenerative arthritis in Little Rock, AR last November and plans to resume a busy golfing schedule.

John Daly sends tweet after knee replacement surgery in November, 2019
John Daly underwent Knee Replacement surgery in November, 2019

Jack Nicklaus, 80

Osteoarthritis of Hip

Known as “The Golden Bear,” Jack Nicklaus is admired by millions of people as a great golf champion, but few realize that he played with hip pain through most of his career. Nicklaus’ left hip problem began with an injury in 1963. By 1988, Nicklaus had employed Pete Egoscue, a well-known physiologist, to design an exercise program to help him manage his hip pain. He adhered to the program religiously, and played through the progressing joint pain. Jack recalls classical symptoms of degenerative hip arthritis,

“I can remember in 1993 at the PGA Championship my hip was bad enough that I told my wife, ‘I’m tired of playing on one leg.’ I had a lot of numbness, but mainly my hip was just non-supportive.”
Jack Nicklaus and Tiger Woods, both arthritis sufferers, meet on golf course

Nicklaus won the U.S. Senior Open for the second time that year, capturing his sixth senior event since becoming eligible in 1990.  By 1998, when he was 58, he had achieved fame and fortune and was undoubtedly the biggest star among the great players of his generation, but Nicklaus also knew he probably had the biggest physical limitations. That year he withdrew from the British Open, and, exhausted from the pain, he made the decision to have hip replacement surgery.

“I underwent surgery in January of 1999, not only because of golf but because of my quality of life. I have always been an active person, and with five children and now a 20th grandchild on the way, I wanted to be healthy and able to do things with them. I wanted to be able to walk through a mall with my wife Barbara, or walk up and down a trout stream with my sons, or just play catch in the backyard with my grandchildren. Being able to play golf again was a bonus, but having my quality of life improve as it did was the driving influence in my decision.”

With what he described as an aggressive rehabilitation program, he found his way back to the golf course within three months. Jamie Diaz, in a 1999 Sports Illustrated article, described the Golden Bear's return to pro competition,

"Last Friday, as Jack Nicklaus made the steep climb up the 18th fairway at Hartefeld National Golf Club during the opening round of the Bell Atlantic Classic, it was as if the ceramic ball and socket implanted in his left hip had not only rejuvenated his 59-year-old body, but also galvanized the hundreds of fans who had come out to see him play again. Even though Nicklaus was two over par and well behind the leaders, a chant rose from the crowd: Jack is back.... Jack is back.... Jack is back."

In 2005, Jack played his final Masters Tournament, and led the U.S. to a victory in the President’s Cup. Nicklaus was awarded the Presidential Medal of Freedom, and Golf World Magazine named Nicklaus Newsmaker of 2005. He’s never stopped working out. His daily routine, which includes strengthening and stretching, takes up to an hour and a half. He considers exercise a fundamental necessity to living an active, full life, and says to anyone facing hip replacement surgery,

“Do as much functional exercise as you can to get yourself as strong as you can get, no matter what you do. I think that’s common sense. When  you have to have surgery, you have it.”
RELATED PATIENT EDUCATION:

Don't Let Arthritis Stop Your Golf Game

Is joint pain keeping you from hitting the course? Take encouragement from other arthritis patients that continue to win over joint pain - even Pro Golfers. If joint pain and stiffness is limiting your activity, CONTACT OUR OFFICE TODAY, and let us customize a joint arthritis treatment program for you.

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Cory Calendine, MD is an Orthopaedic Surgeon and founding partner of the Bone and Joint Institute of Tennessee at Williamson County Hospital in Franklin, TN. Dr. Calendine is an expert in Joint Replacement, specializing in Hip and Knee Surgery. From diagnosis through treatment, the Orthopaedic Surgical experts at the Bone and Joint Institute use the latest techniques and technology to improve care for people with musculoskeletal problems. For more information, please contact our office or schedule your appointment today.  
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